المؤلفون: Porsbjerg, Celeste M., Townend, John, Bergeron, Celine, Christoff, George C., Katsoulotos, Gregory P., Larenas-Linnemann, Désirée, Tran, Trung N., Al-Lehebi, Riyad, Bosnic-Anticevich, Sinthia Z., Busby, John, Hew, Mark, Kostikas, Konstantinos, Papadopoulos, Nikolaos G., Pfeffer, Paul E., Popov, Todor A., Rhee, Chin Kook, Sadatsafavi, Mohsen, Tsai, Ming-Ju, Ulrik, Charlotte Suppli, Al-Ahmad, Mona, Altraja, Alan, Beastall, Aaron, Bulathsinhala, Lakmini, Carter, Victoria, Cosio, Borja G., Fletton, Kirsty, Hansen, Susanne, Heaney, Liam G., Hubbard, Richard B., Kuna, Piotr, Murray, Ruth B., Nagano, Tatsuya, Pini, Laura, Cano Rosales, Diana Jimena, Schleich, Florence, Wechsler, Michael E., Amaral, Rita, Bourdin, Arnaud, Brusselle, Guy G., Chen, Wenjia, Chung, Li Ping, Denton, Eve, Fonseca, Joao A., Hoyte, Flavia, Jackson, David J., Katial, Rohit, Kirenga, Bruce J., Koh, Mariko Siyue, Ławkiedraj, Agnieszka, Lehtimäki, Lauri, Liew, Mei Fong, Mahboub, Bassam, Martin, Neil, Menzies-Gow, Andrew N., Pang, Pee Hwee, Papaioannou, Andriana I., Patel, Pujan H., Perez-De-Llano, Luis, Peters, Matthew J., Ricciardi, Luisa, Rodríguez-Cáceres, Bellanid, Solarte, Ivan, Tay, Tunn Ren, Torres-Duque, Carlos A., Wang, Eileen, Zappa, Martina, Abisheganaden, John, Assing, Karin Dahl, Costello, Richard W., Gibson, Peter G., Heffler, Enrico, Máspero, Jorge, Nicola, Stefania, Perng (Steve), Diahn-Warng, Puggioni, Francesca, Salvi, Sundeep, Sheu, Chau-Chyun, Sirena, Concetta, Taillé, Camille, Tan, Tze Lee, Bjermer, Leif, Canonica, Giorgio Walter, Iwanaga, Takashi, Jiménez-Maldonado, Libardo, Taube, Christian, Brussino, Luisa, Price, David B.

المساهمون: Porsbjerg, Celeste M., Townend, John, Bergeron, Celine, Christoff, George C., Katsoulotos, Gregory P., Larenas-Linnemann, Désirée, Tran, Trung N., Al-Lehebi, Riyad, Bosnic-Anticevich, Sinthia Z., Busby, John, Hew, Mark, Kostikas, Konstantino, Papadopoulos, Nikolaos G., Pfeffer, Paul E., Popov, Todor A., Rhee, Chin Kook, Sadatsafavi, Mohsen, Tsai, Ming-Ju, Ulrik, Charlotte Suppli, Al-Ahmad, Mona, Altraja, Alan, Beastall, Aaron, Bulathsinhala, Lakmini, Carter, Victoria, Cosio, Borja G., Fletton, Kirsty, Hansen, Susanne, Heaney, Liam G., Hubbard, Richard B., Kuna, Piotr, Murray, Ruth B., Nagano, Tatsuya, Pini, Laura, Cano Rosales, Diana Jimena, Schleich, Florence, Wechsler, Michael E., Amaral, Rita, Bourdin, Arnaud, Brusselle, Guy G., Chen, Wenjia, Chung, Li Ping, Denton, Eve, Fonseca, Joao A., Hoyte, Flavia, Jackson, David J., Katial, Rohit, Kirenga, Bruce J., Koh, Mariko Siyue, Ławkiedraj, Agnieszka, Lehtimäki, Lauri, Liew, Mei Fong, Mahboub, Bassam, Martin, Neil, Menzies-Gow, Andrew N., Pang, Pee Hwee, Papaioannou, Andriana I., Patel, Pujan H., Perez-De-Llano, Lui, Peters, Matthew J., Ricciardi, Luisa, Rodríguez-Cáceres, Bellanid, Solarte, Ivan, Tay, Tunn Ren, Torres-Duque, Carlos A., Wang, Eileen, Zappa, Martina, Abisheganaden, John, Assing, Karin Dahl, Costello, Richard W., Gibson, Peter G., Heffler, Enrico, Máspero, Jorge, Nicola, Stefania, Perng (Steve), Diahn-Warng, Puggioni, Francesca, Salvi, Sundeep, Sheu, Chau-Chyun, Sirena, Concetta, Taillé, Camille, Tan, Tze Lee, Bjermer, Leif, Canonica, Giorgio Walter, Iwanaga, Takashi, Jiménez-Maldonado, Libardo, Taube, Christian, Brussino, Luisa, Price, David B.

