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Paucigranulocytic asthma: Do sputum macrophages matter?
Muge Olgac1, Semra Dolek Guler2, Semra Demir1
1From the Division of Immunology and Allergic Diseases, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Allergy and Asthma Proceedings
|December 6, 2021
Summary
Paucigranulocytic asthma (PGA) is characterized by predominant macrophages in sputum and lower airway reversibility. This common asthma phenotype shows a low rate of uncontrolled asthma, distinguishing it from other types.
Area of Science:
- Pulmonology
- Allergy and Immunology
- Respiratory Medicine
Background:
- Paucigranulocytic asthma (PGA) is the most prevalent phenotype of stable asthma.
- The distinct characteristics of PGA have not been thoroughly investigated.
- Understanding PGA is crucial for effective asthma management.
Purpose of the Study:
- To elucidate the defining features of paucigranulocytic asthma.
- To compare PGA with other asthma phenotypes based on sputum cell counts.
Main Methods:
- Inclusion of 116 non-smoking adult asthma patients from three tertiary centers.
- Collection of demographic, clinical, allergy, biochemical, and spirometry data.
- Measurement of exhaled nitric oxide (FeNO) and induced sputum cytometry.
Main Results:
- PGA was the most common phenotype (62.9%), characterized by predominant sputum macrophages.
- PGA patients exhibited higher FEV1/FVC ratios and lower FEV1 reversibility compared to other phenotypes.
- Low FEV1 reversibility in PGA was observed irrespective of inhaled corticosteroid (ICS) use.
Conclusions:
- Macrophages are the predominant cells in the sputum of patients with PGA.
- Lower FEV1 reversibility is a key characteristic of the PGA phenotype.
- PGA is associated with a relatively low ratio of uncontrolled asthma.
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