Background

There is increasing recognition of marked phenotypic heterogeneity within severe asthma patients.

Methods

Severe asthma patients on GINA step 4 or 5 treatment, followed up at Al-Rashed Allergy center Kuwait, were evaluated for: demographics (gender, age, age of asthma onset), comorbidities (allergic rhinitis (AR), chronic rhinosinusitis (CRS), chronic rhinosinusitis with nasal polyposis (CRSwNP), obesity), blood biomarkers (total serum Immunoglobulin E (IgE), peripheral eosinophils), and sensitization to inhalants allergens.

Results

A total of 169 patients were candidates for biological treatment. Patients were divided in two groups based on level of total IgE as a “low” group with IgE<160 IU/ml (n = 55) and “high” group with IgE≥ 160 IU/ml (n = 114). Both groups were further divided in subgroups, “low” and “high”, based on absolute number of eosinophils (Eos) in peripheral blood with <300 cells/μl or ≥ 300 cells/μl. Only 10% of patients were in low IgE/low Eos while majority (46%) were in the high IgE/high Eos group. Mean age of patients was 44.1 year with domination of females (n = 123). Majority of patients were obese. AR, CRS and CRSwNP were more common in group with IgE ≥160 IU/ml, while CRS and CRSwNP in group with Eos ≥300 cells/μl.

Conclusion

The majority of severe asthma patients in Kuwait are obese females with adult-onset asthma (>18 years of age) who were allergic with comorbid conditions including AR, CRS and CRSwNP, which correlates well with the level of Eos.

中文翻译：

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科威特人群中的严重哮喘：基于表型的方法

背景

人们越来越认识到严重哮喘患者的显着表型异质性。

方法

接受 GINA 步骤 4 或 5 治疗的重度哮喘患者在科威特 Al-Rashed 过敏中心进行随访，评估以下方面：人口统计学（性别、年龄、哮喘发作年龄）、合并症（过敏性鼻炎 (AR)、慢性鼻窦炎 (CRS) 、慢性鼻窦炎伴鼻息肉 (CRSwNP)、肥胖）、血液生物标志物（总血清免疫球蛋白 E (IgE)、外周嗜酸性粒细胞）和对吸入剂过敏原的敏感性。

结果

共有169名患者是生物治疗的候选人。根据总 IgE 水平将患者分为两组，即 IgE<160 IU/ml (n = 55) 的“低”组和 IgE ≥ 160 IU/ml 的“高”组 (n = 114)。根据外周血中嗜酸性粒细胞 (Eos) <300 细胞/μl 或 ≥ 300 细胞/μl 的绝对数量，将两组进一步分为“低”和“高”亚组。只有 10% 的患者处于低 IgE/低 Eos，而大多数 (46%) 处于高 IgE/高 Eos 组。患者的平均年龄为 44.1 岁，女性占主导地位 (n = 123)。大多数患者肥胖。AR、CRS和CRSwNP在IgE≥160 IU/ml组更常见，而CRS和CRSwNP在Eos≥300细胞/μl组更常见。

结论

科威特的大多数重度哮喘患者是患有成人哮喘（>18 岁）的肥胖女性，她们对包括 AR、CRS 和 CRSwNP 在内的合并症过敏，这与 Eos 水平密切相关。