الوصف: Background: To date, studies investigating the association between pre-biologic biomarker levels and post-biologic outcomes have been limited to single biomarkers and assessment of biologic efficacy from structured clinical trials. Aim: To elucidate the associations of pre-biologic individual biomarker levels or their combinations with pre-to-post biologic changes in asthma outcomes in real-life. Methods: This was a registry-based, cohort study using data from 23 countries, which shared data with the International Severe Asthma Registry (May 2017-February 2023). The investigated biomarkers (highest pre-biologic levels) were immunoglobulin E (IgE), blood eosinophil count (BEC) and fractional exhaled nitric oxide (FeNO). Pre- to approximately 12-month post-biologic change for each of three asthma outcome domains (i.e. exacerbation rate, symptom control and lung function), and the association of this change with pre-biologic biomarkers was investigated for individual and combined biomarkers. Results: Overall, 3751 patients initiated biologics and were included in the analysis. No association was found between pre-biologic BEC and pre-to-post biologic change in exacerbation rate for any biologic class. However, higher pre-biologic BEC and FeNO were both associated with greater post-biologic improvement in FEV1 for both anti-IgE and anti-IL5/5R, with a trend for anti-IL4Rα. Mean FEV1 improved by 27-178 mL post-anti-IgE as pre-biologic BEC increased (250 to 1000 cells/μL), and by 43-216 mL and 129-250 mL post-anti-IL5/5R and -anti-IL4Rα, respectively along the same BEC gradient. Corresponding improvements along a FeNO gradient (25-100 ppb) were 41-274 mL, 69-207 mL and 148-224 mL for anti-IgE, anti-IL5/5R, and anti-IL4Rα, respectively. Higher baseline BEC was also associated with lower probability of uncontrolled asthma (OR 0.392; p=0.001) post-biologic for anti-IL5/5R. Pre-biologic IgE was a poor predictor of subsequent pre-to-post-biologic change for all outcomes assessed for all biologics. The combination of BEC + ...

العلاقة: volume:15; journal:FRONTIERS IN IMMUNOLOGY; https://hdl.handle.net/11379/596185Test; https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1361891/fullTest

الإتاحة: https://doi.org/10.3389/fimmu.2024.1361891Test
https://hdl.handle.net/11379/596185Test

المؤلفون: Denton, Eve, Hew, Mark, Peters, Matthew J., Upham, John W., Bulathsinhala, Lakmini, Tran, Trung N., Martin, Neil, Bergeron, Celine, Al‐Ahmad, Mona, Altraja, Alan, Larenas‐Linnemann, Désirée, Murray, Ruth, Celis‐Preciado, Carlos Andrés, Al‐Lehebi, Riyad, Belhassen, Manon, Bhutani, Mohit, Bosnic‐Anticevich, Sinthia Z., Bourdin, Arnaud, Brusselle, Guy G., Busby, John, Canonica, Giorgio Walter, Heffler, Enrico, Chapman, Kenneth R., Charriot, Jérémy, Christoff, George C., Chung, Li Ping, Cosio, Borja G., Côté, Andréanne, Costello, Richard W., Cushen, Breda, Fingleton, James, Fonseca, João A., Gibson, Peter G., Heaney, Liam G., Huang, Erick Wan‐Chun, Iwanaga, Takashi, Jackson, David J., Koh, Mariko Siyue, Lehtimäki, Lauri, Máspero, Jorge, Mahboub, Bassam, Menzies‐Gow, Andrew N., Mitchell, Patrick D., Papadopoulos, Nikolaos G., Papaioannou, Andriana I., Perez‐de‐Llano, Luis, Perng, Diahn‐Warng, Pfeffer, Paul E., Popov, Todor A., Porsbjerg, Celeste M.

