Clinical and inflammatory characteristics of the European U-BIOPRED adult severe asthma cohort.
Shaw DERespiratory Research Unit, University of Nottingham, Nottingham, UK Joint first authors dominic.shaw@nottingham.ac.uk.
Sousa ARRespiratory Therapeutic Unit, GSK, Stockley Park, UK Joint first authors.
Fowler SJRespiratory and Allergy Research Group, University of Manchester, Manchester, UK.
Fleming LJNational Heart and Lung Institute, Imperial College, London, UK.
Roberts GNIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences and Human Development and Health, Southampton, UK Faculty of Medicine, University of Southampton, Southampton, UK The David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Isle of Wight, UK.
Corfield JAstraZeneca R&D, Mölndal, Sweden Areteva R&D, Nottingham, UK.
Pandis IData Science Institute, South Kensington Campus, Imperial College London, London, UK.
Bansal ATAcclarogen Ltd, St John's Innovation Centre, Cambridge, UK.
Bel EHDept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Auffray CEuropean Institute for Systems Biology and Medicine, CNRS-ENS-UCBL, Université de Lyon, Lyon, France.
Compton CHRespiratory Therapeutic Unit, GSK, Stockley Park, UK.
Bisgaard HFaculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Strandberg KLung/Allergy Clinic, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Vestbo JRespiratory Research Group, Manchester Academic Health Science Centre, University Hospital South Manchester NHS Foundation Trust, Manchester, UK.
Vissing NThe Danish Pediatric Asthma Center, University of Copenhagen, Copenhagen, Denmark.
Rowe AJanssen Research and Development Ltd, High Wycombe, UK.
Howarth PNIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Wagener AHDept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Djukanovic RNIHR Southampton Respiratory Biomedical Research Unit, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
Sterk PJDept of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Joint last authors.
Chung KFNational Heart and Lung Institute, Imperial College, London, UK Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK Joint last authors.
English
U-BIOPRED is a European Union consortium of 20 academic institutions, 11 pharmaceutical companies and six patient organisations with the objective of improving the understanding of asthma disease mechanisms using a systems biology approach.This cross-sectional assessment of adults with severe asthma, mild/moderate asthma and healthy controls from 11 European countries consisted of analyses of patient-reported outcomes, lung function, blood and airway inflammatory measurements.Patients with severe asthma (nonsmokers, n=311; smokers/ex-smokers, n=110) had more symptoms and exacerbations compared to patients with mild/moderate disease (n=88) (2.5 exacerbations versus 0.4 in the preceding 12 months; p<0.001), with worse quality of life, and higher levels of anxiety and depression. They also had a higher incidence of nasal polyps and gastro-oesophageal reflux with lower lung function. Sputum eosinophil count was higher in severe asthma compared to mild/moderate asthma (median count 2.99% versus 1.05%; p=0.004) despite treatment with higher doses of inhaled and/or oral corticosteroids.Consistent with other severe asthma cohorts, U-BIOPRED is characterised by poor symptom control, increased comorbidity and airway inflammation, despite high levels of treatment. It is well suited to identify asthma phenotypes using the array of "omic" datasets that are at the core of this systems medicine approach.