Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2021

Open Access 01-12-2021 | Expectoration | Research

Distribution of inflammatory phenotypes among patients with asthma in Jilin Province, China: a cross-sectional study

Authors: Bingqing Shi, Wei Li, Hongna Dong, Mengting Xu, Yuqiu Hao, Peng Gao

Published in: BMC Pulmonary Medicine | Issue 1/2021

Login to get access

Abstract

Background

The inflammatory phenotypes of asthma predict the treatment response and prognosis. The phenotype distributions differ depending on the geographical region. This study aimed to assess the distribution of different inflammatory phenotypes among asthma patients in Jilin Province, China.

Methods

A total of 255 patients with asthma were recruited from Jilin Province, China for this cross-sectional study. Each patient underwent sputum induction following clinical assessment and peripheral blood collection. Inflammatory phenotypes were classified according to the inflammatory cell counts in the sputum.

Results

Paucigranulocytic asthma (PGA) was the most common inflammatory phenotype (52.2%), followed by eosinophilic asthma (EA, 38.3%), mixed granulocytic asthma (MGA, 5.2%), and neutrophilic asthma (NA, 4.3%). NA was more common among patients over 45 years old and those who were treated with higher doses of inhaled corticosteroids (ICS), but was less common following antibiotics treatment (p < 0.05). The proportion of patients with EA decreased as the ICS treatment dose and time increased (p = 0.038). Patients with uncontrolled asthma had higher numbers of sputum eosinophils and neutrophils (p < 0.05). Patients with severe asthma had a higher percentage of sputum neutrophils (p < 0.05). A greater proportion of patients with NA had severe asthma (60%) compared to those with EA (18.2%) (p = 0.016).

