https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:24323 T (n=18) and MC_T/CPA3 (mRNA expression of TPSAB1 and CPA3; n=29) subtypes were identified, as well as a group without mast cell gene expression (n=8). The MC_T/CPA3 subtype had elevated exhaled nitric oxide fraction, sputum eosinophils, bronchial sensitivity and reactivity, and poorer asthma control. This was accompanied by upregulation of 13 genes. Multivariable logistic regression identified CPA3 (OR 1.21, p=0.004) rather than TPSAB1 (OR 0.92, p=0.502) as a determinant of eosinophilic asthma. The MC_T/CPA3 subtype had a better clinical response and reduced signature gene expression with corticosteroid treatment. Sputum mast cell subtypes of asthma can be defined by a molecular phenotyping approach. The MC_T/CPA3 subtype demonstrated increased bronchial sensitivity and reactivity, and signature gene expression, which was associated with airway eosinophilia and greater corticosteroid responsiveness.]]> Wed 09 Mar 2022 15:59:02 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7529 Sat 24 Mar 2018 08:38:29 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11071 Sat 24 Mar 2018 08:09:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20832 12% change in FEV₁; AUC, 91.5%). ICS treatment reduced the expression of CLC, CPA3, and DNASE1L3 in patients with eosinophilic asthma. Conclusions: A sputum gene expression signature of 6 biomarkers reproducibly and significantly discriminates inflammatory phenotypes of asthma and predicts ICS treatment response. This signature has the potential to become a useful diagnostic tool to assist in the clinical diagnosis and management of asthma.]]> Sat 24 Mar 2018 08:05:55 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17973 ENO) to guide management are equivocal. We tested the hypothesis that a management algorithm for asthma in pregnancy based on F_ENO and symptoms would reduce asthma exacerbations. Methods: We undertook a double-blind, parallel-group, controlled trial in two antenatal clinics in Australia. 220 pregnant, non-smoking women with asthma were randomly assigned, by a computer-generated random number list, before 22 weeks’ gestation to treatment adjustment at monthly visits by an algorithm using clinical symptoms (control group) or F_ENO concentrations (active intervention group) used to uptitrate (F_ENO >29 ppb) or downtitrate (F_ENO <16 ppb) inhaled corticosteroid dose. Participants, caregivers, and outcome assessors were masked to group assignment. Longacting β2 agonist and minimum dose inhaled corticosteroid were used to treat symptoms when F_ENO was not increased. The primary outcome was total asthma exacerbations (moderate and severe). Analysis was by intention to treat. This study is registered with the Australian and New Zealand Clinical Trials Registry, number 12607000561482. Findings: 111 women were randomly assigned to the F_ENO group (100 completed) and 109 to the control group (103 completed). The exacerbation rate was lower in the F_ENO group than in the control group (0·288 vs 0·615 exacerbations per pregnancy; incidence rate ratio 0·496, 95% CI 0·325–0·755; p=0·001). The number needed to treat was 6. In the F_ENO group, quality of life was improved (score on short form 12 mental summary was 56·9 [95% CI 50·2–59·3] in F_ENO group vs 54·2 [46·1–57·6] in control group; p=0·037) and neonatal hospitalisations were reduced (eight [8%] vs 18 [17%]; p=0·046). Interpretation: Asthma exacerbations during pregnancy can be significantly reduced with a validated F_ENO-based treatment algorithm.]]> Sat 24 Mar 2018 07:56:43 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4818 Sat 24 Mar 2018 07:18:54 AEDT ]]>