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4 results on '"Pieter-Paul Hekking"'

1. Medication Adherence in Patients With Severe Asthma Prescribed Oral Corticosteroids in the U-BIOPRED Cohort

Author

P. J. Sterk, John H. Riley, Thomas Sandström, Anna Selby, Laurie Pahus, C. Auffray, Ioannis Pandis, Julie Corfield, R. Djukanovic, K. Sun, Massimo Caruso, Jørgen Vestbo, Matthew J. Loza, Andrew J. Simpson, Dominic Burg, I.M. Adcock, S. Bates, Scott Wagers, Ana R. Sousa, J. Corfield, Ariane H. Wagener, René Lutter, Barbro Dahlén, Ratko Djukanovic, G. Praticò, I. Pandis, N. Mores, G. Hedlin, Navin Rao, I. Horváth, Alexander Mazein, B. De Meulder, Richard G. Knowles, John-Olof Thörngren, Wolfgang Seibold, P H Howarth, Victoria M. Goss, Cristina Gómez, Clare S. Murray, Paul Brinkman, Ildiko Horvath, Anthony D. Postle, M. Caruso, Martina Gahlemann, M. Puig Valls, F.K. Chung, P. Montuschi, Dominick E. Shaw, Kai Sun, Aruna T. Bansal, Fahad Alahmadi, Amphun Chaiboonchoe, Graham Roberts, Kian Fan Chung, Yike Guo, H. Ahmed, Thomas Geiser, Klaus Bønnelykke, M. Miralpeix, Simone Hashimoto, Diane Lefaudeux, S.S. Wagers, D. Erzen, B. Thornton, Florian Singer, Louise Fleming, Stephen J. Fowler, Neil Fitch, P. Bakke, Craig E. Wheelock, Nadja Hawwa Vissing, Tim Higenbottam, Jamie Matthews, F. Singer, S.E. Dahlén, Sarah Masefield, Roelinde Middelveld, Jens M. Hohlfeld, Anthony V. D'Amico, Paul Skipp, W.M.C. van Aalderen, Alan J. Knox, Sven-Erik Dahlén, Andrew Bush, A.T. Bansal, Pieter-Paul Hekking, Joost Brandsma, Stewart Bates, L.J. Fleming, Norbert Krug, N. Krug, Magnus Ericsson, J. Riley, P. Powel, Jacek Musiał, Amanda Roberts, Peter J. Sterk, Ian M. Adcock, Pascal Chanez, Cecile T.J. Holweg, F. Baribaud, Stelios Pavlidis, Veit J. Erpenbeck, Z. Weiszhart, C.E. Wheelock, Ralf Sigmund, James P.R. Schofield, Alexander Manta, Andrea Meiser, Susan J. Wilson, Jeanette Bigler, G. Roberts, M. van Geest, Hans Bisgaard, Urs Frey, Michael Boedigheimer, Per Bakke, Chris Compton, Enrica Bucchioni, Paolo Montuschi, David Myles, E.H.D. Bel, Anna James, Elena Formaggio, Anthony Rowe, Dominic E. Shaw, J. Haughney, P. Chanez, A.R. Sousa, S.J. Fowler, K. Fichtner, B. Dahlèn, Publica, Commission of the European Communities, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Pulmonology, AII - Inflammatory diseases, and Paediatric Pulmonology