المساهمون: AstraZeneca, Optimum Patient Care

المصدر: Allergy ; ISSN 0105-4538 1398-9995

الوصف: Background Biologic asthma therapies reduce exacerbations and long‐term oral corticosteroids (LTOCS) use in randomized controlled trials (RCTs); however, there are limited data on outcomes among patients ineligible for RCTs. Hence, we investigated responsiveness to biologics in a real‐world population of adults with severe asthma. Methods Adults in the International Severe Asthma Registry (ISAR) with ≥24 weeks of follow‐up were grouped into those who did, or did not, initiate biologics (anti‐IgE, anti‐IL5/IL5R, anti‐IL4/13). Treatment responses were examined across four domains: forced expiratory volume in 1 second (FEV 1 ) increase by ≥100 mL, improved asthma control, annualized exacerbation rate (AER) reduction ≥50%, and any LTOCS dose reduction. Super‐response criteria were: FEV 1 increase by ≥500 mL, new well‐controlled asthma, no exacerbations, and LTOCS cessation or tapering to ≤5 mg/day. Results 5.3% of ISAR patients met basic RCT inclusion criteria; 2116/8451 started biologics. Biologic initiators had worse baseline impairment than non‐initiators, despite having similar biomarker levels. Half or more of initiators had treatment responses: 59% AER reduction, 54% FEV 1 increase, 49% improved control, 49% reduced LTOCS, of which 32%, 19%, 30%, and 39%, respectively, were super‐responses. Responses/super‐responses were more frequent in biologic initiators than in non‐initiators; nevertheless, ~40–50% of initiators did not meet response criteria. Conclusions Most patients with severe asthma are ineligible for RCTs of biologic therapies. Biologics are initiated in patients who have worse baseline impairments than non‐initiators despite similar biomarker levels. Although biologic initiators exhibited clinical responses and super‐responses in all outcome domains, 40–50% did not meet the response criteria.

الإتاحة: https://doi.org/10.1111/all.16178Test

المؤلفون: Higbee, Daniel H., Lirio, Alvin, Hamilton, Fergus, Granell, Raquel, Wyss, Annah B., London, Stephanie J., Bartz, Traci M., Gharib, Sina A., Cho, Michael H., Wan, Emily, Silverman, Edwin, Crapo, James D., Lominchar, Jesus V.T., Hansen, Torben, Grarup, Niels, Dantoft, Thomas, Kårhus, Line, Linneberg, Allan, O’Connor, George T., Dupuis, Josée, Xu, Hanfie, De Vries, Maaike M., Hu, Xiaowei, Rich, Stephen S., Barr, R. Graham, Manichaikul, Ani, Wijnant, Sara R.A., Brusselle, Guy G., Lahousse, Lies, Li, Xuan, Hernández Cordero, Ana I., Obeidat, Maen, Sin, Don D., Harris, Sarah E., Redmond, Paul, Taylor, Adele M., Cox, Simon R., Williams, Alexander T., Shrine, Nick, John, Catherine, Guyatt, Anna L., Hall, Ian P., Smith, George Davey, Tobin, Martin D., Dodd, James W.

المصدر: Higbee , D H , Lirio , A , Hamilton , F , Granell , R , Wyss , A B , London , S J , Bartz , T M , Gharib , S A , Cho , M H , Wan , E , Silverman , E , Crapo , J D , Lominchar , J V T , Hansen , T , Grarup , N , Dantoft , T , Kårhus , L , Linneberg , A , O’Connor , G T , Dupuis , J , Xu , H , De Vries , M M ....

مصطلحات موضوعية: /dk/atira/pure/core/keywords/population_health_SRI, name=Bristol Population Health Science Institute

