Clinical and Biological Phenotyping of Upper and Lower Airways as a Mean of Therapy Optimization in Severe Asthmatic Patients Eligible for Biological Treatment

Paggiaro, Pierluigi; Latorre, María Dolores Linares; Bradicich, Matteo; Bacci, Elizabeth D.; Cianchetti, Silvana; Cardini, Cristina; Miccoli, Mario; Seccia, Veronica; Mencacci, Lodovica Cristofani; Celi, Alessandro

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a1342

Cited by 1 publication

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“…The mean age of these participants ranged from 9 to 72, with 96.6% ( n = 30) of articles focusing on the adult population. Five studies did not provide age information 18–22 . These studies obtained biological samples from the airway, 77.7% ( n = 21) from the upper airway, 11.1% ( n = 3) from the lower airway, and 11.1% ( n = 3) from both the upper and lower airways.…”

Section: Resultsmentioning

confidence: 99%

“…Patients diagnosed with both CRS and asthma demonstrated type 2 (40.0%, n = 8), 10,20,24–29 type 1 (7.5%, n = 1.5), 30,31 type 3 (5.0%, n = 1), 32 mixed types 1 and 2 (T1/2) (5.0%, n = 1), 33 and mixed type 1, 2, and 3 (T1/2/3) (42.5%, n = 8.5) 11,14,18,19,30,34–37 endotype shifts in upper and lower airway samples (Table I) (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies did not provide age information. [18][19][20][21][22] These studies obtained biological samples from the airway, 77.7% (n = 21) from the upper airway, 11.1% (n = 3) from the lower airway, and 11.1% (n = 3) from both the upper and lower airways. Among upper airway samples, material included sinonasal mucosa (n = 15), nasal polyps (n = 3), nasal secretions (n = 2), and rhinonasal lavage (n = 1).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Non‐Type 2 and Mixed Inflammation in Chronic Rhinosinusitis and Lower Airway Disease

Heffernan,

Shafiee,

Chan

et al. 2023

The Laryngoscope

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ObjectiveThe aim was to discuss the role of non‐type 2 inflammation in patients diagnosed with chronic rhinosinusitis (CRS) and comorbid lower airway disease.Data SourcesMedline, Embase, National Institute for Health and Care Excellence, TRIP Database, ProQuest, Clinicaltrials.gov, Cochrane Central Registry of Controlled Trials, Web of Science, government and health organizations, and graduate‐level theses.Review MethodsThis scoping review followed PRISMA‐ScR guidelines. Search strategy was peer‐reviewed by medical librarians. Studies were included if they utilized airway sampling, non‐type 2 cytokines, and patients with CRS and lower airway disease.ResultsTwenty‐seven from 7060 articles were included. In patients with CRS and comorbid asthma, aspirin‐exacerbated respiratory disease (AERD), and chronic obstructive pulmonary disease (COPD)/bronchiectasis, 60% (n = 12), 33% (n = 2), and 100% (n = 1), respectively, demonstrated mixed or non‐type 2 endotypes. Comorbid CRS and asthma produced type 1 (n = 1.5), type 2 (n = 8), type 3 (n = 1), mixed type 1/2 (n = 1), and mixed type 1/2/3 (n = 8.5) endotype shifts. AERD demonstrated type 2 (n = 4), mixed type 2/3 (n = 1), and mixed type 1/2/3 (n = 1) endotype shifts. CRS with COPD or bronchiectasis demonstrated a mixed 1/2 (n = 1) endotype shift.ConclusionType 2 disease has been extensively reviewed due to advent biologics targeting type 2 inflammation, but outcomes may be suboptimal due to the presence of non‐type 2 inflammation. A proportion of patients with CRS and comorbid lower airway disease demonstrated mixed and non‐type 2 endotype shifts. This emphasizes that patients with unified airway disease may have forms of inflammation beyond classical type 2 disease which could inform biologic development. Laryngoscope, 2023

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Section: Resultsmentioning

confidence: 99%