Race is associated with differences in airway inflammation in patients with asthma

Sharmilee M. Nyenhuis, Jerry A. Krishnan, Alalia Berry, William Calhoun, Vernon M. Chinchilli, Linda Engle, Nicole Grossman, Fernando Holguin, Elliot Israel, Rick A. Kittles, Monica Kraft, Stephen C. Lazarus, Erik B. Lehman, David T. Mauger, James N. Moy, Stephen P. Peters, Wanda Phipatanakul, Lewis J. Smith, Kaharu Sumino, Stanley J. SzeflerMichael E. Wechsler, Sally Wenzel, Steven R. White, Steven J. Ackerman

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). Methods: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (≥2%) or noneosinophilic (<2%) inflammatory phenotype. Results: Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P < .01), greater total IgE levels (197 vs 120 IU/mL, P < .01), and a greater proportion with uncontrolled asthma (43% vs 28%, P < .01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS- group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P = .28; ICS- group: 39% vs 35%, P = .65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P = .046) but not in the ICS- group (P = .984). Conclusion: African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
DOIs
StateAccepted/In press - Nov 3 2015

Fingerprint

African Americans
Asthma
Inflammation
Sputum
Phenotype
National Heart, Lung, and Blood Institute (U.S.)
Eosinophils
Immunoglobulin E
Cell Biology
Adrenal Cortex Hormones
Odds Ratio
Demography
Clinical Trials
Research

Keywords

  • African American
  • Airway inflammation
  • Asthma
  • Body mass index
  • Clinical trial
  • Corticosteroid
  • Eosinophil
  • Induced sputum
  • Race

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Nyenhuis, S. M., Krishnan, J. A., Berry, A., Calhoun, W., Chinchilli, V. M., Engle, L., ... Ackerman, S. J. (Accepted/In press). Race is associated with differences in airway inflammation in patients with asthma. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2016.10.024

Race is associated with differences in airway inflammation in patients with asthma. / Nyenhuis, Sharmilee M.; Krishnan, Jerry A.; Berry, Alalia; Calhoun, William; Chinchilli, Vernon M.; Engle, Linda; Grossman, Nicole; Holguin, Fernando; Israel, Elliot; Kittles, Rick A.; Kraft, Monica; Lazarus, Stephen C.; Lehman, Erik B.; Mauger, David T.; Moy, James N.; Peters, Stephen P.; Phipatanakul, Wanda; Smith, Lewis J.; Sumino, Kaharu; Szefler, Stanley J.; Wechsler, Michael E.; Wenzel, Sally; White, Steven R.; Ackerman, Steven J.

In: Journal of Allergy and Clinical Immunology, 03.11.2015.

Research output: Contribution to journalArticle

Nyenhuis, SM, Krishnan, JA, Berry, A, Calhoun, W, Chinchilli, VM, Engle, L, Grossman, N, Holguin, F, Israel, E, Kittles, RA, Kraft, M, Lazarus, SC, Lehman, EB, Mauger, DT, Moy, JN, Peters, SP, Phipatanakul, W, Smith, LJ, Sumino, K, Szefler, SJ, Wechsler, ME, Wenzel, S, White, SR & Ackerman, SJ 2015, 'Race is associated with differences in airway inflammation in patients with asthma', Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2016.10.024
Nyenhuis, Sharmilee M. ; Krishnan, Jerry A. ; Berry, Alalia ; Calhoun, William ; Chinchilli, Vernon M. ; Engle, Linda ; Grossman, Nicole ; Holguin, Fernando ; Israel, Elliot ; Kittles, Rick A. ; Kraft, Monica ; Lazarus, Stephen C. ; Lehman, Erik B. ; Mauger, David T. ; Moy, James N. ; Peters, Stephen P. ; Phipatanakul, Wanda ; Smith, Lewis J. ; Sumino, Kaharu ; Szefler, Stanley J. ; Wechsler, Michael E. ; Wenzel, Sally ; White, Steven R. ; Ackerman, Steven J. / Race is associated with differences in airway inflammation in patients with asthma. In: Journal of Allergy and Clinical Immunology. 2015.
@article{5108c961bcd54b858816a8916e74f8d2,
title = "Race is associated with differences in airway inflammation in patients with asthma",
abstract = "Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). Methods: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2{\%} cut point to define subjects with either an eosinophilic (≥2{\%}) or noneosinophilic (<2{\%}) inflammatory phenotype. Results: Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80{\%} vs 85{\%}, P < .01), greater total IgE levels (197 vs 120 IU/mL, P < .01), and a greater proportion with uncontrolled asthma (43{\%} vs 28{\%}, P < .01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS- group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19{\%} vs 16{\%}, P = .28; ICS- group: 39{\%} vs 35{\%}, P = .65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95{\%} CI, 1.01-2.48; P = .046) but not in the ICS- group (P = .984). Conclusion: African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.",
keywords = "African American, Airway inflammation, Asthma, Body mass index, Clinical trial, Corticosteroid, Eosinophil, Induced sputum, Race",
author = "Nyenhuis, {Sharmilee M.} and Krishnan, {Jerry A.} and Alalia Berry and William Calhoun and Chinchilli, {Vernon M.} and Linda Engle and Nicole Grossman and Fernando Holguin and Elliot Israel and Kittles, {Rick A.} and Monica Kraft and Lazarus, {Stephen C.} and Lehman, {Erik B.} and Mauger, {David T.} and Moy, {James N.} and Peters, {Stephen P.} and Wanda Phipatanakul and Smith, {Lewis J.} and Kaharu Sumino and Szefler, {Stanley J.} and Wechsler, {Michael E.} and Sally Wenzel and White, {Steven R.} and Ackerman, {Steven J.}",
year = "2015",
month = "11",
day = "3",
doi = "10.1016/j.jaci.2016.10.024",
language = "English (US)",
journal = "Journal of Allergy and Clinical Immunology",
issn = "0091-6749",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Race is associated with differences in airway inflammation in patients with asthma

