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Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data
Wenzhi Zhan1, Feng Wu2, Yunhui Zhang3
1Guangzhou Institute of Respiratory Health, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
The Journal of Allergy and Clinical Immunology
|May 13, 2023
Summary
Cough-variant asthma (CVA) patients can be classified into three distinct clusters based on clinical and molecular features. These phenotypes show varied responses to asthma treatments, paving the way for personalized cough management strategies.
Area of Science:
- Pulmonary Medicine
- Immunology
- Genomics
Background:
- Cough-variant asthma (CVA) exhibits significant heterogeneity in treatment response.
- Limited data exists on the diverse clinical and molecular characteristics of CVA phenotypes.
Purpose of the Study:
- To classify CVA patients into distinct phenotypes using cluster analysis.
- To investigate the molecular pathways associated with these CVA phenotypes using sputum transcriptomics.
Main Methods:
- K-mean clustering was applied to 342 CVA patients.
- Analysis utilized 10 baseline clinical and pathophysiologic variables.
- Clusters were compared based on clinical features, treatment response, and sputum transcriptomic data.
Main Results:
- Three distinct CVA clusters were identified.
- Cluster 1: Female, late-onset, normal lung function, 60.8% cough resolution.
- Cluster 2: Young, atopic, high type 2 inflammation, 73.3% cough resolution, upregulated type 2 immunity network.
- Cluster 3: High BMI, long duration, low lung function, 54.1% cough resolution, upregulated TH17 and type 2 immunity networks.
Conclusions:
- Identified three CVA clusters with unique clinical, pathophysiologic, and transcriptomic profiles.
- These findings highlight differential responses to antiasthmatic treatments across CVA phenotypes.
- Understanding these clusters can guide individualized treatment approaches for cough in asthma.
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