Examination of the relationship between endotype and exacerbation in severe asthma

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17206
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53030:Respiratory medicine-related
• Research Institution: Hokkaido University
• Principal Investigator: Kimura Hirokazu 北海道大学, 大学病院, 助教 (90789330)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 重症喘息 / 増悪 / エンドタイプ / バイオマーカー

Outline of Final Research Achievements

Various analyzes were performed using data from a prospective 6-year refractory asthma cohort study, including smokers. In particular, we focused on the relationship between the endotype, which is a phenotype of cytokines in blood, sputum, and urine, and the situation of exacerbation, but no significant results have been obtained so far. We would like to continue the analysis in the future.
On the other hand, it was shown that when the three items of high peripheral blood eosinophil count, high exhaled nitric oxide level, which is reflecting eosinophil airway inflammation, and positive atopic status were all present, the exacerbation occurred frequently. Regarding nitric oxide in exhaled breath, the period until the first exacerbation was short when the fluctuation was large.

Free Research Field

呼吸器内科

Academic Significance and Societal Importance of the Research Achievements

本研究では喫煙者を含む集団を対象として、より実臨床を反映している質の高いコホート研究である。吸入ステロイド薬の普及により、多くの喘息患者のコントロールは良くなったが、治療が難しい「難治性喘息」の患者をどのように診療するかは、今なお多くの問題が残っている。
難治性喘息患者の中でも、増悪を繰り返しやすい群が存在することがわかってきた。本研究結果からは、この対象を早期に見つけ出して介入することに繋がると考えられる。