ArticleInternational journal of epidemiology2023
Asthma inflammatory phenotypes on four continents: most asthma is non-eosinophilic.
Article in International journal of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 29 citations in OpenAlex.
- Global Asthma Disparities: Deciphering the Multifaceted Environmental Exposome Between Eastern and Western Populations.Clinical reviews in allergy & immunology · 2026Review
- Airway microbiota in young people across four continents differ by country, asthma status and inflammatory phenotype.Thorax · 2026Article
- The role of objective testing in urban adolescents with asthma symptoms in an African centre.BMC pediatrics · 2026Article
- Characteristics and management of asthma from the China Asthma Data Registry Project.ERJ open research · 2026Article
- Asthma management in pregnancy and lactation: A review of current evidence and best practice recommendations.NPJ primary care respiratory medicine · 2026Review
- Asthma endotypes and theratypes.Chinese medical journal pulmonary and critical care medicine · 2026Review
- Fractional exhaled nitric oxide (FeNO) in chronic obstructive respiratory diseases is associated with the bronchodilator response.Journal of thoracic disease · 2025Article
- Article
- Induced sputum: current progress and prospect.European journal of medical research · 2025Review
- Causes and MEchanisms foR non-atopic Asthma in Children (CAMERA) study: rationale and protocol.Respiratory research · 2025Article
- Sputum quality affects assessment of airway microbiology in childhood asthma.Respiratory research · 2025Article
- The new biologic drugs: Which children with asthma should get what?Pediatric pulmonology · 2024Review
- Eosinophils prevent diet-induced airway hyperresponsiveness in mice on a high-fat diet.American journal of physiology. Lung cellular and molecular physiology · 2024Article
- Evaluating Severe Therapy-Resistant Asthma in Children: Diagnostic and Therapeutic Strategies.Medicina (Kaunas, Lithuania) · 2024Review
- Assessment of Airway Inflammation by Induced Sputum in Children with Persistent Asthma.Indian journal of pediatrics · 2024Article
- Gut microbiome signature and nasal lavage inflammatory markers in young people with asthma.The journal of allergy and clinical immunology. Global · 2024Article
- Global Burden of Asthma, and Its Impact on Specific Subgroups: Nasal Polyps, Allergic Rhinitis, Severe Asthma, Eosinophilic Asthma.Journal of asthma and allergy · 2023Article
- Sphingosine-1-Phosphate Receptor 4 Attenuates Neutrophilic Airway Inflammation in Experimental Asthma via Repressing Proinflammatory Macrophage Activation.International journal of biological sciences · 2023Article
- Bioinformatic analysis and preliminary validation of potential therapeutic targets for COVID-19 infection in asthma patients.Cell communication and signaling : CCS · 2022Article
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Authors and funding
20 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundMost studies assessing pathophysiological heterogeneity in asthma have been conducted in high-income countries (HICs), with little known about the prevalence and characteristics of different asthma inflammatory phenotypes in low-and middle-income countries (LMICs). This study assessed sputum inflammatory phenotypes in five centres, in Brazil, Ecuador, Uganda, New Zealand (NZ) and the United Kingdom (UK).
methodsWe conducted a cross-sectional study of 998 asthmatics and 356 non-asthmatics in 2016-20. All centres studied children and adolescents (age range 8-20 years), except the UK centre which involved 26-27 year-olds. Information was collected using questionnaires, clinical characterization, blood and induced sputum.
resultsOf 623 asthmatics with sputum results, 39% (243) were classified as eosinophilic or mixed granulocytic, i.e. eosinophilic asthma (EA). Adjusted for age and sex, with NZ as baseline, the UK showed similar odds of EA (odds ratio 1.04, 95% confidence interval 0.37-2.94) with lower odds in the LMICs: Brazil (0.73, 0.42-1.27), Ecuador (0.40, 0.24-0.66) and Uganda (0.62, 0.37-1.04). Despite the low prevalence of neutrophilic asthma in most centres, sputum neutrophilia was increased in asthmatics and non-asthmatics in Uganda.
conclusionsThis is the first time that sputum induction has been used to compare asthma inflammatory phenotypes in HICs and LMICs. Most cases were non-eosinophilic, including in settings where corticosteroid use was low. A lower prevalence of EA was observed in the LMICs than in the HICs. This has major implications for asthma prevention and management, and suggests that novel prevention strategies and therapies specifically targeting non-eosinophilic asthma are required globally.
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