Subjects
Pulmonary and Respiratory Medicine, Male, medicine.medical_specialty, urinary corticosteroids, Prescription Drugs, Settore BIO/14 - FARMACOLOGIA, medicine.drug_class, [SDV]Life Sciences [q-bio], Urinary system, Respiratory System, Administration, Oral, 610 Medicine & health, Critical Care and Intensive Care Medicine, Hospital Anxiety and Depression Scale, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Interquartile range, Internal medicine, Surveys and Questionnaires, Administration, Inhalation, Medicine, Humans, 030212 general & internal medicine, adherence, Glucocorticoids, ComputingMilieux_MISCELLANEOUS, U-BIOPRED Study Group, Asthma, Dose-Response Relationship, Drug, business.industry, 1103 Clinical Sciences, Middle Aged, asthma, medicine.disease, 030228 respiratory system, Cohort, Prednisolone, Quality of Life, Corticosteroid, Female, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background: Although estimates of suboptimal adherence to oral corticosteroids in asthma range from 30% to 50%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high. Research Questions: What is the prevalence of suboptimal adherence detected by self-reporting and direct measures? Is suboptimal adherence associated with disease activity? Study Design and Methods: Data were included from individuals with severe asthma taking part in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study and prescribed daily oral corticosteroids. Participants completed the Medication Adherence Report Scale, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid chromatography-mass spectrometry. Results: Data from 166 participants were included in this study: mean (SD) age, 54.2 (± 11.9) years; FEV 1, 65.1% (± 20.5%) predicted; female, 58%; 37% completing the Medication Adherence Report Scale reported suboptimal adherence; and 43% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in 49 of the 142 (35%) of participants in whom both methods were performed; adherence detection did not match between methods in 53%. Self-reported high adherers had better asthma control and quality of life, whereas directly measured high adherers had lower blood eosinophil levels. Interpretation: Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods, suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.

Published
2021

2. Asthma similarities across ProAR (Brazil) and U-BIOPRED (Europe) adult cohorts of contrasting locations, ethnicity and socioeconomic status

Author

Ana R. Sousa, Anna Selby, Jeanette Bigler, Hans Bisgaard, J. Cunha, I.M. Adcock, A.C.C. Coelho, Ryan Santos Costa, Pieter-Paul Hekking, Louise Fleming, Kai Sun, Amphun Chaiboonchoe, C.V.N. Santana, P. Moura-Santos, Scott Wagers, Ratko Djukanovic, G.P. Pinheiro, G. Hedlin, J.V. de Jesus, Kian Fan Chung, Jacek Musiał, Thomas Geiser, F. Baribaud, Emília Maria Medeiros de Andrade Belitardo, L. Cardoso, Klaus Bønnelykke, Anthony D. Postle, P H Howarth, Adelmir Souza-Machado, Valmar Biao-Lima, Stephen J. Fowler, Craig E. Wheelock, Alvaro A. Cruz, Mauricio Lima Barreto, Maria Ilma Araujo, Massimo Caruso, Laurie Pahus, P. J. Cooper, Florian Singer, W.M.C. van Aalderen, Paulo Augusto Moreira Camargos, Wolfgang Seibold, Ildiko Horvath, René Lutter, P.C.A. Almeida, I. Pandis, Victoria M. Goss, Aruna T. Bansal, John H. Riley, M. Puig Valls, P. Powel, Amanda Roberts, Alexander Mazein, M. Miralpeix, I. Paixao-Araujo, B. De Meulder, Michael Boedigheimer, Isaac Suzart Gomes-Filho, Chris Compton, C. Auffray, Jamie Matthews, Diane Lefaudeux, Elena Formaggio, A.A. Cruz, L.M. Mello, Anthony V. D'Amico, A. Lima-Matos, J. Fernandes, P. J. Sterk, Clare S. Murray, Enrica Bucchioni, Andrea Meiser, D. Erzen, Roelinde Middelveld, M. van Geest, Jørgen Vestbo, Alan J. Knox, Graham Roberts, Norbert Krug, Stewart Bates, G. Santos-Lima, Maggie Davis, Stelios Pavlidis, Paul Skipp, Yike Guo, Ariane H. Wagener, E.V. Ponte, Jens M. Hohlfeld, A. Souza-Machado, M.A. Lessa, I.S. Muniz, C.S. Cruz, Nadja Hawwa Vissing, Neuza Maria Alcantara-Neves, Tim Higenbottam, Navin Rao, Dominic Burg, Sarah Masefield, Z. Weiszhart, Matthew J. Loza, J. Haughney, Simone Hashimoto, Per Bakke, B. Thornton, José Miguel Chatkin, Andrew Bush, SE Dahlen, Joost Brandsma, N. Mores, G. Praticò, Kathleen C. Barnes, Carolina Souza-Machado, Rafael Stelmach, V. Bião-Lima, Martina Gahlemann, Paolo Montuschi, T.M.O. Souza, V.S. Vasquez, Camila Alexandrina Figueiredo, P. Chanez, Eduardo Vieira Ponte, Neil Fitch, Anthony Rowe, Cecile T.J. Holweg, S.J. Wilson, K. Fichtner, Alexander Manta, Lidia Lins, Dominic E. Shaw, David Myles, Julie Corfield, B. Dahlén, Thomas Sandström, Peter J. Sterk, Ian M. Adcock, Ralf Sigmund, James P.R. Schofield, Urs Frey, Laura C. Rodrigues, Leila Denise Alves Ferreira Amorim, E.H.D. Bel, Anna James, R.A. Franco, Paula Cristina Andrade Almeida, Paul Brinkman, H. Ahmed, Veit J. Erpenbeck, Richard G. Knowles, National Institute for Health Research, Pulmonology, and AII - Inflammatory diseases

