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Asthma–COPD Overlap. Clinical Relevance of Genomic Signatures of Type 2 Inflammation in Chronic Obstructive Pulmonary Disease
Open accessAbstract
RATIONALE: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease and likely includes a subgroup that is biologically comparable to asthma. Studying asthma-associated gene expression changes in COPD could add insight into COPD pathogenesis and reveal biomarkers that predict a favorable response to corticosteroids. OBJECTIVES: To determine whether asthma-associated gene signatures are increased in COPD and associated with asthma-related features. METHODS: We compared disease-associated airway epithelial gene expression alterations in an asthma cohort (n = 105) and two COPD cohorts (n = 237, 171). The T helper type 2 (Th2) signature (T2S) score, a gene expression metric induced in Th2-high asthma, was evaluated in these COPD cohorts. The T2S score was correlated with asthma-related features and response to corticosteroids in COPD in a randomized, placebo-controlled trial, the Groningen and Leiden Universities study of Corticosteroids in Obstructive Lung Disease (GLUCOLD; n = 89). MEASUREMENTS AND MAIN RESULTS: The 200 genes most differentially expressed in asthma versus healthy control subjects were enriched among genes associated with more severe airflow obstruction in these COPD cohorts (P < 0.001), suggesting significant gene expression overlap. A higher T2S score was associated with decreased lung function (P < 0.001), but not asthma history, in both COPD cohorts. Higher T2S scores correlated with increased airway wall eosinophil counts (P = 0.003), blood eosinophil percentage (P = 0.03), bronchodilator reversibility (P = 0.01), and improvement in hyperinflation after corticosteroid treatment (P = 0.019) in GLUCOLD. CONCLUSIONS: These data identify airway gene expression alterations that can co-occur in asthma and COPD. The association of the T2S score with increased severity and "asthma-like" features (including a favorable corticosteroid response) in COPD suggests that Th2 inflammation is important in a COPD subset that cannot be identified by clinical history of asthma.
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What is asthma−COPD overlap syndrome? Towards a consensus definition from a round table discussion
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Agache, I., & Akdis, C. A. (2019) · Journal of Clinical Investigation · doi:10.1172/jci124611 · Cited by 313
Strategies targeting the IL-4/IL-13 axes in disease
May, R. D., & Fung, M. (2015) · Cytokine · doi:10.1016/j.cyto.2015.05.018 · Cited by 166
Singh, D., Bassi, M., Balzano, D., Lucci, G., Emirova, A., Anna Nandeuil, M., Jellema, G., Afolabi, E. K., Leaker, B., Kornmann, O., et al. (2021) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.16146 · Cited by 20
Metadata
- Authors
- Christenson, S. A., Steiling, K., van den Berge, M., Hijazi, K., Hiemstra, P. S., Postma, D. S., Lenburg, M. E., Spira, A., & Woodruff, P. G.
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-04-01
- Volume
- 191
- Issue
- 7
- Pages
- 758-766
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2155112552
- Cited by
- 329
- References
- 32
- FWCI
- 28.78
- Type
- journal article
- Language
- en
- Open access
- green
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- Christenson, S. A., Steiling, K., van den Berge, M., Hijazi, K., Hiemstra, P. S., Postma, D. S., Lenburg, M. E., Spira, A., & Woodruff, P. G. (2015). Asthma–COPD Overlap. Clinical Relevance of Genomic Signatures of Type 2 Inflammation in Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine. https://doi.org/10.1164/rccm.201408-1458oc
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