الوصف: Background Preserved ratio impaired spirometry (PRISm) is defined as a forced expiratory volume in 1 s (FEV 1 ) <80% predicted and FEV 1 /forced vital capacity ≤0.70. PRISm is associated with respiratory symptoms and comorbidities. Our objective was to discover novel genetic signals for PRISm and see if they provide insight into the pathogenesis of PRISm and associated comorbidities. Methods We undertook a genome-wide association study (GWAS) of PRISm in UK Biobank participants (Stage 1), and selected single nucleotide polymorphisms (SNPs) reaching genome-wide significance for replication in 13 cohorts (Stage 2). A combined meta-analysis of Stage 1 and Stage 2 was done to determine top SNPs. We used cross-trait linkage disequilibrium score regression to estimate genome-wide genetic correlation between PRISm and pulmonary and extrapulmonary traits. Phenome-wide association studies of top SNPs were performed. Results 22 signals reached significance in the joint meta-analysis, including four signals novel for lung function. A strong genome-wide genetic correlation (r g ) between PRISm and spirometric COPD (r g =0.62, p<0.001) was observed, and genetic correlation with type 2 diabetes (r g =0.12, p=0.007). Phenome-wide association studies showed that 18 of 22 signals were associated with diabetic traits and seven with blood pressure traits. Conclusion This is the first GWAS to successfully identify SNPs associated with PRISm. Four of the signals, rs7652391 (nearest gene MECOM), rs9431040 (HLX), rs62018863 (TMEM114) and rs185937162 (HLA-B), have not been described in association with lung function before, demonstrating the utility of using different lung function phenotypes in GWAS. Genetic factors associated with PRISm are strongly correlated with risk of both other lung diseases and extrapulmonary comorbidity.

العلاقة: https://research-information.bris.ac.uk/en/publications/0cd68ec7-3139-4cfc-a88a-3b4c3390688fTest

الإتاحة: https://doi.org/10.1183/13993003.00337-2023Test
https://hdl.handle.net/1983/0cd68ec7-3139-4cfc-a88a-3b4c3390688fTest
https://research-information.bris.ac.uk/en/publications/0cd68ec7-3139-4cfc-a88a-3b4c3390688fTest
http://www.scopus.com/inward/record.url?scp=85181773328&partnerID=8YFLogxKTest

المؤلفون: Lu, Tianqi, Lahousse, Lies, Wijnant, Sara, Chen, Jinluan, Brusselle, Guy G., van Hoek, Mandy, Zillikens, M. Carola

المصدر: Lu , T , Lahousse , L , Wijnant , S , Chen , J , Brusselle , G G , van Hoek , M & Zillikens , M C 2024 , ' The AGE-RAGE axis associates with chronic pulmonary diseases and smoking in the Rotterdam study ' , Respiratory Research , vol. 25 , no. 1 , 85 . https://doi.org/10.1186/s12931-024-02698-1Test

الوصف: Background: Chronic obstructive pulmonary disease (COPD) and asthma associate with high morbidity and mortality. High levels of advanced glycation end products (AGEs) were found in tissue and plasma of COPD patients but their role in COPD and asthma is unclear. Methods: In the Rotterdam Study (n = 2577), AGEs (by skin autofluorescence (SAF)), FEV 1 and lung diffusing capacity (D LCO c and D LCO c /alveolar volume [V A ]) were measured. Associations of SAF with asthma, COPD, GOLD stage, and lung function were analyzed using logistic and linear regression adjusted for covariates, followed by interaction and stratification analyses. sRAGE and EN-RAGE associations with COPD prevalence were analyzed by logistic regression. Results: SAF associated with COPD prevalence (OR = 1.299 [1.060, 1.591]) but not when adjusted for smoking (OR = 1.106 [0.89, 1.363]). SAF associated with FEV 1 % predicted (β=-3.384 [-4.877, -1.892]), D LCO c (β=-0.212 [-0.327, -0.097]) and GOLD stage (OR = 4.073, p = 0.001, stage 3&4 versus 1). Stratified, the association between SAF and FEV 1 %predicted was stronger in COPD (β=-6.362 [-9.055, -3.670]) than non-COPD (β=-1.712 [-3.306, -0.118]). Association of SAF with D LCO c and D LCO c/V A were confined to COPD (β=-0.550 [-0.909, -0.191]; β=-0.065 [-0.117, -0.014] respectively). SAF interacted with former smoking and COPD prevalence for associations with lung function. Lower sRAGE and higher EN-RAGE associated with COPD prevalence (OR = 0.575[0.354, 0.931]; OR = 1.778[1.142, 2.768], respectively). Conclusions: Associations between SAF, lung function and COPD prevalence were strongly influenced by smoking. SAF associated with COPD severity and its association with lung function was more prominent within COPD. These results fuel further research into interrelations and causality between SAF, smoking and COPD. Take-home message: Skin AGEs associated with prevalence and severity of COPD and lung function in the general population with a stronger effect in COPD, calling for further research into ...

