Race is associated with differences in airway inflammation in patients with asthma

被引：43

作者：

Nyenhuis, Sharmilee M. ^{[1
,2
]}

Krishnan, Jerry A. ^{[1
,2
]}

Berry, Alalia ^{[3
]}

Calhoun, William J. ^{[4
]}

Chinchilli, Vernon M. ^{[5
]}

Engle, Linda ^{[5
]}

Grossman, Nicole ^{[6
]}

Holguin, Fernando ^{[7
]}

Israel, Elliot ^{[6
]}

Kittles, Rick A. ^{[8
]}

Kraft, Monica ^{[8
]}

Lazarus, Stephen C. ^{[9
]}

Lehman, Erik B. ^{[5
]}

Mauger, David T. ^{[5
]}

Moy, James N. ^{[10
]}

Peters, Stephen P. ^{[11
]}

Phipatanakul, Wanda ^{[12
]}

Smith, Lewis J. ^{[13
]}

Sumino, Kaharu ^{[14
]}

Szefler, Stanley J. ^{[15
]}

Wechsler, Michael E. ^{[6
,16
]}

Wenzel, Sally ^{[7
]}

White, Steven R. ^{[17
]}

Ackerman, Steven J. ^{[1
]}

机构：

[1] Univ Illinois, Dept Med, Chicago, IL USA

[2] Univ Illinois Hosp & Hlth Sci Syst, Chicago, IL USA

[3] Univ Wisconsin, Dept Med, Div Allergy Pulm & Crit Care, Sch Med & Publ Hlth, Madison, WI USA

[4] Univ Texas Med Branch, Dept Internal Med, Div Pulm Crit Care & Sleep Med, Galveston, TX 77555 USA

[5] Penn State Univ, Dept Publ Hlth Sci, Hershey, PA USA

[6] Brigham & Womens Hosp, Dept Med, Pulm & Crit Care Med, 75 Francis St, Boston, MA 02115 USA

[7] Univ Pittsburgh, Sch Med, Dept Med, Div Pulm Allergy & Crit Care Med, Pittsburgh, PA 15213 USA

[8] Univ Arizona, Coll Med, Tucson, AZ USA

[9] Univ Calif San Francisco, Dept Med, Div Pulm & Crit Care, San Francisco, CA USA

[10] John H Stroger Jr Hosp Cook Cty, Chicago, IL USA

[11] Wake Forest Sch Med, Dept Med, Div Pulm Crit Care Allergy & Immunol Dis, Winston Salem, NC USA

[12] Boston Childrens Hosp, Dept Pediat, Div Allergy & Immunol, Boston, MA USA

[13] Northwestern Univ, Dept Med, Div Pulm & Crit Care, Chicago, IL USA

[14] Washington Univ, Sch Med, Dept Med, Div Pulm & Crit Care Med, St Louis, MO 63110 USA

[15] Childrens Hosp Colorado, Dept Pediat, Div Pulm Med, Aurora, CO USA

[16] Natl Jewish Hlth, Dept Med, Div Pulm Crit Care & Sleep Med, Denver, CO USA

[17] Univ Chicago, Dept Med, Div Pulm Crit Care, 5841 S Maryland Ave, Chicago, IL 60637 USA

来源：

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY | 2017年 / 140卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Asthma; race; eosinophil; airway inflammation; African American; body mass index; corticosteroid; induced sputum; clinical trial; GLUCOCORTICOID-RECEPTOR-BETA; RANDOMIZED CONTROLLED-TRIAL; CLINICAL-RESEARCH NETWORK; BODY-MASS INDEX; INDUCED SPUTUM; INHALED CORTICOSTEROIDS; PERSISTENT ASTHMA; EOSINOPHILIC INFLAMMATION; TIOTROPIUM BROMIDE; RACIAL DISPARITIES;

D O I：

10.1016/j.jaci.2016.10.024

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). Methods: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (>= 2%) or noneosinophilic (<2%) inflammatory phenotype. Results: Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P <.01), greater total IgE levels (197 vs 120 IU/mL, P <.01), and a greater proportion with uncontrolled asthma (43% vs 28%, P <.01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS- group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P = .28; ICS- group: 39% vs 35%, P = .65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P = .046) but not in the ICS- group (P = .984). Conclusion: African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.

引用

页码：257 / +

页数：20

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