单位：[a]Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, PR China四川大学华西医院[b]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, PR China四川大学华西医院[c]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Diseaserelated Molecular Network, Sichuan University, Chengdu, PR China[d]Shanghai Institute of Respiratory Disease, Respiratory Division of Zhongshan Hospital, Fudan University, Shanghai, PR China[e]School of Life Sciences, University of Technology Sydney, Ultimo, NSW, Australia[f]Respiratory Cellular and Molecule Biology, Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia[g]Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia[h]Department of Respiratory and Critical Care Medicine, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, PR China华中科技大学同济医学院附属同济医院内科学系呼吸与危重症医学科[i]Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, PR China[j]Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Jilin University, Changchun, PR China
Background: Reducing asthma exacerbations is a major target of current clinical guidelines, but identifying features of exacerbation-prone asthma (EPA) using multidimensional assessment (MDA) is lacking. Objective: To systemically explore the clinical and inflammatory features of adults with EPA in a Chinese population. Methods: We designed a cross-sectional study using the Severe Asthma Web-based Database from the Australasian Severe Asthma Network (ASAN). Eligible Chinese adults with asthma (n = 546) were assessed using MDA. We stratified patients based on exacerbation frequency: none, few (1 or 2), and exacerbation prone (>= 3). Univariate and multivariable negative binomial regression analyses were performed to investigate features associated with the frequency of exacerbations. Results: Of 546 participants, 61.9% had no exacerbations (n = 338), 29.6% had few exacerbations (n = 162), and 8.4% were exacerbation prone (n = 46) within the preceding year. EPA patients were characterized by elevated blood and sputum eosinophils but less atopy, with more controller therapies but worse asthma control and quality of life (all p < 0.05). In multivariable models, blood and sputum eosinophils (adjusted rate ratio = 2.23, 95% confidence interval = [1.26, 3.84] and 1.67 [1.27, 2.21], respectively), FEV1 (0.90 [0.84, 0.96]), bronchodilator responsiveness (1.16 [1.05, 1.27]), COPD (2.22 [1.41, 3.51]), bronchiectasis (2.87 [1.69, 4.89]), anxiety (2.56 [1.10, 5.95]), and depression (1.94 [1.20, 3.13]) were found. Further, upper respiratory tract infection (1.83 [1.32, 2.54]) and food allergy (1.67 [1.23, 2.25]) were at high risk of asthma symptom triggers. Conclusion: EPA is a clinically recognizable phenotype associated with several recognizable traits that could be addressed by targeted treatment.
基金：
This study was supported by the National Key Development
Plan for Precision Medicine Research (2017YFC091004), the National
Natural Science Foundation of China (81570023, 81670023,
81870027, and 81920108002), the Science and Technology Foundation
of Sichuan Province (No. 2018SZ0167), and the 1.3.5 project
for disciplines of excellence-Clinical Research Incubation Project,
West China Hospital, Sichuan University (2018HXFH016).
第一作者单位：[a]Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, PR China[b]Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, PR China[c]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Diseaserelated Molecular Network, Sichuan University, Chengdu, PR China
通讯作者：
通讯机构：[a]Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, PR China[c]Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Diseaserelated Molecular Network, Sichuan University, Chengdu, PR China[*1]Pneumology Group, Department of Integrated Traditional Chinese and Western Medicine Clinical Research Center for Respiratory Disease West China Hospital, Sichuan University, Guoxue Road, Chengdu 610041 (China)
推荐引用方式(GB/T 7714)：
Min Feng,Xin Zhang,Wen Wen Wu,et al.Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment[J].RESPIRATION.2021,99(12):1109-1121.doi:10.1159/000510793.
APA：
Min Feng,Xin Zhang,Wen Wen Wu,Zhi Hong Chen,Brian G. Oliver...&Peter G. Gibson.(2021).Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment.RESPIRATION,99,(12)
MLA：
Min Feng,et al."Clinical and Inflammatory Features of Exacerbation-Prone Asthma: A Cross-Sectional Study Using Multidimensional Assessment".RESPIRATION 99..12(2021):1109-1121