وصف الملف: application/pdf

العلاقة: https://pure.eur.nl/en/publications/4b07ecab-bb1b-4ce7-acaf-318f46271f4cTest

الإتاحة: https://doi.org/10.1186/s12931-024-02698-1Test
https://pure.eur.nl/en/publications/4b07ecab-bb1b-4ce7-acaf-318f46271f4cTest
https://pure.eur.nl/ws/files/136375155/The_AGE-RAGE_axis_associates_with_chronic_pulmonary_diseases_and_smoking_in_the_Rotterdam_study.pdfTest
http://www.scopus.com/inward/record.url?scp=85184786781&partnerID=8YFLogxKTest

المؤلفون: Markus, Aniek F., Rijnbeek, Peter R., Kors, Jan A., Burn, Edward, Duarte-Salles, Talita, Haug, Markus, Kim, Chungsoo, Kolde, Raivo, Lee, Youngsoo, Park, Hae Sim, Park, Rae Woong, Prieto-Alhambra, Daniel, Reyes, Carlen, Krishnan, Jerry A., Brusselle, Guy G., Verhamme, Katia M.C.

المصدر: Markus , A F , Rijnbeek , P R , Kors , J A , Burn , E , Duarte-Salles , T , Haug , M , Kim , C , Kolde , R , Lee , Y , Park , H S , Park , R W , Prieto-Alhambra , D , Reyes , C , Krishnan , J A , Brusselle , G G & Verhamme , K M C 2024 , ' Real-world treatment trajectories of adults with newly diagnosed asthma or COPD ' , BMJ Open Respiratory Research , vol. 11 , no. 1 , ....

الوصف: Background There is a lack of knowledge on how patients with asthma or chronic obstructive pulmonary disease (COPD) are globally treated in the real world, especially with regard to the initial pharmacological treatment of newly diagnosed patients and the different treatment trajectories. This knowledge is important to monitor and improve clinical practice. Methods This retrospective cohort study aims to characterise treatments using data from four claims (drug dispensing) and four electronic health record (EHR; drug prescriptions) databases across six countries and three continents, encompassing 1.3 million patients with asthma or COPD. We analysed treatment trajectories at drug class level from first diagnosis and visualised these in sunburst plots. Results In four countries (USA, UK, Spain and the Netherlands), most adults with asthma initiate treatment with short-acting ß2 agonists monotherapy (20.8%-47.4% of first-line treatments). For COPD, the most frequent first-line treatment varies by country. The largest percentages of untreated patients (for asthma and COPD) were found in claims databases (14.5%-33.2% for asthma and 27.0%-52.2% for COPD) from the USA as compared with EHR databases (6.9%-15.2% for asthma and 4.4%-17.5% for COPD) from European countries. The treatment trajectories showed step-up as well as step-down in treatments. Conclusion Real-world data from claims and EHRs indicate that first-line treatments of asthma and COPD vary widely across countries. We found evidence of a stepwise approach in the pharmacological treatment of asthma and COPD, suggesting that treatments may be tailored to patients' needs.

وصف الملف: application/pdf

العلاقة: https://pure.eur.nl/en/publications/d1d8824c-0386-446e-9ac4-abdd784e6693Test

الإتاحة: https://doi.org/10.1136/bmjresp-2023-002127Test
https://pure.eur.nl/en/publications/d1d8824c-0386-446e-9ac4-abdd784e6693Test
https://pure.eur.nl/ws/files/139026282/e002127.full.pdfTest
http://www.scopus.com/inward/record.url?scp=85186450986&partnerID=8YFLogxKTest

المؤلفون: Bertels, Xander, Ross, James C., Faner, Rosa, Cho, Michael H., Ikram, M. Arfan, Brusselle, Guy G., Lahousse, Lies

المصدر: Bertels , X , Ross , J C , Faner , R , Cho , M H , Ikram , M A , Brusselle , G G & Lahousse , L 2024 , ' Clinical relevance of lung function trajectory clusters in middle-aged and older adults ' , ERJ Open Research , vol. 10 , no. 1 , 00793-2023 . https://doi.org/10.1183/23120541.00793-2023Test

