Asthma phenotype: Clinical, physiological, and biochemical profiles of North Indian patients

Abstract

Background and Objectives: Asthma is a common, chronic and heterogeneous disease with various phenotypes. The clinical phenotypes has aided in revealing the genetic heterogeneity, provide education, life style advice and novel biological treatments. The few common factors associated with phenotypes are smoking, rhinitis and obesity. The present study was thus planned to analyse and correlate the clinical, physiological, biochemical and serological parameters of asthma and to study the phenotypic characteristics in different asthmatic. Methods: This was a prospective observational study of 120 patients with 30 each in BA-rhinitis, BA, BA-obesity and BA smoker phenotypes. All the enrolled patients were assessed by SGRQ, Mini-AQLQ, GINA with ACE, chest X ray, Spirometry, SPT against common aero-allergens, FENO, hsCRP, vitamin-D, IgE, and Interleukins (IL) including IL-5, IL-6, IL-8, IL-13, IL-17 and IL-33. The mentioned profiles of each phenotype correlated and characterized among different phenotypes. Results: The majority of patients 78(65%) were female with mean BMI of 24.07±4.73kg/m2. Majority of the patient in BA and BA-rhinitis phenotype are in mild severity and young compared to majority in BA-obesity and BA-smoker are moderate to severe severity with older. (p<0.001) The SPT and FENO level were highest among BA-rhinitis phenotype with significant difference among phenotypes. (p<0.001) Similarly the most of inflammatory markers were significantly different in various phenotypes. The FEV1 showed correlation with most of parameters with statistically significant correlation with IL-5, IL-8 and FENO. Conclusion: The majority of parameters were significantly different among various phenotypes. We advise to phenotypic classification of asthma whenever possible for better management and quality of life.

Assessment of coexistence of subclinical bronchial asthma in patients with allergic nasal polyposis refractory to medical therapy

“…It has two defining features; first is history of respiratory symptoms as wheeze, chest tightness, cough and shortness of breath that vary over time and in intensity and the second is variable expiratory airflow limitation (GINA 2020). Both asthma and allergic rhinitis are presenting with numerous phenotypes and are considered the most frequent chronic inflammation of both upper and lower airways (Vennilavan et al, 2022).…”