严重嗜酸性粒细胞性哮喘或嗜酸性粒细胞性肉芽肿伴多发性咽炎：新型诊断策略的潜在生物标记物。

IF 8.2 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2024-11-01 DOI:10.1016/j.jaip.2024.08.011

Manuela Latorre MD, PhD , Veronica Seccia MD, PhD , Ilaria Puxeddu MD, PhD , Francesco Pisani MD , Erica Statuti MD , Lodovica Cristofani-Mencacci MD , Alessandro Celi MD, PhD , Silvana Cianchetti MD , Cristina Cardini MD , Eleonora Di Carluccio MD , Francesco Ferro MD, PhD , Pierluigi Paggiaro MD, PhD , Chiara Baldini MD, PhD

{"title":"严重嗜酸性粒细胞性哮喘或嗜酸性粒细胞性肉芽肿伴多发性咽炎：新型诊断策略的潜在生物标记物。","authors":"Manuela Latorre MD, PhD , Veronica Seccia MD, PhD , Ilaria Puxeddu MD, PhD , Francesco Pisani MD , Erica Statuti MD , Lodovica Cristofani-Mencacci MD , Alessandro Celi MD, PhD , Silvana Cianchetti MD , Cristina Cardini MD , Eleonora Di Carluccio MD , Francesco Ferro MD, PhD , Pierluigi Paggiaro MD, PhD , Chiara Baldini MD, PhD","doi":"10.1016/j.jaip.2024.08.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Severe eosinophilic asthma (SEA) may be the prodromal phase of eosinophilic granulomatosis with polyangiitis (EGPA). Nevertheless, few studies have tried to recognize EGPA in the early stages of the disease.</div></div><div><h3>Objective</h3><div>To identify a panel of clinical and biological markers to detect which severe asthmatic patient might be considered in a prodromal phase of EGPA and crafting a strategy for diagnostic decision-making.</div></div><div><h3>Methods</h3><div>A total of 30 patients with EGPA and 49 with SEA were enrolled. A complete pulmonary, ear, nose, and throat, and rheumatologic assessment were made. Blood (eosinophil count, eosinophilic cationic protein, IL-5, IL-4, total-IgE, IgG<sub>4</sub>, and antineutrophil cytoplasmic antibody), sputum (eosinophils count, periostin, IL-8, and granulocyte-monocyte colony-stimulating factor [GM-CSF]), and nasal smear (eosinophilia) biomarkers were assessed. Asthma Control Test, Short Form-36, SinoNasalOutcome Test-22, and Asthma Quality of Life Questionnaire were also used.</div></div><div><h3>Results</h3><div>Patients with SEA had poorer asthma control (<em>P</em> < .001) and a higher level of sputum eosinophils (<em>P</em> < .002), whereas patients with EGPA reported higher levels of blood eosinophils in the past. Sputum GM-CSF was the only biomarker significantly increased in patients with EGPA compared with those with SEA (<em>P</em> < .0001). Among patients with SEA, those with some suggestive but not diagnostic criteria of EGPA, particularly tissue eosinophilic infiltrates, presented higher levels of sputum GM-CSF (<em>P</em> < .0005), blood, and sputum eosinophils (<em>P</em> < .0006 and <em>P</em> < .011) than the other patients.</div></div><div><h3>Conclusion</h3><div>Sputum GM-CSF and eosinophils might be useful biomarkers to support early diagnosis and treatment choices in patients with SEA, suspected of having EGPA.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"12 11","pages":"Pages 3057-3067"},"PeriodicalIF":8.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severe Eosinophilic Asthma or Eosinophilic Granulomatosis With Polyangiitis: Potential Biomarkers for Novel Diagnostic Strategies\",\"authors\":\"Manuela Latorre MD, PhD , Veronica Seccia MD, PhD , Ilaria Puxeddu MD, PhD , Francesco Pisani MD , Erica Statuti MD , Lodovica Cristofani-Mencacci MD , Alessandro Celi MD, PhD , Silvana Cianchetti MD , Cristina Cardini MD , Eleonora Di Carluccio MD , Francesco Ferro MD, PhD , Pierluigi Paggiaro MD, PhD , Chiara Baldini MD, PhD\",\"doi\":\"10.1016/j.jaip.2024.08.011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Severe eosinophilic asthma (SEA) may be the prodromal phase of eosinophilic granulomatosis with polyangiitis (EGPA). Nevertheless, few studies have tried to recognize EGPA in the early stages of the disease.</div></div><div><h3>Objective</h3><div>To identify a panel of clinical and biological markers to detect which severe asthmatic patient might be considered in a prodromal phase of EGPA and crafting a strategy for diagnostic decision-making.</div></div><div><h3>Methods</h3><div>A total of 30 patients with EGPA and 49 with SEA were enrolled. A complete pulmonary, ear, nose, and throat, and rheumatologic assessment were made. Blood (eosinophil count, eosinophilic cationic protein, IL-5, IL-4, total-IgE, IgG<sub>4</sub>, and antineutrophil cytoplasmic antibody), sputum (eosinophils count, periostin, IL-8, and granulocyte-monocyte colony-stimulating factor [GM-CSF]), and nasal smear (eosinophilia) biomarkers were assessed. Asthma Control Test, Short Form-36, SinoNasalOutcome Test-22, and Asthma Quality of Life Questionnaire were also used.</div></div><div><h3>Results</h3><div>Patients with SEA had poorer asthma control (<em>P</em> < .001) and a higher level of sputum eosinophils (<em>P</em> < .002), whereas patients with EGPA reported higher levels of blood eosinophils in the past. Sputum GM-CSF was the only biomarker significantly increased in patients with EGPA compared with those with SEA (<em>P</em> < .0001). Among patients with SEA, those with some suggestive but not diagnostic criteria of EGPA, particularly tissue eosinophilic infiltrates, presented higher levels of sputum GM-CSF (<em>P</em> < .0005), blood, and sputum eosinophils (<em>P</em> < .0006 and <em>P</em> < .011) than the other patients.</div></div><div><h3>Conclusion</h3><div>Sputum GM-CSF and eosinophils might be useful biomarkers to support early diagnosis and treatment choices in patients with SEA, suspected of having EGPA.</div></div>\",\"PeriodicalId\":51323,\"journal\":{\"name\":\"Journal of Allergy and Clinical Immunology-In Practice\",\"volume\":\"12 11\",\"pages\":\"Pages 3057-3067\"},\"PeriodicalIF\":8.2000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Allergy and Clinical Immunology-In Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2213219824008274\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ALLERGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Allergy and Clinical Immunology-In Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2213219824008274","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ALLERGY","Score":null,"Total":0}