الوصف: Background The determinants and health outcomes of lung function trajectories in adults among the general population are poorly understood. We aimed to identify and characterise clusters of lung function trajectories in adults aged ≥45 years. Methods Gaussian finite-mixture modelling was applied to baseline and annualised change of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio z-scores in participants of the Rotterdam Study, a prospective population-based cohort study, with repeated spirometry (n=3884; mean±SD age 64.7±8.9 years). Longitudinal outcomes were all-cause mortality, respiratory outcomes (symptoms, COPD (FEV1/FVC <0.7 in absence of asthma), preserved ratio impaired spirometry (PRISm; FEV 1 /FVC ≥0.7 and FEV1 or FVC <80%)), smoking cessation and weight changes. Independent risk factors, including genetics, were identified by multiple logistic regression. Results We identified eight trajectory clusters, with the reference group having persistently normal spirometry (prevalence 42.8%). Three clusters showed higher mortality, adjusted for confounders: 1) the persistently low FEV1 cluster (prevalence 6.8%, hazard ratio (HR) 1.71, 95% CI 1.37-2.13); 2) rapid FEV1 decliners (prevalence 4.6%, HR 1.48, 95% CI 1.10-1.99); and 3) FVC decliners (prevalence 3.7%, HR 1.49, 95% CI 1.09-2.03). In contrast, FVC improvers (prevalence 6.7%, HR 0.61, 95% CI 0.41-0.90) and persistently high FEV1 (prevalence 29.2%, HR 0.82, 95% CI 0.69-0.98) were protective trajectory clusters. Clusters were characterised by differences in genetic predisposition (polygenic scores of FEV1 and FEV1/FVC), demographics, cigarette smoking, respiratory symptoms (chronic cough, wheezing and dyspnoea), cardiovascular factors (body mass index, hypertension and heart failure) and serum C-reactive protein levels. Frailty, weight changes and the development of respiratory symptoms, COPD and PRISm were significantly associated with trajectory clusters. Conclusions This study reveals clinically relevant ...

وصف الملف: application/pdf

العلاقة: https://pure.eur.nl/en/publications/a25fe125-f3b5-49e8-a60d-8feca04365afTest

الإتاحة: https://doi.org/10.1183/23120541.00793-2023Test
https://pure.eur.nl/en/publications/a25fe125-f3b5-49e8-a60d-8feca04365afTest
https://pure.eur.nl/ws/files/137688945/00793-2023.full.pdfTest
http://www.scopus.com/inward/record.url?scp=85185948113&partnerID=8YFLogxKTest

المؤلفون: Khan, C.F., Kamran Ikram, M., Terzikhan, Natalie, Brusselle, Guy G., Bos, Daniel

المصدر: Academic Radiology ; ISSN 1076-6332

مصطلحات موضوعية: Radiology, Nuclear Medicine and imaging

الإتاحة: https://doi.org/10.1016/j.acra.2024.03.037Test
https://api.elsevier.com/content/article/PII:S1076633224002022?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1076633224002022?httpAccept=text/plainTest

المؤلفون: Bertels, Xander, Edris, Ahmed, Garcia-Aymerich, Judith, Faner, Rosa, Meteran, Howraman, Sigsgaard, Torben, Alter, Peter, Vogelmeier, Claus, Olvera, Nuria, Kermani, Nazanin Zounemat, Agusti, Alvar, Donaldson, Gavin C., Wedzicha, Jadwiga A., Brusselle, Guy G., Backman, Helena, Rönmark, Eva, Lindberg, Anne, Vonk, Judith M., Chung, Kian Fan, Adcock, Ian M., van den Berge, Maarten, Lahousse, Lies

المصدر: BMJ open respiratory research. 10(1)

مصطلحات موضوعية: Asthma, Asthma Epidemiology, Clinical Epidemiology, COPD epidemiology, Pulmonary Disease, Chronic Obstructive

