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Identification of cough variant asthma phenotypes based on clinical and pathophysiological data

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作者：
Zhan Wenzhi[1] * ; Wu Feng[2] ; Zhang Yunhui[3] ; Lin Lin[4] ; Li Wen[5] ; Luo Wei[1] ; Yi Fang[1] ; Dai Yuanrong[6] ; Li Suyun[7] ; Lin Jiangtao[8] ; Yuan Yadong[9] ; Qiu Chen[10] ; Jiang Yong[11] ; Zhao Limin[12] ; Chen Meihua[13] ; Qiu Zhongmin[14] ; Chen Ruchong[1] ; Xie Jiaxing[1] ; Guo Chunxing[1] ; Jiang Mei[1] ; Yang Xiaohong[15] ; Shi Guochao[16] ; Sun Dejun[17] ; Chen Rongchang[1,10] ; Zhong Nanshan[1] ; Shen Huahao[5] ; Lai Kefang[1,*1] ;
机构： [1]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, [2]Department of Pulmonary and Critical Care Medicine, Huizhou the Third People's Hospital,Guangzhou Medical College, Huizhou, China, [3]Department of Pulmonary and Critical Care Medicine, The First People's Hospital of Yunnan Province, Kunming, China, [4]Department of Pulmonary and Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China, [5]Department of Pulmonary and Critical Care Medicine, Key Laboratory of Respiratory Disease of Zhejiang Province, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China, [6]Department of Respiratory and Critical Care Medicine, The Second A filiated Hospital of Wenzhou Medical University, Wenzhou, China, [7]Department of Respiratory and Critical Care Medicine, The First Afiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China, [8]Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China, [9]Department of Pulmonary and Critical Care Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, China [10]Department of Respiratory and Critical Care Medicine, Shenzhen Institute of Respiratory Diseases, Shenzhen People's Hospital, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen, China, [11]Department of Respiratory and Critical Care Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, Shenzhen, China, [12]Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China, [13]Department of Pulmonary and Critical Care Medicine, Songshan Lake Central Hospital of Dongguan City, The Third People's Hospital of Dongguan City, Dongguan, China, [14]Department of Pulmonary and Critical Care Medicine, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China, [15]Department of Respiratory and Critical Care Medicine, Xinjiang Interstitial Lung Disease Clinical Medicine Research Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China, [16]Department of Pulmonary and Critical Care Medicine, Rujin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China, [17]Department of Pulmonary and Critical Care Medicine, The Inner Mongolia Autonomous Region People's Hospital, Hohhot, China
出处：
DOI： 10.1016/j.jaci.2023.04.017
ISSN：

摘要：
Cough variant asthma (CVA) may respond differently to anti-asthmatic treatment. There is limited data on the heterogeneity of CVA.We aimed to classify patients with CVA using cluster analysis based on clinico-physiological parameters and to unveil the underlying molecular pathways of these phenotypes with transcriptomic data of sputum cells.K-mean clustering was applied to 342 newly physician-diagnosed patients with CVA from a prospective, multicenter, observational cohort using 10 pre-specified baseline clinic-pathophysiological variables. The clusters were compared based on clinical features, treatment response and sputum transcriptomic data.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 anti-asthmatic treatment. Cluster 2 (n=105) presented with young, nocturnal cough, atopy, type 2-high inflammation, and a high proportion of complete resolution of cough (73.3%) with highly upregulated co-expression gene network that related to type 2 immunity. Cluster 3 (n= 61) had a high body mass index, long duration, family history of asthma, low lung function, and low proportion of complete resolution of cough (54.1%). Th17 immunity and type 2 immunity co-expression gene networks were both upregulated in clusters 1 and 3.Three clusters of CVA were identified with different clinical, pathophysiological, and transcriptomic features and responses to anti-asthmatics treatment, which may improve our understanding of pathogenesis and develop individualized treatment of cough in asthma.Copyright © 2023. Published by Elsevier Inc.

基金：
This study was supported by AstraZeneca; Key-Area Research and Development Program of Guangdong Province (201 9B020227006); Incubative Project for Innovation Team of GMU (2017- 159); and Clinical Research Foundation of GMU (2017-160). The funder had no role in study design, data collction and analysis, decision to publish, or preparation of the manuscript.
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出版当年[2023]版：
大类 | 1 区 医学
小类 | 1 区 过敏 1 区 免疫学
最新[2023]版：
大类 | 1 区 医学
小类 | 1 区 过敏 1 区 免疫学
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出版当年[2022]版：
Q1 ALLERGY Q1 IMMUNOLOGY
最新[2023]版：
Q1 ALLERGY Q1 IMMUNOLOGY

影响因子： 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者：
第一作者机构： [1]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China,
通讯作者：
通讯机构： [1]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, [*1]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd., Guangzhou, 510120. P. R. China
推荐引用方式(GB/T 7714)：
Zhan Wenzhi,Wu Feng,Zhang Yunhui,et al.Identification of cough variant asthma phenotypes based on clinical and pathophysiological data[J].JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY.2023,152(3):622-632.doi:10.1016/j.jaci.2023.04.017.
APA：
Zhan Wenzhi,Wu Feng,Zhang Yunhui,Lin Lin,Li Wen...&Lai Kefang.(2023).Identification of cough variant asthma phenotypes based on clinical and pathophysiological data.JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY,152,(3)
MLA：
Zhan Wenzhi,et al."Identification of cough variant asthma phenotypes based on clinical and pathophysiological data".JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY 152..3(2023):622-632

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