Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data

Zhan, Wenzhi1; Wu, Feng2; Zhang, Yunhui3; Lin, Lin4; Li, Wen5; Luo, Wei1; Yi, Fang1; Dai, Yuanrong6; Li, Suyun7; Lin, Jiangtao8; Yuan, Yadong9; Qiu, Chen10; Jiang, Yong11; Zhao, Limin12; Chen, Meihua13; Qiu, Zhongmin14; Chen, Ruchong1; Xie, Jiaxing1; Guo, Chunxing1; Jiang, Mei1; Yang, Xiaohong15; Shi, Guochao16; Sun, Dejun17; Chen, Rongchang1,10; Zhong, Nanshan1; Shen, Huahao; Lai, Kefang1

2023-09-01

10.1016/j.jaci.2023.04.017

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY   Impact Factor & Quartile

0091-6749

1097-6825

Background: Cough-variant asthma (CVA) may respond differently to antiasthmatic treatment. There are limited data on the heterogeneity of CVA. Objective: We aimed to classify patients with CVA using cluster analysis based on clinicophysiologic parameters and to unveil the underlying molecular pathways of these phenotypes with transcriptomic data of sputum cells.Methods: We applied k-mean clustering to 342 newly physician diagnosed patients with CVA from a prospective multicenter observational cohort using 10 prespecified baseline clinical and pathophysiologic variables. The clusters were compared according to clinical features, treatment response, and sputum transcriptomic data.Results: Three stable CVA clusters were identified. Cluster 1 (n = 176) was characterized by female predominance, late onset, normal lung function, and a low proportion of complete resolution of cough (60.8%) after antiasthmatic treatment. Patients in cluster 2 (n = 105) presented with young, nocturnal cough, atopy, high type 2 inflammation, and a high proportion of complete resolution of cough (73.3%) with a highly upregulated coexpression gene network that related to type 2 immunity. Patients in cluster 3 (n = 61) had high body mass index, long disease duration, family history of asthma, low lung function, and low proportion of complete resolution of cough (54.1%). TH17 immunity and type 2 immunity coexpression gene networks were both upregulated in clusters 1 and 3.Conclusion: Three clusters of CVA were identified with different clinical, pathophysiologic, and transcriptomic features and responses to antiasthmatics treatment, which may improve our understanding of pathogenesis and help clinicians develop individualized cough treatment in asthma.

Cough-variant asthma cough cluster transcriptome treatment response airway inflammation

SCI

English

Others

Allergy ; Immunology

Allergy ; Immunology

WOS:001076468300001

MOSBY-ELSEVIER

IMMUNOLOGY

Web of Science

1.Guangzhou Med Univ, Guangzhou Inst Resp Hlth, Natl Clin Res Ctr Resp Dis, Natl Ctr Resp Med,State Key Lab Resp Dis,Affiliate, 151 Yanjiang Rd, Guangzhou 510120, Peoples R China
2.Guangzhou Med Univ, Huizhou Peoples Hosp 3, Dept Pulm & Crit Care Med, Huizhou, Peoples R China
3.First Peoples Hosp Yunnan Prov, Dept Pulm & Crit Care Med, Kunming, Peoples R China
4.Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Guangdong Prov Acad Chinese Med Sci, Dept Pulm & Crit Care Med,Clin Sch 2, Guangzhou, Peoples R China
5.Zhejiang Univ, Dept Pulm & Crit Care Med, Key Lab Resp Dis Zhejiang Prov, Sch Med,Affiliated Hosp 2, Hangzhou, Peoples R China
6.Wenzhou Med Univ, Dept Resp & Crit Care Med, Affiliated Hosp 2, Wenzhou, Peoples R China
7.Henan Univ Chinese Med, Affiliated Hosp 1, Dept Resp & Crit Care Med, Zhengzhou, Peoples R China
8.China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Beijing, Peoples R China
9.Hebei Med Univ, Hosp 2, Dept Pulm & Crit Care Med, Shijiazhuang, Peoples R China
10.Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Shenzhen Inst Resp Dis,Affiliated Hosp 1,Clin Med, Shenzhen, Peoples R China
11.Shenzhen Hosp Integrated Tradit Chinese & Western, Dept Resp & Crit Care Med, Shenzhen, Peoples R China
12.Zhengzhou Univ, Henan Prov Peoples Hosp, Dept Resp & Crit Care Med, Peoples Hosp, Zhengzhou, Peoples R China
13.Songshan Lake Cent Hosp Dongguan City, Peoples Hosp Dongguan City 3, Dept Pulm & Crit Care Med, Dongguan, Peoples R China
14.Tongji Univ, Tongji Hosp, Sch Med, Dept Pulm & Crit Care Med, Shanghai, Peoples R China
15.Peoples Hosp Xinjiang Uygur Autonomous Reg, Xinjiang Interstitial Lung Dis Clin Med Res Ctr, Dept Resp & Crit Care Med, Urumqi, Peoples R China
16.Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Dept Pulm & Crit Care Med, Shanghai, Peoples R China
17.Inner Mongolia Autonomous Reg Peoples Hosp, Dept Pulm & Crit Care Med, Hohhot, Peoples R China

Zhan, Wenzhi,Wu, Feng,Zhang, Yunhui,et al. Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data[J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY,2023,152(3).

Zhan, Wenzhi.,Wu, Feng.,Zhang, Yunhui.,Lin, Lin.,Li, Wen.,...&Lai, Kefang.(2023).Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data.JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY,152(3).

Zhan, Wenzhi,et al."Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data".JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 152.3(2023).