Evidence map›Paper›PMID 42435581›Full record

ArticleEBioMedicine2026

Clinical phenotyping of asthma patients with elevated sputum eosinophils and low blood eosinophils: a post-hoc analysis of the multicentre ATLANTIS cohort.

Pauline J M Kuks, Atheer M A Aabed, Lauren C A Premereur, Monica Kraft, Salman Siddiqui, Leonardo M Fabbri, Bianca Beghé, Klaus F Rabe, Alberto Papi, Christopher E Brightling and 10 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in EBioMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Pauline J M KuksDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands. Electronic address: p.j.m.kuks@umcg.nl.
Atheer M A AabedUniversity of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.
Lauren C A PremereurUniversity of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.
Monica KraftSamuel Bronfman Department of Medicine, Icahn School of Medicine, Mount Sinai Medical Center, New York, NY, USA.
Salman SiddiquiNational Heart & Lung Institute, Imperial College London, London, UK.
Leonardo M FabbriSection of Respiratory Medicine, Department of Translational Medicine, University of Ferrara, Italy.
Bianca BeghéDepartment of Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Klaus F RabeDepartment of Medicine, Christian Albrechts University Kiel, Kiel and Lungen Clinic, Grosshansdorf, Germany.
Alberto PapiResearch Centre on Asthma and COPD, University of Ferrara, Ferrara, Italy.
Christopher E BrightlingInstitute for Lung Health, National Institute for Health Research Biomedical Research Centre, University of Leicester, Leicester, UK.
Dave SinghCentre for Respiratory Medicine and Allergy, University Hospital of South Manchester, University of Manchester, Manchester, UK.
Alessio PirainoGlobal Medical Affairs, Chiesi Farmaceutici S.p.A. Parma, Italy.
Ulrica Scaffidi-ArgentinaGlobal Medical Affairs, Chiesi Farmaceutici S.p.A. Parma, Italy.
Janwillem H KocksUniversity of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.
Lies LahousseDepartment of Bioanalysis, Ghent University, Ghent, Belgium; Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands.
Huib A M KerstjensDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.
Irene H HeijinkDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands; Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, the Netherlands.
Simon D PouwelsDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands; Department of Pathology & Medical Biology, University of Groningen, University Medical Center Groningen, the Netherlands.
Dirk-Jan SlebosDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.
Maarten van den BergeDepartment of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD, Groningen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with eosinophilic asthma are responsive to treatment with corticosteroids and biologics. Eosinophilia is usually identified based on blood eosinophil counts, but there is discordance between blood and sputum in some cases. A subset of patients may have sputum eosinophilia despite low blood eosinophil levels. The clinical implications of this so-called isolated sputum eosinophilia are unknown. The aim of this study is to investigate the clinical expression of asthma in patients with isolated sputum eosinophilia.

methodsIn this post-hoc ATLANTIS analysis we included patients with available blood and/or sputum data from ATLANTIS. Patients were classified according to blood eosinophils (< or ≥300 cells/μL). Patients with isolated sputum eosinophilia were compared with those with low eosinophils in both compartments.

findingsOf the 487 patients with low blood eosinophils counts, sputum samples were available in 146. Among these, 25 (17%) had isolated sputum eosinophilia. Compared with patients with low eosinophils in both compartments (n = 121), patients with isolated sputum eosinophilia had more airflow obstruction (FEV

interpretationIsolated sputum eosinophilia occurs in a subgroup of patients with asthma, in association with worse clinical outcomes. These findings suggest that airway eosinophilia may not always be captured by conventional blood biomarkers and warrant further investigation into the clinical implications of this phenotype to determine whether these patients may benefit from treatment strategies targeting type 2 inflammation, such as intensified steroids or biologics.

fundingChiesi Farmaceutici sponsored the ATLANTIS study.

Indexed as

AsthmaEosinophilsPhenotypeSputumAdultAgedBiomarkersEosinophiliaFemaleHumansLeukocyte CountMaleMiddle AgedBiomarkersAsthmaEosinophilic asthmaIsolated sputum eosinophiliaLarge and small airways disease

Identifiers

PMID42435581
PMCPMC13382052

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