Conclusions

The most common asthma inflammatory cell phenotype in Jilin Province, China is PGA, followed by EA, MGA, and NA. The low prevalence of NA in Jilin Province compared to other countries and also other regions in China might be due to excessive antibiotic use and irregular ICS treatment in this region.
Literature
1.
go back to reference Barnes PJ. Cellular and molecular mechanisms of asthma and COPD. Clin Sci (Lond). 2017;131(13):1541–58.CrossRef Barnes PJ. Cellular and molecular mechanisms of asthma and COPD. Clin Sci (Lond). 2017;131(13):1541–58.CrossRef
3.
go back to reference Simpson JL, Scott R, Boyle MJ, Gibson PG. Inflammatory subtypes in asthma: assessment and identification using induced sputum. Respirology (Carlton, Vic). 2006;11(1):54–61.CrossRef Simpson JL, Scott R, Boyle MJ, Gibson PG. Inflammatory subtypes in asthma: assessment and identification using induced sputum. Respirology (Carlton, Vic). 2006;11(1):54–61.CrossRef
4.
go back to reference Brown HM. Treatment of chronic asthma with prednisolone; significance of eosinophils in the sputum. Lancet (London, England). 1958;2(7059):1245–7.CrossRef Brown HM. Treatment of chronic asthma with prednisolone; significance of eosinophils in the sputum. Lancet (London, England). 1958;2(7059):1245–7.CrossRef
5.
go back to reference Schleich FN, Manise M, Sele J, Henket M, Seidel L, Louis R. Distribution of sputum cellular phenotype in a large asthma cohort: predicting factors for eosinophilic vs neutrophilic inflammation. BMC Pulm Med. 2013;13:11.PubMedPubMedCentralCrossRef Schleich FN, Manise M, Sele J, Henket M, Seidel L, Louis R. Distribution of sputum cellular phenotype in a large asthma cohort: predicting factors for eosinophilic vs neutrophilic inflammation. BMC Pulm Med. 2013;13:11.PubMedPubMedCentralCrossRef
6.
go back to reference Taylor SL, Leong LEX, Choo JM, Wesselingh S, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, Jenkins C, et al. Inflammatory phenotypes in patients with severe asthma are associated with distinct airway microbiology. J Allergy Clin Immunol. 2018;141(1):94-103.e115.PubMedCrossRef Taylor SL, Leong LEX, Choo JM, Wesselingh S, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, Jenkins C, et al. Inflammatory phenotypes in patients with severe asthma are associated with distinct airway microbiology. J Allergy Clin Immunol. 2018;141(1):94-103.e115.PubMedCrossRef
7.
go back to reference Gai XY, Chang C, Wang J, Liang Y, Li MJ, Sun YC, He B, Yao WZ. Airway inflammation and small airway wall remodeling in neutrophilic asthma. J Peking Univ Health Sci. 2018;50(4):645–50. Gai XY, Chang C, Wang J, Liang Y, Li MJ, Sun YC, He B, Yao WZ. Airway inflammation and small airway wall remodeling in neutrophilic asthma. J Peking Univ Health Sci. 2018;50(4):645–50.
8.
go back to reference Gibson PG. Inflammatory phenotypes in adult asthma: clinical applications. Clin Respir J. 2009;3(4):198–206.PubMedCrossRef Gibson PG. Inflammatory phenotypes in adult asthma: clinical applications. Clin Respir J. 2009;3(4):198–206.PubMedCrossRef
9.
go back to reference Green RH, Brightling CE, Woltmann G, Parker D, Wardlaw AJ, Pavord ID. Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax. 2002;57(10):875–9.PubMedPubMedCentralCrossRef Green RH, Brightling CE, Woltmann G, Parker D, Wardlaw AJ, Pavord ID. Analysis of induced sputum in adults with asthma: identification of subgroup with isolated sputum neutrophilia and poor response to inhaled corticosteroids. Thorax. 2002;57(10):875–9.PubMedPubMedCentralCrossRef
10.
go back to reference McGrath KW, Icitovic N, Boushey HA, Lazarus SC, Sutherland ER, Chinchilli VM, Fahy JV. A large subgroup of mild-to-moderate asthma is persistently noneosinophilic. Am J Respir Crit Care Med. 2012;185(6):612–9.PubMedPubMedCentralCrossRef McGrath KW, Icitovic N, Boushey HA, Lazarus SC, Sutherland ER, Chinchilli VM, Fahy JV. A large subgroup of mild-to-moderate asthma is persistently noneosinophilic. Am J Respir Crit Care Med. 2012;185(6):612–9.PubMedPubMedCentralCrossRef
11.
go back to reference Choi JS, Jang AS, Park JS, Park SW, Paik SH, Park JS, Uh ST, Kim YH, Park CS. Role of neutrophils in persistent airway obstruction due to refractory asthma. Respirology (Carlton, Vic). 2012;17(2):322–9.CrossRef Choi JS, Jang AS, Park JS, Park SW, Paik SH, Park JS, Uh ST, Kim YH, Park CS. Role of neutrophils in persistent airway obstruction due to refractory asthma. Respirology (Carlton, Vic). 2012;17(2):322–9.CrossRef
13.
go back to reference Yang G, Wang Y, Zeng Y, Gao GF, Liang X, Zhou M, Wan X, Yu S, Jiang Y, Naghavi M, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet (London, England). 2013;381(9882):1987–2015.CrossRef Yang G, Wang Y, Zeng Y, Gao GF, Liang X, Zhou M, Wan X, Yu S, Jiang Y, Naghavi M, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet (London, England). 2013;381(9882):1987–2015.CrossRef
14.