Subjects
Male, Cardiac & Cardiovascular Systems, BLOOD, Cross-sectional study, COUNT, Respiratory System, Ethnic group, Disease, Severity of Illness Index, Cohort Studies, 0302 clinical medicine, Quality of life, Forced Expiratory Volume, Disease management, Medicine, 030212 general & internal medicine, 610 Medicine & health, 1102 Cardiorespiratory Medicine and Haematology, Middle Aged, PREVALENCE, Europe, Phenotypes, Phenotype, INFECTIONS, Female, Life Sciences & Biomedicine, Brazil, Cohort study, Pulmonary and Respiratory Medicine, Adult, Cross sectional study, U-BIOPRED Study Groups, 03 medical and health sciences, FEV1/FVC ratio, ProAR Study Group, Humans, Socioeconomic status, Asthma, Science & Technology, business.industry, 1103 Clinical Sciences, medicine.disease, SPIROMETRY, REFERENCE VALUES, respiratory tract diseases, SEVERITY, Cross-Sectional Studies, 030228 respiratory system, Social Class, Cardiovascular System & Cardiology, Quality of Life, business, Biomarkers, Demography
Abstract

Background Asthma prevalence is 339 million globally. ‘Severe asthma’ (SA) comprises subjects with uncontrolled asthma despite proper management. Objectives To compare asthma from diverse ethnicities and environments. Methods A cross-sectional analysis of two adult cohorts, a Brazilian (ProAR) and a European (U-BIOPRED). U-BIOPRED comprised of 311 non-smoking with Severe Asthma (SAn), 110 smokers or ex-smokers with SA (SAs) and 88 mild to moderate asthmatics (MMA) while ProAR included 544 SA and 452 MMA. Although these projects were independent, there were similarities in objectives and methodology, with ProAR adopting operating procedures of U-BIOPRED. Results Among SA subjects, age, weight, proportion of former smokers and FEV1 pre-bronchodilator were similar. The proportion of SA with a positive skin prick tests (SPT) to aeroallergens, the scores of sino-nasal symptoms and quality of life were comparable. In addition, blood eosinophil counts (EOS) and the % of subjects with EOS > 300 cells/μl were not different. The Europeans with SA however, were more severe with a greater proportion of continuous oral corticosteroids (OCS), worse symptoms and more frequent exacerbations. FEV1/FVC pre- and post-bronchodilator were lower among the Europeans. The MMA cohorts were less comparable in control and treatment, but similar in the proportion of allergic rhinitis, gastroesophageal reflux disease and EOS >3%. Conclusions ProAR and U-BIOPRED cohorts, with varying severity, ethnicity and environment have similarities, which provide the basis for global external validation of asthma phenotypes. This should stimulate collaboration between asthma consortia with the aim of understanding SA, which will lead to better management.