引用次数: 0

摘要

背景：严重嗜酸性粒细胞性哮喘（SEA严重嗜酸性粒细胞性哮喘（SEA）可能是嗜酸性粒细胞性多血管炎（EGPA）的前驱期。然而，很少有研究试图在疾病的早期阶段识别 EGPA：确定一组临床和生物标记物，以检测哪些重症哮喘患者可能被认为处于 EGPA 的前驱期，并制定诊断决策策略。方法：30 名 EGPA 患者和 49 名 SEA 患者接受了全面的肺部、耳鼻喉（ENT）和风湿病学评估。对血液（嗜酸性粒细胞计数、嗜酸性粒细胞阳离子蛋白-ECP、IL5、IL4、总 IgE、IgG4、抗中性粒细胞胞浆抗体 (ANCA)）、痰液（嗜酸性粒细胞计数、骨膜蛋白、IL8 和 GMCSF）和鼻涂片（嗜酸性粒细胞增多）生物标记物进行了评估。此外，还使用了哮喘控制测试、短表格-36、SinoNasalOutcome Test-22 和哮喘生活质量问卷：结果：SEA 患者的哮喘控制能力较差（pConclusion：痰GMCSF和嗜酸性粒细胞可能是有用的生物标志物，有助于对疑似EGPA的SEA患者进行早期诊断和治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Severe Eosinophilic Asthma or Eosinophilic Granulomatosis With Polyangiitis: Potential Biomarkers for Novel Diagnostic Strategies

Background

Severe eosinophilic asthma (SEA) may be the prodromal phase of eosinophilic granulomatosis with polyangiitis (EGPA). Nevertheless, few studies have tried to recognize EGPA in the early stages of the disease.

Objective

To identify a panel of clinical and biological markers to detect which severe asthmatic patient might be considered in a prodromal phase of EGPA and crafting a strategy for diagnostic decision-making.

Methods

A total of 30 patients with EGPA and 49 with SEA were enrolled. A complete pulmonary, ear, nose, and throat, and rheumatologic assessment were made. Blood (eosinophil count, eosinophilic cationic protein, IL-5, IL-4, total-IgE, IgG₄, and antineutrophil cytoplasmic antibody), sputum (eosinophils count, periostin, IL-8, and granulocyte-monocyte colony-stimulating factor [GM-CSF]), and nasal smear (eosinophilia) biomarkers were assessed. Asthma Control Test, Short Form-36, SinoNasalOutcome Test-22, and Asthma Quality of Life Questionnaire were also used.

Results

Patients with SEA had poorer asthma control (P < .001) and a higher level of sputum eosinophils (P < .002), whereas patients with EGPA reported higher levels of blood eosinophils in the past. Sputum GM-CSF was the only biomarker significantly increased in patients with EGPA compared with those with SEA (P < .0001). Among patients with SEA, those with some suggestive but not diagnostic criteria of EGPA, particularly tissue eosinophilic infiltrates, presented higher levels of sputum GM-CSF (P < .0005), blood, and sputum eosinophils (P < .0006 and P < .011) than the other patients.

Conclusion

Sputum GM-CSF and eosinophils might be useful biomarkers to support early diagnosis and treatment choices in patients with SEA, suspected of having EGPA.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.