Source: International Congress 2014 – New mechanisms in the pathogenesis of asthma and other lung diseases
Disease area: Airway diseases

Abstract

BackgroundRecently we have reported that bronchial submucosal, but not sputum, eosinophils are increased in obese severe asthmatics (1). However, the relationship between obesity and other markers of eosinophilic inflammation remains unclear.AimExplore the association in asthma between BMI and markers of eosinophilic inflammation.MethodsPatients with moderate-to-severe persistent asthma and sputum eosinophilia (>2%) underwent sputum, airway tissue and blood sampling in addition to exhaled nitric oxide measurement. Subjects had not participated in our earlier report (1). Sputum was analysed for eosinophil percentage and bronchial biopsies were analysed for eosinophilic inflammation expressed as cells/mm² of submucosa and of epithelium. Blood was tested for IgE, eosinophil count and eosinophilic cationic protein levels.Results61 patients were recruited with 34 undergoing endobronchial sampling. BMI was strongly correlated with submucosal eosinophils (r_s=0.559, p=0.001) but neither with epithelial eosinophils nor with other blood or sputum eosinophilic markers. There was significant difference in submucosal eosinophils between groups of lean, overweight, obese and morbidly obese patients (p=0.009). Using multiple regression to control for the effect of corticosteroid use, BMI was a strong predictor of submucosal eosinophilia (R² change=0.349) (p=0.0001).ConclusionThis study confirms that in moderate-to-severe asthma, BMI is associated with submucosal, but not with epithelial, sputum or blood eosinophilic markers. This relationship is not explained by the effect of corticosteroid use.Ref: (1) Desai et al, AJRCCM, 2013; 188(6):657-63Acknowledgements: Work funded by Novartis Pharmaceuticals.

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R. Berair, V. Mistry, A. Singapuri, S. Gonem, C. Newby, S. Siddiqui, R. Kay, C. Brightling (Leicester, United Kingdom; Basel, Switzerland). Association between body mass index (BMI) and markers of eosinophilic inflammation in asthma. Eur Respir J 2014; 44: Suppl. 58, 3870

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