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Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation
Edgar Delgado-Eckert1, Anna James2, Delphine Meier-Girard1
1University of Basel, University Children's Hospital, Basel, Switzerland.
The Journal of Allergy and Clinical Immunology
|February 6, 2021
Summary
New fluctuation-based clustering (FBC) identifies distinct obstructive airway disease phenotypes. This method reveals patient subgroups with varying lung function, clinical severity, and exacerbation risk, independent of eosinophilic inflammation.
Area of Science:
- Pulmonary Medicine
- Respiratory Research
- Biomarker Discovery
Background:
- Chronic airway diseases involve inflammation, hyperresponsiveness, and remodeling, impacting lung function dynamics.
- These factors contribute to diverse clinical presentations, quality of life, and treatment responses.
Purpose of the Study:
- To determine if lung function fluctuation patterns can identify specific phenotypes in obstructive airway diseases.
- To link these phenotypes to distinct clinical characteristics and biomarkers.
Main Methods:
- Applied fluctuation-based clustering (FBC) to twice-daily FEV1 measurements over one year.
- Utilized data from 134 adults with asthma or COPD in the European BIOAIR cohort.
Main Results:
- FBC identified 4 stable clusters independent of clinical diagnosis, showing increasing lung function decline and clinical severity.
- Clusters correlated with elevated biomarkers for remodeling and senescence, alongside reduced airway reversibility and diffusion capacity.
- No differences in type 2 inflammation markers (eosinophils, periostin) were observed across clusters.
Conclusions:
- FBC-based phenotyping offers complementary information to clinical diagnosis for obstructive airway diseases.
- This approach is independent of eosinophilic inflammation and can identify patients needing tailored treatments or closer monitoring.
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