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- Kolmert, Johan, et al.
(författare)
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Urinary Leukotriene E-4 and Prostaglandin D-2 Metabolites Increase in Adult and Childhood Severe Asthma Characterized by Type 2 Inflammation A Clinical Observational Study
- 2021
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - NEW YORK, USA : AMER THORACIC SOC. - 1073-449X .- 1535-4970. ; 203:1, s. 37-53
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: New approaches are needed to guide personalized treatment of asthma. Objectives: To test if urinary eicosanoid metabolites can direct asthma phenotyping. Methods: Urinary metabolites of prostaglandins (PGs), cysteinyl leukotrienes (CysLTs), and isoprostanes were quantified in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Diseases Outcomes) study including 86 adults with mild-to-moderate asthma (MMA), 411 with severe asthma (SA), and 100 healthy control participants. Validation was performed internally in 302 participants with SA followed up after 12-18 months and externally in 95 adolescents with asthma. Measurement and Main Results: Metabolite concentrations in healthy control participants were unrelated to age, body mass index, and sex, except for the PGE(2) pathway. Eicosanoid concentrations were generally greater in participants with MMA relative to healthy control participants, with further elevations in participants with SA. However, PGE(2) metabolite concentrations were either the same or lower in male nonsmokers with asthma than in healthy control participants. Metabolite concentrations were unchanged in those with asthma who adhered to oral corticosteroid treatment as documented by urinary prednisolone detection, whereas those with SA treated with omalizumab had lower concentrations of LTE4 and the PGD(2) metabolite 2,3-dinor-11 beta-PGF(2 alpha). High concentrations of LTE4 and PGD(2) metabolites were associated with lower lung function and increased amounts of exhaled nitric oxide and eosinophil markers in blood, sputum, and urine in U-BIOARED participants and in adolescents with asthma. These type 2 (T2) asthma associations were reproduced in the follow-up visit of the U-BIOPRED study and were found to be as sensitive to detect T2 inflammation as the established biomarkers. Conclusions: Monitoring of urinary eicosanoids can identify T2 asthma and introduces a new noninvasive approach for molecular phenotyping of adult and adolescent asthma.
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| 2. |
- Wilson, Susan Jane, et al.
(författare)
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Periostin expression in the U-BIOPRED severe asthma bronchoscopy cohort
- 2018
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Ingår i: European Respiratory Journal. - : European Respiratory Society. - 0903-1936 .- 1399-3003. ; 52
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Periostin (POSTN) is secreted basolaterally by bronchial epithelial cells in asthma and is expressed in the extracellular matrix where it is thought to play a role in fibrosis and is associated with airway eosinophilia.In this study we have assessed the protein expression of POSTN in bronchial biopsies by immunohistochemistry, in serum by the Elecsys Periostin Immunoassay and measured gene expression by Affymetrix arrays in bronchial biopsies, bronchial brushings and in sputum in the U-BIOPRED severe asthma study in the bronchoscopy sub-cohort, which included 4 groups; severe non-smoker asthmatics (SAns), current / ex-smoker severe asthmatics (SAs), mild-moderate asthmatics (MMA) and non-asthmatic healthy controls (HC).Subepithelial protein expression in the bronchial biopsies was higher (p=0.02) in SAns, 9.2% (IQR 5.8-12.6)(n=44) compared to SAs 6.2% (3-9.2)(n=16), and in MMA 11% (7.5-12.6)(n=32) compared to SAs (p=0.002) or HC 7.1% (5.5-10.3)(p=0.01)(n=39). There was no difference between SAns and MMA. Gene expression was higher in biopsies from SAns (n=30), -0.044 (IQR -0.425-0.508), compared to both the SAs (n=9), -0.274 (-0.590-0.200), (p=0.02) and HC (n=21), -0.377 (-0.583-0.125), (p=0.008), but similar in MMA. There was no difference between the groups in POSTN serum levels or in gene expression in bronchial brushings or sputum.In asthmatics, the biopsy protein expression correlated with the biopsy gene expression, and both correlated with eosinophils numbers in the biopsies and blood, exhaled NO, and thickness of the lamina reticularis.These results highlight the potential relevance of tissue POSTN to asthma pathophysiology however, this does not appear to be reflected by serum POSTN measures.
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