Background: Asthma is a global health problem that causes reversible airway obstruction. Chronic airflow obstruction shows airway wall remodeling as increased airway wall thickness. Recurrent exacerbations show increased sputum esinophils and reduced response to inhaled corticosteroids (ICS) and/or oral corticosteroids (OCS). Corticosteroid insensitivity shows increased neutrophils in sputum.
Objective: Assessment of interleukin 13 (IL-13), IL-4, immunoglobulin E (IgE), and others as biomarkers in cases of severe asthma and their role in the detection of asthma phenotypes and choice of treatment.
Patients and Methods: A cross sectional study was conducted on forty patients with severe asthma admitted at ICU Unit at Al-HusseinUniversityHospital between January 2016 and April 2021. The patients were categorized into atopic and non-atopic asthma, early and late onset asthma, and persistent airflow obstruction and non-persistent airflow obstruction. All patients were subjected to full history taken, full clinical examinations, and laboratory investigations included complete blood count (CBC), blood and sputum esinophils, blood and sputum neutrophils, blood and sputum immunoglobulin E (IgE), blood and sputum IL-13, and IL-4.
Results: There were statistically significant negative correlations between IL-13 (pg/ml) and neutrophils, and between IL-4 (pg/ml) and ICs dose (mcg/d) in the studied asthma patients. However, no statistically significant difference between non-atopic and atopic asthma groups regarding total count cell (×106 cells/mL), neutrophils %, and esinophils % was detected. Also, there was no statistically significant difference among the studied asthma groups regarding FVC, FEV1, FEV1/FVC, TLC, RV/TLC, IgE (IU/mI), IL-13 (pg/ml), and IL-4 (pg/ml).
Conclusion: Our study concluded high burden of severe asthma in adults with the existence of clinical possible phenotypes among them.