Published
2019

3. Pathway discovery using transcriptomic profiles in adult-onset severe asthma

Author

Pieter-Paul Hekking, Matt J. Loza, Stelios Pavlidis, Bertrand de Meulder, Diane Lefaudeux, Fred Baribaud, Charles Auffray, Ariane H. Wagener, Paul Brinkman, Rene Lutter, Aruna T. Bansal, Ana R. Sousa, Steve A. Bates, Yannis Pandis, Louise J. Fleming, Dominique E. Shaw, Stephen J. Fowler, Y. Guo, Andrea Meiser, Kai Sun, Julie Corfield, Peter H. Howarth, Elisabeth H. Bel, Ian M. Adcock, Kian Fan Chung, Ratko Djukanovic, Peter J. Sterk, I.M. Adcock, H. Ahmed, C. Auffray, P. Bakke, A.T. Bansal, F. Baribaud, S. Bates, E.H. Bel, J. Bigler, H. Bisgaard, M.J. Boedigheimer, K. Bønnelykke, J. Brandsma, P. Brinkman, E. Bucchioni, D. Burg, A. Bush, M. Caruso, A. Chaiboonchoe, P. Chanez, F.K. Chung, C.H. Compton, J. Corfield, A. D'Amico, S.E. Dahlen, B. De Meulder, R. Djukanovic, V.J. Erpenbeck, D. Erzen, K. Fichtner, N. Fitch, L.J. Fleming, E. Formaggio, S.J. Fowler, U. Frey, M. Gahlemann, T. Geiser, S. Hashimoto, J. Haughney, G. Hedlin, P.W. Hekking, T. Higenbottam, J.M. Hohlfeld, C. Holweg, I. Horváth, P. Howarth, A.J. James, R. Knowles, N. Krug, D. Lefaudeux, M.J. Loza, R. Lutter, A. Manta, S. Masefield, J.G. Matthews, A. Mazein, A. Meiser, R.J.M. Middelveld, M. Miralpeix, N. Mores, C.S. Murray, J. Musial, D. Myles, L. Pahus, I. Pandis, S. Pavlidis, P. Powel, G. Praticò, M Puig Valls, N. Rao, J. Riley, A. Roberts, G. Roberts, A. Rowe, T. Sandström, W. Seibold, A. Selby, D.E. Shaw, R. Sigmund, F. Singer, P.J. Skipp, A.R. Sousa, P.J. Sterk, K. Sun, B. Thornton, W.M. van Aalderen, M. van Geest, J. Vestbo, N.H. Vissing, A.H. Wagener, S.S. Wagers, Z. Weiszhart, C.E. Wheelock, S.J. Wilson, Publica, Pulmonology, AII - Inflammatory diseases, Graduate School, AII - Amsterdam institute for Infection and Immunity, ARD - Amsterdam Reproduction and Development, Medical Research Council (MRC), and Pediatric surgery

Subjects
0301 basic medicine, Male, Allergy, Severe asthma, ILC3, mast cells, Disease, Eosinophil, Severity of Illness Index, transcriptomics, 0302 clinical medicine, Eosinophilic, Immunology and Allergy, Medicine, Age of Onset, Oligonucleotide Array Sequence Analysis, mechanisms, Innate lymphoid cell, Adult-onset asthma, eosinophils, gene set variation analysis, phenotyping, severe asthma, Middle Aged, Phenotype, Asthma Control Questionnaire, 1107 Immunology, Female, medicine.symptom, Adult, Genetic Markers, Immunology, mechanism, macromolecular substances, Lung injury, 03 medical and health sciences, Humans, adult-onset asthma, Asthma, U-BIOPRED Study Group, business.industry, Gene Expression Profiling, medicine.disease, respiratory tract diseases, 030104 developmental biology, Cross-Sectional Studies, 030228 respiratory system, Sputum, business, Transcriptome, mast cell
Abstract

Background: Adult-onset severe asthma is characterized by highly symptomatic disease despite high-intensity asthma treatments. Understanding of the underlying pathways of this heterogeneous disease is needed for the development of targeted treatments. Gene set variation analysis is a statistical technique used to identify gene profiles in heterogeneous samples. Objective: We sought to identify gene profiles associated with adult-onset severe asthma. Methods: This was a cross-sectional, observational study in which adult patients with adult-onset of asthma (defined as starting at age ≥18 years) as compared with childhood-onset severe asthma (

