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Diagnosing eosinophilic asthma using a multivariate prediction model based on blood granulocyte responsiveness
B Hilvering1,2, S J H Vijverberg1,3, J Jansen4
1Department of Respiratory Medicine, Laboratory of Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Allergy
|December 29, 2016
Summary
This study developed a noninvasive blood test to identify eosinophilic asthma, avoiding invasive sputum analysis. The model accurately predicts asthma phenotypes, aiding in diagnosis and monitoring.
Area of Science:
- Pulmonology
- Immunology
- Biomarker Discovery
Background:
- Sputum analysis is valuable for asthma phenotyping but has technical limitations.
- Noninvasive diagnostic methods are needed for faster asthma assessment.
- This study investigated blood granulocyte activation for asthma phenotyping.
Purpose of the Study:
- Construct a multivariable model using blood granulocyte activation.
- Compare the model's diagnostic value against sputum eosinophilia.
- Validate the model in an independent patient cohort.
Main Methods:
- Assessed clinical parameters, blood granulocyte activation, and sputum characteristics.
- Included 115 adult asthma patients in a training cohort (Utrecht).
- Validated the model in an independent cohort of 34 asthma patients (Oxford).
Main Results:
- A model combining blood eosinophil count, exhaled nitric oxide, and other factors identified sputum eosinophilia with high sensitivity and specificity in the training cohort.
- The model showed moderate performance in the validation cohort, particularly in patients on oral corticosteroids.
- Key predictors included blood eosinophil count, fractional exhaled nitric oxide, and neutrophil/eosinophil responsiveness.
Conclusions:
- The developed model noninvasively identifies eosinophilic asthma without sputum induction.
- This offers a validated, noninvasive test for assessing eosinophilic asthma, especially in patients not using oral corticosteroids.
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