Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
Volume 7, Issue 2, Pages 556-+Publisher
ELSEVIER
DOI: 10.1016/j.jaip.2018.08.008
Keywords
Asthma control; Asthma phenotypes; Cluster analysis; Life quality; Sex
Categories
Funding
- Ministry of Science and Technology, Taiwan [MOST103-2314-B-037-018-MY3, MOST106-2314-B-037-023]
- Research Center for Environmental Medicine, Kaohsiung Medical University [KMU-TP104A01, KMU-TP105A05]
- Kaohsiung, Taiwan
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BACKGROUND: Asthma is a heterogeneous disease with complex mechanisms and involves many risk factors and in vivo cellular molecules. It is notable that sex differences may have a potential effect on asthma phenotype. OBJECTIVE: To identify sex-specific phenotypes and health outcomes of asthma. METHODS: We conducted the Taiwanese Adult Asthma Cohorts study to enroll female (n = 421) and male (n = 299) adult patients with stable asthma. Eight variables were selected by a factor analysis. We further performed a 2-step sensitivity cluster analysis to classify asthma clusters. The risks of asthma-related outcomes among the clusters were assessed using simple logistic regressions. RESULTS: Three different clusters were identified in males and females. In the female clusters, atopy/eosinophil-predominant (cluster 2), and obesity/neutrophil-predominant pattern (cluster 3) had more than a 2-fold risk of asthma exacerbations (odds ratio, 2.51; 95% CI, 1.12-5.59 and odds ratio, 2.22; 95% CI, 1.01-4.93). In the male clusters, current smoker/neutrophilic atopic cluster (cluster 5) and ex-smoker/eosinophil-predominant or mixed inflammatory pattern (cluster 6) also had a higher risk of asthma exacerbations. CONCLUSIONS: This study identified heterogeneous characteristics between sexes. In females, the analysis showed atopy with eosinophil-predominant and obese with neutrophil-predominant inflammation. Two distinct asthma phenotypes were found in current and ex-smokers in males. Understanding asthma phenotypes and explaining the potentially biological pathways have become important. (C) 2018 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology
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