C-BIOPRED severe asthma clinical phenotypes: link to complement and coagulation pathways and galectin 10

Area of Science:

• Pulmonary Medicine
• Translational Research
• Proteomics

Background:

• Severe asthma is a complex airway inflammatory disease with diverse clinical presentations and treatment responses.
• Understanding severe asthma heterogeneity is crucial for developing targeted therapies.

Purpose of the Study:

• To identify distinct clinical phenotypes within the Chinese C-BIOPRED severe asthma cohort.
• To investigate the association between these clinical phenotypes and the sputum proteome.

Main Methods:

• Partition-around-medoids clustering was used on clinicophysiological variables from 362 severe asthma patients and 181 mild-moderate asthma patients.
• Sputum supernatants were analyzed using liquid chromatography-tandem mass spectrometry to identify protein expression differences.

Main Results:

• Three stable clinical clusters were defined: T1 (female, nonsmoking, frequent exacerbations), T2 (nonsmoking, mild-moderate obstruction, no exacerbations), and T3 (elderly, male, smoking/ex-smoking, severe obstruction).
• Significant differences in sputum complement and coagulation cascade pathways were observed between clusters.
• Galectin 10 was upregulated in Cluster 1, correlating with exacerbations and eosinophilic markers.

Conclusions:

• Clinical clusters of severe asthma are distinguishable by smoking status, airflow obstruction, and exacerbation history.
• Sputum proteomic analysis revealed distinct complement and coagulation pathway profiles and galectin 10 levels across these clusters.