go back to reference Chen WW, Liu Y, Wu XW, Bao QY, Gao ZT, Zhang XL, Zhao HM, Zhang SC, Xiu AJ, Cheng TH. Spatial and temporal characteristics of air quality and cause analysis of heavy pollution in northeast China. Huanjing kexue. 2019;40(11):4810–23.PubMed Chen WW, Liu Y, Wu XW, Bao QY, Gao ZT, Zhang XL, Zhao HM, Zhang SC, Xiu AJ, Cheng TH. Spatial and temporal characteristics of air quality and cause analysis of heavy pollution in northeast China. Huanjing kexue. 2019;40(11):4810–23.PubMed
15.
go back to reference Lin J, Wang W, Chen P, Zhou X, Wan H, Yin K, Ma L, Wu C, Li J, Liu C, et al. Prevalence and risk factors of asthma in mainland China: the CARE study. Respir Med. 2018;137:48–54.PubMedCrossRef Lin J, Wang W, Chen P, Zhou X, Wan H, Yin K, Ma L, Wu C, Li J, Liu C, et al. Prevalence and risk factors of asthma in mainland China: the CARE study. Respir Med. 2018;137:48–54.PubMedCrossRef
16.
go back to reference Wang G, Wang F, Gibson PG, Guo M, Zhang WJ, Gao P, Zhang HP, Harvey ES, Li H, Zhang J. Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network. J Thorac Dis. 2017;9(5):1333–44.PubMedPubMedCentralCrossRef Wang G, Wang F, Gibson PG, Guo M, Zhang WJ, Gao P, Zhang HP, Harvey ES, Li H, Zhang J. Severe and uncontrolled asthma in China: a cross-sectional survey from the Australasian Severe Asthma Network. J Thorac Dis. 2017;9(5):1333–44.PubMedPubMedCentralCrossRef
18.
go back to reference ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005;171(8):912–30. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005;171(8):912–30.
19.
go back to reference Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.PubMedCrossRef Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.PubMedCrossRef
20.
go back to reference Juniper EF, O’Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14(4):902–7.PubMedCrossRef Juniper EF, O’Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. Eur Respir J. 1999;14(4):902–7.PubMedCrossRef
21.
go back to reference Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004;113(1):59–65.PubMedCrossRef Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, Murray JJ, Pendergraft TB. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004;113(1):59–65.PubMedCrossRef
22.
go back to reference Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a standardized version of the Asthma Quality of Life Questionnaire. Chest. 1999;115(5):1265–70.PubMedCrossRef Juniper EF, Buist AS, Cox FM, Ferrie PJ, King DR. Validation of a standardized version of the Asthma Quality of Life Questionnaire. Chest. 1999;115(5):1265–70.PubMedCrossRef
23.
go back to reference Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983;67(6):361–70.PubMedCrossRef
26.
go back to reference Wittig HJ, Belloit J, De Fillippi I, Royal G. Age-related serum immunoglobulin E levels in healthy subjects and in patients with allergic disease. J Allergy Clin Immunol. 1980;66(4):305–13.PubMedCrossRef Wittig HJ, Belloit J, De Fillippi I, Royal G. Age-related serum immunoglobulin E levels in healthy subjects and in patients with allergic disease. J Allergy Clin Immunol. 1980;66(4):305–13.PubMedCrossRef
27.
go back to reference Gibson PG, Wlodarczyk JW, Hensley MJ, Gleeson M, Henry RL, Cripps AW, Clancy RL. Epidemiological association of airway inflammation with asthma symptoms and airway hyperresponsiveness in childhood. Am J Respir Crit Care Med. 1998;158(1):36–41.PubMedCrossRef Gibson PG, Wlodarczyk JW, Hensley MJ, Gleeson M, Henry RL, Cripps AW, Clancy RL. Epidemiological association of airway inflammation with asthma symptoms and airway hyperresponsiveness in childhood. Am J Respir Crit Care Med. 1998;158(1):36–41.PubMedCrossRef
28.
go back to reference Wong HH, Fahy JV. Safety of one method of sputum induction in asthmatic subjects. Am J Respir Crit Care Med. 1997;156(1):299–303.PubMedCrossRef Wong HH, Fahy JV. Safety of one method of sputum induction in asthmatic subjects. Am J Respir Crit Care Med. 1997;156(1):299–303.PubMedCrossRef
29.
go back to reference Thomas RA, Green RH, Brightling CE, Birring SS, Parker D, Wardlaw AJ, Pavord ID. The influence of age on induced sputum differential cell counts in normal subjects. Chest. 2004;126(6):1811–4.PubMedCrossRef Thomas RA, Green RH, Brightling CE, Birring SS, Parker D, Wardlaw AJ, Pavord ID. The influence of age on induced sputum differential cell counts in normal subjects. Chest. 2004;126(6):1811–4.PubMedCrossRef
30.
go back to reference Brooks CR, Gibson PG, Douwes J, Van Dalen CJ, Simpson JL. Relationship between airway neutrophilia and ageing in asthmatics and non-asthmatics. Respirology (Carlton, Vic). 2013;18(5):857–65.CrossRef Brooks CR, Gibson PG, Douwes J, Van Dalen CJ, Simpson JL. Relationship between airway neutrophilia and ageing in asthmatics and non-asthmatics. Respirology (Carlton, Vic). 2013;18(5):857–65.CrossRef
31.
go back to reference Cowan DC, Cowan JO, Palmay R, Williamson A, Taylor DR. Effects of steroid therapy on inflammatory cell subtypes in asthma. Thorax. 2010;65(5):384–90.PubMedCrossRef Cowan DC, Cowan JO, Palmay R, Williamson A, Taylor DR. Effects of steroid therapy on inflammatory cell subtypes in asthma. Thorax. 2010;65(5):384–90.PubMedCrossRef