AU - Nyenhuis, Sharmilee M.

AU - Krishnan, Jerry A.

AU - Berry, Alalia

AU - Calhoun, William

AU - Chinchilli, Vernon M.

AU - Engle, Linda

AU - Grossman, Nicole

AU - Holguin, Fernando

AU - Israel, Elliot

AU - Kittles, Rick A.

AU - Kraft, Monica

AU - Lazarus, Stephen C.

AU - Lehman, Erik B.

AU - Mauger, David T.

AU - Moy, James N.

AU - Peters, Stephen P.

AU - Phipatanakul, Wanda

AU - Smith, Lewis J.

AU - Sumino, Kaharu

AU - Szefler, Stanley J.

AU - Wechsler, Michael E.

AU - Wenzel, Sally

AU - White, Steven R.

AU - Ackerman, Steven J.

PY - 2015/11/3

Y1 - 2015/11/3

N2 - Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). Methods: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (≥2%) or noneosinophilic (<2%) inflammatory phenotype. Results: Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P < .01), greater total IgE levels (197 vs 120 IU/mL, P < .01), and a greater proportion with uncontrolled asthma (43% vs 28%, P < .01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS- group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P = .28; ICS- group: 39% vs 35%, P = .65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P = .046) but not in the ICS- group (P = .984). Conclusion: African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.

AB - Background: African American subjects have a greater burden from asthma compared with white subjects. Whether the pattern of airway inflammation differs between African American and white subjects is unclear. Objective: We sought to compare sputum airway inflammatory phenotypes of African American and white subjects treated or not with inhaled corticosteroids (ICSs; ICS+ and ICS-, respectively). Methods: We performed a secondary analysis of self-identified African American and white subjects with asthma enrolled in clinical trials conducted by the National Heart, Lung, and Blood Institute-sponsored Asthma Clinical Research Network and AsthmaNet. Demographics, clinical characteristics, and sputum cytology after sputum induction were examined. We used a sputum eosinophil 2% cut point to define subjects with either an eosinophilic (≥2%) or noneosinophilic (<2%) inflammatory phenotype. Results: Among 1018 participants, African American subjects (n = 264) had a lower FEV1 percent predicted (80% vs 85%, P < .01), greater total IgE levels (197 vs 120 IU/mL, P < .01), and a greater proportion with uncontrolled asthma (43% vs 28%, P < .01) compared with white subjects (n = 754). There were 922 subjects in the ICS+ group (248 African American and 674 white subjects) and 298 subjects in the ICS- group (49 African American and 249 white subjects). Eosinophilic airway inflammation was not significantly different between African American and white subjects in either group (percentage with eosinophilic phenotype: ICS+ group: 19% vs 16%, P = .28; ICS- group: 39% vs 35%, P = .65; respectively). However, when adjusted for confounding factors, African American subjects were more likely to exhibit eosinophilic airway inflammation than white subjects in the ICS+ group (odds ratio, 1.58; 95% CI, 1.01-2.48; P = .046) but not in the ICS- group (P = .984). Conclusion: African American subjects exhibit greater eosinophilic airway inflammation, which might explain the greater asthma burden in this population.

KW - African American

KW - Airway inflammation

KW - Asthma

KW - Body mass index

KW - Clinical trial

KW - Corticosteroid

KW - Eosinophil

KW - Induced sputum

KW - Race

UR - http://www.scopus.com/inward/record.url?scp=85008618902&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008618902&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2016.10.024

DO - 10.1016/j.jaci.2016.10.024

M3 - Article

C2 - 28069248

AN - SCOPUS:85008618902

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

SN - 0091-6749

ER -