Volume 5 Supplement 2

Abstracts from the 2nd International Severe Asthma Forum (ISAF)

Open Access

Th2-high asthma: a heterogeneous asthma population?

  • Seys Sven1,
  • Hans Scheers2,
  • Gudrun Marijsse1,
  • Ellen Dilissen1,
  • Annelies Van Den Bergh3,
  • Pieter Goeminne3,
  • Paul Van den Brande3,
  • Jan Ceuppens1,
  • Lieven Dupont3 and
  • Dominique Bullens4
Clinical and Translational Allergy20155(Suppl 2):O1

https://doi.org/10.1186/2045-7022-5-S2-O1

Published: 23 March 2015

Background

Airway inflammation in asthma can be subdivided in Th2-high and Th2-low.

Objective

To identify unique patient clusters with a specific airway cytokine expression profile in an unselected population with asthma.

Methods

Induced sputum and clinical records were analysed from 208 asthmatics and 80 healthy individuals. Cytokine-high patients had cytokine mRNA levels above the 90th percentile value in controls. Unsupervised hierarchical clustering was used to determine unique cytokine-based patient clusters.

Results

Cubic Clustering Criterion, pseudo F and t2 statistics revealed a two- and a six-cluster model. The first cluster (n=23) was found in both models and consists of patients who present with an “IL-5-high and IL-17F-high” profile. Patients with an “IL-4- or IL-13-high” profile did not cluster in one single group. In the six-cluster model, the “IL-17F-low” group was divided into 5 separate clusters: “IL-5-high” profile (n=7), “IFN-γ-high” profile (n=15), “IL-6- and/or TNF-high” profile (n=15), “IL-22-high” profile (n=15) and those patients that were low for all preceding cytokines (n=130; cluster 6). “IL-17F- and IL-5-high” patients had significantly lower FEV1 and higher sputum neutrophils. Patients that were only “IL-4- or IL-13-high” (cluster 6) had highest FENO levels and sputum eosinophils.

Conclusion

Th2-high asthma can be subdivided in patients with “IL-5-high and IL-17F-high” asthma and those with “IL-4- or IL-13-high” asthma. The inflammatory pattern is different between both groups. The former group is characterized by mixed granulocytic airway inflammation whereas the latter group consists of patients with eosinophilic airway inflammation.

Authors’ Affiliations

(1)
University of Leuven, Clinical Immunology
(2)
University of Leuven, Pneumology
(3)
University Hospitals Leuven, Pneumology
(4)
University of Leuven, Pediatric Immunology

Copyright

© Sven et al; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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