University of Oulu

Flinkman, E., Vähätalo, I., Tuomisto, L. E., Lehtimäki, L., Nieminen, P., Niemelä, O., Hämäläinen, M., Moilanen, E., Kankaanranta, H., & Ilmarinen, P. (2023). Association Between Blood Eosinophils and Neutrophils With Clinical Features in Adult-Onset Asthma. In The Journal of Allergy and Clinical Immunology: In Practice (Vol. 11, Issue 3, pp. 811-821.e5). Elsevier BV.

Association between blood eosinophils and neutrophils with clinical features in adult-onset asthma

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Author: Flinkman, Ella1; Vähätalo, Iida1,2; Tuomisto, Leena E.1,2;
Organizations: 1Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
2Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
3Allergy Centre, Tampere University Hospital, Tampere, Finland
4Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
5Department of Laboratory Medicine, Seinäjoki Central Hospital, Seinäjoki, and University of Tampere, Tampere, Finland
6Immunopharmacology Research Group, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
7Krefting Research Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: Elsevier, 2022
Publish Date: 2023-09-27


Background: Asthma is a disease that can be separated into different phenotypes and endotypes based on the clinical characteristics and the molecular mechanisms of the condition, respectively.

Objektive: To assess the association between blood eosinophil and neutrophil counts with clinical and molecular features in patients with adult-onset asthma.

Methods: Blood eosinophil and neutrophil counts were measured from 203 patients who took part in the Seinäjoki Adult Asthma Study and attended the 12-year follow-up visit. The patients were then divided into four groups (paucigranulocytic [n = 108], neutrophilic [n = 60], eosinophilic [n = 21], and mixed granulocytic [n = 14]), according to eosinophil and neutrophil levels. The cutoff values used to define the groups were 0.30 × 109 · L-1 for blood eosinophils and 4.4 × 109 · L-1 for blood neutrophils.

Results: The neutrophilic group had highest body mass index. It was dispensed the highest doses of inhaled corticosteroids during the 12-year follow-up and made the most unplanned respiratory visits. The neutrophilic, eosinophilic, and mixed granulocytic groups had more severe asthma compared with the paucigranulocytic group. The neutrophilic and eosinophilic groups were associated with higher dispensed antibiotics. The eosinophilic group had more nasal polyps, more suspected sinusitis, a greater decline in lung function, and increased levels of periostin, FeNO, and IgE. The neutrophilic group had increased high-sensitivity C-reactive protein, matrix metalloproteinase-9, IL-6, leptin, and soluble urokinase plasminogen activator receptor levels. The mixed granulocytic group showed increased resistin levels together with the neutrophilic group.

Conclusions: In addition to blood eosinophils, the blood neutrophil count reflects underlying inflammatory patterns and indicates important differences in asthma clinical features and outcomes.

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Series: Journal of allergy and clinical immunology. In practice
ISSN: 2213-2198
ISSN-E: 2213-2201
ISSN-L: 2213-2198
Volume: 11
Issue: 3
Pages: 811 - 821.e5
DOI: 10.1016/j.jaip.2022.11.025
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was supported by the Tampere Tuberculosis Foundation (Tampere, Finland), the Pirkanmaa Regional Fund of the Finnish Cultural Foundation (Helsinki, Finland), the Finnish Anti-Tuberculosis Association Foundation (Helsinki, Finland), the Research Foundation of the Pulmonary Diseases (Helsinki, Finland), the Väino and Laina Kivi Foundation (Helsinki, Finland), the Ida Montini Foundation (Kerava, Finland), the Allergy Research Foundation (Helsinki, Finland), Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland), and the Medical Research Fund of Seinäjoki Central Hospital (Seinäjoki, Finland). None of the sponsors had any involvement in the planning, execution, drafting or write-up of this study.
Copyright information: © 2022 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology. This is an open access article under the CC BY license (