الوصف: BACKGROUND: The prevalence and clinical profile of asthma with airflow obstruction (AO) remain uncertain. We aimed to phenotype AO in population- and clinic-based cohorts.METHODS: This cross-sectional multicohort study included adults ≥50 years from nine CADSET cohorts with spirometry data (N=69 789). AO was defined as ever diagnosed asthma with pre-BD or post-BD FEV1/FVC <0.7 in population-based and clinic-based cohorts, respectively. Clinical characteristics and comorbidities of AO were compared with asthma without airflow obstruction (asthma-only) and chronic obstructive pulmonary disease (COPD) without asthma history (COPD-only). ORs for comorbidities adjusted for age, sex, smoking status and body mass index (BMI) were meta-analysed using a random effects model.RESULTS: The prevalence of AO was 2.1% (95% CI 2.0% to 2.2%) in population-based, 21.1% (95% CI 18.6% to 23.8%) in asthma-based and 16.9% (95% CI 15.8% to 17.9%) in COPD-based cohorts. AO patients had more often clinically relevant dyspnoea (modified Medical Research Council score ≥2) than asthma-only (+14.4 and +14.7 percentage points) and COPD-only (+24.0 and +5.0 percentage points) in population-based and clinic-based cohorts, respectively. AO patients had more often elevated blood eosinophil counts (>300 cells/µL), although only significant in population-based cohorts. Compared with asthma-only, AO patients were more often men, current smokers, with a lower BMI, had less often obesity and had more often chronic bronchitis. Compared with COPD-only, AO patients were younger, less often current smokers and had less pack-years. In the general population, AO patients had a higher risk of coronary artery disease than asthma-only and COPD-only (OR=2.09 (95% CI 1.26 to 3.47) and OR=1.89 (95% CI 1.10 to 3.24), respectively) and of depression (OR=1.41 (95% CI 1.19 to 1.67)), osteoporosis (OR=2.30 (95% CI 1.43 to 3.72)) and gastro-oesophageal reflux disease (OR=1.68 (95% CI 1.06 to 2.68)) than COPD-only, independent of age, sex, smoking status and BMI.CONCLUSIONS: AO is a relatively prevalent respiratory phenotype associated with more dyspnoea and a higher risk of coronary artery disease and elevated blood eosinophil counts in the general population compared with both asthma-only and COPD-only.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-214066Test
https://doi.org/10.1136/bmjresp-2023-001760Test
https://umu.diva-portal.org/smash/get/diva2:1794318/FULLTEXT01.pdfTest

المؤلفون: Heaney, Liam G., Perez de Llano, Luis, Al-Ahmad, Mona, Backer, Vibeke, Busby, John, Canonica, Giorgio Walter, Christoff, George C., Cosio, Borja G., FitzGerald, J. Mark, Heffler, Enrico, Iwanaga, Takashi, Jackson, David J., Menzies-Gow, Andrew N., Papadopoulos, Nikolaos G., Papaioannou, Andriana I., Pfeffer, Paul E., Popov, Todor A., Porsbjerg, Celeste M., Rhee, Chin Kook, Sadatsafavi, Mohsen, Tohda, Yuji, Wang, Eileen, Wechsler, Michael E., Alacqua, Marianna, Altraja, Alan, Bjermer, Leif, Björnsdóttir, Unnur S., Bourdin, Arnaud, Brusselle, Guy G., Buhl, Roland, Costello, Richard W., Hew, Mark, Koh, Mariko Siyue, Lehmann, Sverre, Lehtimäki, Lauri, Peters, Matthew, Taillé, Camille, Taube, Christian, Tran, Trung N., Zangrilli, James, Bulathsinhala, Lakmini, Carter, Victoria A., Chaudhry, Isha, Eleangovan, Neva, Hosseini, Naeimeh, Kerkhof, Marjan, Murray, Ruth B., Price, Chris A., Price, David B.

المصدر: Chest EpiHealth: Epidemiology for Health. 160(3):814-830

مصطلحات موضوعية: Asia, Europe, International Severe Asthma Registry, Middle East, North America, Medicin och hälsovetenskap, Klinisk medicin, Lungmedicin och allergi, Medical and Health Sciences, Clinical Medicine, Respiratory Medicine and Allergy

