RT Journal Article
SR Electronic
T1 The sputum transcriptome better predicts COPD exacerbations after the withdrawal of inhaled corticosteroids than sputum eosinophils
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00097-2021
DO 10.1183/23120541.00097-2021
VO 7
IS 3
A1 Benedikt Ditz
A1 Aartik Sarma
A1 Huib A.M. Kerstjens
A1 Jeroen J.W. Liesker
A1 Erik Bathoorn
A1 Judith M. Vonk
A1 Victor Bernal
A1 Peter Horvatovich
A1 Victor Guryev
A1 Saharai Caldera
A1 Chaz Langelier
A1 Alen Faiz
A1 Stephanie A. Christenson
A1 Maarten van den Berge
YR 2021
UL http://openres.ersjournals.com/content/7/3/00097-2021.abstract
AB Introduction Continuing inhaled corticosteroid (ICS) use does not benefit all patients with COPD, yet it is difficult to determine which patients may safely sustain ICS withdrawal. Although eosinophil levels can facilitate this decision, better biomarkers could improve personalised treatment decisions.Methods We performed transcriptional profiling of sputum to explore the molecular biology and compared the predictive value of an unbiased gene signature versus sputum eosinophils for exacerbations after ICS withdrawal in COPD patients. RNA-sequencing data of induced sputum samples from 43 COPD patients were associated with the time to exacerbation after ICS withdrawal. Expression profiles of differentially expressed genes were summarised to create gene signatures. In addition, we built a Bayesian network model to determine coregulatory networks related to the onset of COPD exacerbations after ICS withdrawal.Results In multivariate analyses, we identified a gene signature (LGALS12, ALOX15, CLC, IL1RL1, CD24, EMR4P) associated with the time to first exacerbation after ICS withdrawal. The addition of this gene signature to a multiple Cox regression model explained more variance of time to exacerbations compared to a model using sputum eosinophils. The gene signature correlated with sputum eosinophil as well as macrophage cell counts. The Bayesian network model identified three coregulatory gene networks as well as sex to be related to an early versus late/nonexacerbation phenotype.Conclusion We identified a sputum gene expression signature that exhibited a higher predictive value for predicting COPD exacerbations after ICS withdrawal than sputum eosinophilia. Future studies should investigate the utility of this signature, which might enhance personalised ICS treatment in COPD patients.Sputum gene expression may have utility in biomarker development for identifying subjects who are at higher risk of exacerbation after ICS withdrawal https://bit.ly/3gYl2OL