Published
2018

4. U-BIOPRED clinical adult asthma clusters linked to a subset of sputum -omics

Author

Hugo H. Knobel, Koos Zwinderman, Anton Vink, Laurie Pahus, Elisabeth H. Bel, Wim van Aalderenm, Massimo Caruso, Marianne A. van de Pol, Lorraine Hewitt, David Balgoma, Jilaiha Gent, Paul Skipp, Sally Meah, Grazyna Bochenek, Martina Gahlemann, Xugang Hu, Graham Roberts, Stephen J. Fowler, Aleksandra Draper, Jon R Konradsen, Craig E. Wheelock, Philips Monk, Roelinde Middelveld, Päivi Söderman, Stelios Pavlidis, João P. Carvalho da Purfição Rocha, Caroline Smith, Alan J. Knox, Doroteya Staykova, Ildiko Horvath, Nadia Mores, Christophe von Garnier, Frans Wald, Uruj Hoda, Giuseppe Santini, Anne Petrén, Thomas Sandström, Alexander Mazein, Tamara Dekker, Ana R. Sousa, Andrea Maiser, Zsoka Weiszhart, Wolfgang Seibold, Susanna Palkonnen, Johan Kolmert, Cristina Gómez, Marco Sentoninco, Nancy Peffer, Anna James, Ingrid Delin, Montse Miralpeix, Antonios Aliprantis, Annemiek Dijkhuis, Amanda Roberts, Clare S. Murray, Lara Ravanetti, Yike Guo, Jenny Versnel, Richard Hu, Saeeda Lone-Satif, Jonathan Ward, Martine Robberechts, René Lutter, Linn Krueger, Antonio Pacino, Arnaldo D'Amico, Jans Hohlfeld, Scott Wagers, Neil Fitch, Pippa Powel, Matthew J. Loza, Karin Strandberg, Damijan Erzen, H. Ahmed, Per Bakke, Neil Gozzard, David Gibeon, Arianne Wagerner, Kerry Gove, Siân Williams, Ann Berglind, Rosalia Emma, Bob Thornton, Val Hudson, Elizabeth Yeyashingham, John Haughney, Ann-Sofie Lantz, Kjell Alving, Bart N. Lambrecht, Marek Sanak, Lilla Tamasi, Nadja Hawwa Vissing, Katja Nething, Barbro Dahlén, Jacek Musiał, Pim de Boer, Marcus O.D. Sjödin, Sarah Masefield, Marleen van Geest, Maciej Kupczyk, Peter H. Howarth, Alix Berton, Peter J. Sterk, David Myles, Peter Nilsson, Emma Ray, Ian M. Adcock, Pascal Chanez, Christos Rossios, Paolo Montuschi, Inge De Lepeleire, Armin Braun, Juliette Kamphuis, Davide Campagna, Salvatore Valente, Kees van Drunen, Urs Frey, Philipp Badorek, Ralf Sigmund, Malayka Rahman-Amin, Maria Mikus, James P.R. Schofield, Simone Hashimoto, Marton Szentkereszty, Gabriella Galffy, Lisa Marouzet, Barbara Smids, L. Larsson, Louise Fleming, Corinna Schoelch, Leanne Metcalf, Ashley Woosdcock, Anthony D. Postle, Maxim Kots, Sven-Erik Dahlén, J. M. Edwards, J.C. Smith, Gunilla Hedlin, Breda Flood, Veit J. Erpenbeck, Wen Yu, Susan J. Wilson, Jeanette Bigler, Jorge De Alba, Leon Carayannopoulos, Kristiane Wetzel, Klaus Fichtner, Paul Brinkman, Cecile T.J. Holweg, David Supple, Romanas Chaleckis, Coen Wiegman, Anthony Rowe, Hans Bisgaard, Annelie F. Behndig, Joost Brandsma, Richard G. Knowles, Jorge Beleta, Scott Kuo, Katherine M. Smith, Sandy Pink, Pieter-Paul Hekking, An Bautmans, Ben Nicholas, Kathrin Riemann, Michael Rutgers, Leanne Reynolds, Adesimbo Sogbesan, Dominic Burg, Aruna T. Bansal, Ulf Nihlen, Dyson Kerry, Ioannis Pandis, Julie Corfield, Björn Nordlund, Shama Naz, Wilhelm Zetterquist, Diane Lefaudeux, Xian Yang, Clair Barber, Kirsty E. Russell, Andrew Menzies-Gow, Dominic E. Shaw, Patrick Dennison, Elisabeth Henriksson, John G. Matthews, Tim Higgenbottam, Ratko Djukanovic, Charles Auffray, Kai Sun, Amphun Chaiboonchoe, Jonathan Thorsen, Nikos Lazarinis, Samantha Walker, John-Olof Thörngren, Frédéric Baribaud, Florian Singer, Klaus Bøonnelykke, John H. Riley, Magnus Ericsson, Sile Hu, Jørgen Vestbo, Bertrand De Meulder, Kamran Tariq, Maria Gerhardsson de Verdier, Stacey N. Reinke, Navin Rao, Trevor Garret, Norbert Krug, Michael Boedigheimer, Chris Compton, Cornelia Faulenbach, Hector Gallart, Matthias Klüglich, Caroline Mathon, Giorgio Pennazza, Kian Fan Chung, Thomas Geiser, Jörgen Östling, Courtney Coleman, Erika Kennington, Nora Adriaens, Jane Martin, Medical Research Council (MRC), Commission of the European Communities, National Institute for Health Research, AII - Inflammatory diseases, Pulmonology, AII - Amsterdam institute for Infection and Immunity, Graduate School, Experimental Immunology, Ear, Nose and Throat, APH - Methodology, Epidemiology and Data Science, ARD - Amsterdam Reproduction and Development, and Publica

