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. 2021 Nov 12;21(1):364.
doi: 10.1186/s12890-021-01722-0.

Distribution of inflammatory phenotypes among patients with asthma in Jilin Province, China: a cross-sectional study

Bingqing Shi  1 , Wei Li  1 , Hongna Dong  1 , Mengting Xu  1 , Yuqiu Hao  2 , Peng Gao  3
Affiliations

Distribution of inflammatory phenotypes among patients with asthma in Jilin Province, China: a cross-sectional study

Bingqing Shi et al. BMC Pulm Med. .

Abstract

Background: The inflammatory phenotypes of asthma predict the treatment response and prognosis. The phenotype distributions differ depending on the geographical region. This study aimed to assess the distribution of different inflammatory phenotypes among asthma patients in Jilin Province, China.

Methods: A total of 255 patients with asthma were recruited from Jilin Province, China for this cross-sectional study. Each patient underwent sputum induction following clinical assessment and peripheral blood collection. Inflammatory phenotypes were classified according to the inflammatory cell counts in the sputum.

Results: Paucigranulocytic asthma (PGA) was the most common inflammatory phenotype (52.2%), followed by eosinophilic asthma (EA, 38.3%), mixed granulocytic asthma (MGA, 5.2%), and neutrophilic asthma (NA, 4.3%). NA was more common among patients over 45 years old and those who were treated with higher doses of inhaled corticosteroids (ICS), but was less common following antibiotics treatment (p < 0.05). The proportion of patients with EA decreased as the ICS treatment dose and time increased (p = 0.038). Patients with uncontrolled asthma had higher numbers of sputum eosinophils and neutrophils (p < 0.05). Patients with severe asthma had a higher percentage of sputum neutrophils (p < 0.05). A greater proportion of patients with NA had severe asthma (60%) compared to those with EA (18.2%) (p = 0.016).

Conclusions: The most common asthma inflammatory cell phenotype in Jilin Province, China is PGA, followed by EA, MGA, and NA. The low prevalence of NA in Jilin Province compared to other countries and also other regions in China might be due to excessive antibiotic use and irregular ICS treatment in this region.

Keywords: Asthma; Induced sputum; Inflammatory cell phenotypes; Severe asthma; Uncontrolled asthma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The distribution of four inflammatory phenotypes among patients with asthma and different subgroups. (a) The distribution of asthma inflammatory phenotype in all subjects. (b) Distribution characteristics of the inflammatory phenotype of asthma in different groups divided by age group, BMI classification, and smoking history. BMI, body mass index; NA, neutrophilic asthma; EA, eosinophilic asthma; PGA, paucigranulocytic asthma; MGA, mixed granulocytic asthma; ICS, inhaled corticosteroid
Fig. 2
Fig. 2
Changes in the proportions of four asthma phenotypes in different asthma treatment groups. NA, neutrophilic asthma; EA, eosinophilic asthma; PGA, paucigranulocytic asthma; MGA, mixed granulocytic asthma; ICS, inhaled corticosteroid
See this image and copyright information in PMC

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