الوصف: Background: Phenotypic characteristics of patients with eosinophilic and noneosinophilic asthma are not well characterized in global, real-life severe asthma cohorts. Research Question: What is the prevalence of eosinophilic and noneosinophilic phenotypes in the population with severe asthma, and can these phenotypes be differentiated by clinical and biomarker variables? Study Design and Methods: This was an historical registry study. Adult patients with severe asthma and available blood eosinophil count (BEC) from 11 countries enrolled in the International Severe Asthma Registry (January 1, 2015-September 30, 2019) were categorized according to likelihood of eosinophilic phenotype using a predefined gradient eosinophilic algorithm based on highest BEC, long-term oral corticosteroid use, elevated fractional exhaled nitric oxide, nasal polyps, and adult-onset asthma. Demographic and clinical characteristics were defined at baseline (ie, 1 year before or closest to date of BEC). Results: One thousand seven hundred sixteen patients with prospective data were included; 83.8% were identified as most likely (grade 3), 8.3% were identified as likely (grade 2), and 6.3% identified as least likely (grade 1) to have an eosinophilic phenotype, and 1.6% of patients showed a noneosinophilic phenotype (grade 0). Eosinophilic phenotype patients (ie, grades 2 or 3) showed later asthma onset (29.1 years vs 6.7 years; P < .001) and worse lung function (postbronchodilator % predicted FEV1, 76.1% vs 89.3%; P = .027) than those with a noneosinophilic phenotype. Patients with noneosinophilic phenotypes were more likely to be women (81.5% vs 62.9%; P = .047), to have eczema (20.8% vs 8.5%; P = .003), and to use anti-IgE (32.1% vs 13.4%; P = .004) and leukotriene receptor antagonists (50.0% vs 28.0%; P = .011) add-on therapy. Interpretation: According to this multicomponent, consensus-driven, and evidence-based eosinophil gradient algorithm (using variables readily accessible in real life), the severe asthma eosinophilic phenotype was more prevalent than previously identified and was phenotypically distinct. This pragmatic gradient algorithm uses variables readily accessible in primary and specialist care, addressing inherent issues of phenotype heterogeneity and phenotype instability. Identification of treatable traits across phenotypes should improve therapeutic precision.

الوصول الحر: https://lup.lub.lu.se/record/c6493898-632f-4ecb-97c3-0193c0977fb6Test
http://dx.doi.org/10.1016/j.chest.2021.04.013Test

المؤلفون: Xu, Jiayi, Bartz, Traci M, Chittoor, Geetha, Eiriksdottir, Gudny, Manichaikul, Ani W, Sun, Fangui, Terzikhan, Natalie, Zhou, Xia, Booth, Sarah L, Brusselle, Guy G, de Boer, Ian H, Fornage, Myriam, Frazier-Wood, Alexis C, Graff, Mariaelisa, Gudnason, Vilmundur, Harris, Tamara B, Hofman, Albert, Hou, Ruixue, Houston, Denise K, Jacobs, David R, Kritchevsky, Stephen B, Latourelle, Jeanne, Lemaitre, Rozenn N, Lutsey, Pamela L, O’Connor, George, Oelsner, Elizabeth C, Pankow, James S, Psaty, Bruce M, Rohde, Rebecca R, Rich, Stephen S, Rotter, Jerome I, Smith, Lewis J, Stricker, Bruno H, Voruganti, V Saroja, Wang, Thomas J, Zillikens, M Carola, Barr, R Graham, Dupuis, Josée, Gharib, Sina A, Lahousse, Lies, London, Stephanie J, North, Kari E, Smith, Albert V, Steffen, Lyn M, Hancock, Dana B, Cassano, Patricia A

المصدر: British Journal Of Nutrition. 120(10)

مصطلحات موضوعية: Biomedical and Clinical Sciences, Nutrition and Dietetics, Complementary and Integrative Health, Aging, Clinical Research, Adult, Aged, Black People, Cross-Sectional Studies, Female, Forced Expiratory Volume, Genome, Human, Heart, Heart Diseases, Humans, Lung, Lung Diseases, Male, Middle Aged, Molecular Epidemiology, Prospective Studies, Regression Analysis, Respiratory Function Tests, Smoking, Vital Capacity, Vitamin D, White People, 1, 25(OH)D 25-hydroxyvitamin D, AA African ancestry, AGES Age, ARIC Atherosclerosis Risk in Communities Study, Aging, CARDIA Coronary Artery Risk Development in Young Adults Study, CHARGE Cohorts for Heart and Aging Research in Genomic Epidemiology, CHS Cardiovascular Health Study, COPD chronic obstructive pulmonary disease, EA European ancestry, Environment, FEV1 forced expiratory volume in the 1st second, FHS (Gen3) Framingham Heart Study – Generation 3 Cohort, FHS (Offspring) Framingham Heart Study –Offspring Cohort, FVC forced vital capacity, Gene, HABC Health, Iceland, MESA Multi-Ethnic Study of Atherosclerosis, PFT pulmonary function test, RIA radioimmunoassay, Susceptibility Study − Reykjavik, and Body Composition Study, 25-(OH)2D 1, 25-dihydroxyvitamin D, African Americans, Forced expiratory volume, Respiratory function tests, Vital capacity, Whites, Animal Production, Food Sciences, Nutrition & Dietetics, Animal production, Food sciences, Nutrition and dietetics

الوصف: The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)-pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D-pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/9696h6m0Test