Subjects
0301 basic medicine, Male, Proteomics, Allergy, Severe asthma, Severity of Illness Index, Leukocyte Count, 0302 clinical medicine, Immunology and Allergy, Medicine, CLASS DISCOVERY, 610 Medicine & health, Oligonucleotide Array Sequence Analysis, COPD, EPITHELIAL-CELLS, Middle Aged, sputum eosinophilia, Phenotype, 1107 Immunology, Cohort, Female, medicine.symptom, Life Sciences & Biomedicine, Algorithms, clustering, EXPRESSION, Adult, Settore BIO/14 - FARMACOLOGIA, Immunology, PHENOTYPES, 03 medical and health sciences, INFLAMMATION, partition-around-medoids algorithm, Severity of illness, Humans, LYN, Asthma, Aged, U-BIOPRED Study Group, Science & Technology, IDENTIFICATION, business.industry, Gene Expression Profiling, Sputum, Omics, medicine.disease, respiratory tract diseases, 030104 developmental biology, 030228 respiratory system, Exhaled nitric oxide, business, Biomarkers
Abstract

BACKGROUND: Asthma is a heterogeneous disease in which there is a differential response to asthma treatments. This heterogeneity needs to be evaluated so that a personalised management approach can be provided.OBJECTIVES: We stratified patients with moderate-to-severe asthma based on clinico-physiological parameters and performed an -omics analysis of sputum.METHODS: Partition-around-medoid clustering was applied to a training set of 266 asthma participants from the European U-BIOPRED adult cohort using 8 pre-specified clinic-physiological variables. This was repeated in a separate validation set of 152 asthmatics. The clusters were compared based on sputum proteomic and transcriptomic data.RESULTS: Four reproducible and stable clusters of asthmatics were identified. The training set cluster T1 consists of well-controlled moderate-to-severe asthmatics, while cluster T2 is a group of late-onset severe asthmatics with history of smoking and chronic airflow obstruction. Cluster T3 is similar to cluster T2 in terms of chronic airflow obstruction but is composed of non-smokers. Cluster T4 is predominantly composed of obese female uncontrolled severe asthmatics with increased exacerbations, but with normal lung function. The validation set exhibited similar clusters, demonstrating reproducibility of the classification. There were significant differences in sputum proteomics and transcriptomics between the clusters. The severe asthma clusters, T2, T3 and T4, had higher sputum eosinophilia than T1 with no differences in sputum neutrophil counts, exhaled nitric oxide and serum IgE levels.CONCLUSION: Clustering based on clinico-physiological parameters yielded 4 stable and reproducible clusters that associate with different pathobiological pathways.CLINICAL IMPLICATIONS: The definition of four distinct clusters of asthma linked to different pathobiological pathways provides a better template for the phenotyping and personalised treatment of severe asthma, where high unmet needs remain.CAPSULE SUMMARY: Unsupervised clustering of asthma on clinical features alone has led to the definition of four phenotypes. Sputum 'omics' analysis has revealed different biological pathways pointing towards potential new treatments.

Published
2017

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