Nasal transcriptomics characterize T-helper

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In SOL-Asthma, cases were more likely to be female, Puerto Rican, and current/former smokers, and to have physician-diagnosed COPD than controls. Five transcriptomic profiles were identified in cases: T2 HIGH (n=16 [5.1%]), T1 HIGH (n=71 [22.7%]), T17 HIGH (n=96 [30.7%]), T1 HIGH /T17 HIGH (n=53 [16.9%]), and T2 LOW /T1 LOW /T17 LOW (n=77 [24.6%]). In a multivariable analysis, Puerto Ricans were more likely to have a T17 HIGH profile than Dominicans (odds ratio [OR]=2.48, 95% confidence interval [CI]=1.08-5.74) and female sex was associated with T1 HIGH (OR=3.44, 95% CI=1.33-8.88), T1 HIGH /T17 HIGH and T2 LOW /T1 LOW /T17 LOW profiles, while COPD was associated with profiles other than T2 HIGH or T1 HIGH The Ti HIGH profile was associated with >1 SAE in the year prior to baseline and during the one-year follow-up (OR=4.31, 95% CI=1.26-14.77). Each profile had unique differentially expressed genes (DEGs), with substantial replication of the profile distribution and DEGs in CAAPA. Conclusions and relevance: Nasal transcriptomics identified profiles corresponding to five asthma endotypes in a cohort of Puerto Rican and Dominican adults. Puerto Rican background, female sex, and physician-diagnosed COPD were associated with non-T2 HIGH (T2 LOW ) asthma endotypes, and T1 HIGH asthma was strongly associated with SAEs. Key points: Question: Can nasal transcriptomics identify asthma endotypes and associated variables and outcomes in high-risk adults?Findings: Five transcriptomic profiles were identified in Puerto Rican and Dominican adults: T helper (T)2 HIGH , T1 HIGH , T17 HIGH , T1 HIGH /T17 HIGH , and T2 LOW /T1 LOW /T17 LOW . Puerto Ricans were more likely to have a T17 HIGH profile than Dominicans and female sex was associated with T1 HIGH , T1 HIGH /T17 HIGH and T2 LOW /T1 LOW /T17 LOW profiles, while COPD was associated with profiles other than T2 HIGH or T1 HIGH . The T1 HIGH profile was strongly associated with severe asthma exacerbations. Meaning: Women and Puerto Ricans were more likely to have T2 LOW asthma endotypes, for which there is no specific treatment.

Nasal transcriptomics characterize T-helper (T)2-low asthma endotypes in a study of Puerto Rican and Dominican adults living in the U.S

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