32.
go back to reference Chalmers GW, MacLeod KJ, Thomson L, Little SA, McSharry C, Thomson NC. Smoking and airway inflammation in patients with mild asthma. Chest. 2001;120(6):1917–22.PubMedCrossRef Chalmers GW, MacLeod KJ, Thomson L, Little SA, McSharry C, Thomson NC. Smoking and airway inflammation in patients with mild asthma. Chest. 2001;120(6):1917–22.PubMedCrossRef
33.
35.
go back to reference Wang Z, Zhang H, Han J, Xing H, Wu MC, Yang T. Deadly sins of antibiotic abuse in China. Infect Control Hosp Epidemiol. 2017;38(6):758–9.PubMedCrossRef Wang Z, Zhang H, Han J, Xing H, Wu MC, Yang T. Deadly sins of antibiotic abuse in China. Infect Control Hosp Epidemiol. 2017;38(6):758–9.PubMedCrossRef
36.
go back to reference Yan K, Xue M, Ye D, Yang C, Chang J, Jiang M, Zhao M, Zhang H, Fang Y. Antibiotic prescribing practices in secondary and tertiary hospitals in Shaanxi province, western China, 2013–2015. PLoS ONE. 2018;13(12):e0207229.PubMedPubMedCentralCrossRef Yan K, Xue M, Ye D, Yang C, Chang J, Jiang M, Zhao M, Zhang H, Fang Y. Antibiotic prescribing practices in secondary and tertiary hospitals in Shaanxi province, western China, 2013–2015. PLoS ONE. 2018;13(12):e0207229.PubMedPubMedCentralCrossRef
37.
go back to reference Yin X, Song F, Gong Y, Tu X, Wang Y, Cao S, Liu J, Lu Z. A systematic review of antibiotic utilization in China. J Antimicrob Chemother. 2013;68(11):2445–52.PubMedCrossRef Yin X, Song F, Gong Y, Tu X, Wang Y, Cao S, Liu J, Lu Z. A systematic review of antibiotic utilization in China. J Antimicrob Chemother. 2013;68(11):2445–52.PubMedCrossRef
38.
go back to reference Yu M, Zhao G, Stålsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.PubMedPubMedCentralCrossRef Yu M, Zhao G, Stålsby Lundborg C, Zhu Y, Zhao Q, Xu B. Knowledge, attitudes, and practices of parents in rural China on the use of antibiotics in children: a cross-sectional study. BMC Infect Dis. 2014;14:112.PubMedPubMedCentralCrossRef
39.
go back to reference Dong H, Hao Y, Li D, Su Z, Li W, Shi B, Gao P. Risk factors for acute exacerbation of chronic obstructive pulmonary disease in industrial regions of China: a multicenter cross-sectional study. Int J Chronic Obstr Pulm Dis. 2020;15:2249–56.CrossRef Dong H, Hao Y, Li D, Su Z, Li W, Shi B, Gao P. Risk factors for acute exacerbation of chronic obstructive pulmonary disease in industrial regions of China: a multicenter cross-sectional study. Int J Chronic Obstr Pulm Dis. 2020;15:2249–56.CrossRef
40.
go back to reference Patrick DM, Sbihi H, Dai DLY, Al Mamun A, Rasali D, Rose C, Marra F, Boutin RCT, Petersen C, Stiemsma LT, et al. Decreasing antibiotic use, the gut microbiota, and asthma incidence in children: evidence from population-based and prospective cohort studies. Lancet Respir Med. 2020;8(11):1094–105.PubMedCrossRef Patrick DM, Sbihi H, Dai DLY, Al Mamun A, Rasali D, Rose C, Marra F, Boutin RCT, Petersen C, Stiemsma LT, et al. Decreasing antibiotic use, the gut microbiota, and asthma incidence in children: evidence from population-based and prospective cohort studies. Lancet Respir Med. 2020;8(11):1094–105.PubMedCrossRef
41.
go back to reference Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, Jenkins C, Peters MJ, Marks GB, Baraket M, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Lancet (London, England). 2017;390(10095):659–68.CrossRef Gibson PG, Yang IA, Upham JW, Reynolds PN, Hodge S, James AL, Jenkins C, Peters MJ, Marks GB, Baraket M, et al. Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Lancet (London, England). 2017;390(10095):659–68.CrossRef
42.
go back to reference Moore WC, Hastie AT, Li X, Li H, Busse WW, Jarjour NN, Wenzel SE, Peters SP, Meyers DA, Bleecker ER. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133(6):1557-1563.e1555.PubMedCrossRef Moore WC, Hastie AT, Li X, Li H, Busse WW, Jarjour NN, Wenzel SE, Peters SP, Meyers DA, Bleecker ER. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133(6):1557-1563.e1555.PubMedCrossRef
43.
go back to reference Gao J, Chen Z, Jie X, Ye R, Wu F. Both fractional exhaled nitric oxide and sputum eosinophil were associated with uncontrolled asthma. J Asthma Allergy. 2018;11:73–9.PubMedPubMedCentralCrossRef Gao J, Chen Z, Jie X, Ye R, Wu F. Both fractional exhaled nitric oxide and sputum eosinophil were associated with uncontrolled asthma. J Asthma Allergy. 2018;11:73–9.PubMedPubMedCentralCrossRef
44.
go back to reference Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet (London, England). 2019;394(10196):407–18.CrossRef Huang K, Yang T, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, et al. Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Lancet (London, England). 2019;394(10196):407–18.CrossRef
45.
go back to reference McCreanor J, Cullinan P, Nieuwenhuijsen MJ, Stewart-Evans J, Malliarou E, Jarup L, Harrington R, Svartengren M, Han IK, Ohman-Strickland P, et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med. 2007;357(23):2348–58.PubMedCrossRef McCreanor J, Cullinan P, Nieuwenhuijsen MJ, Stewart-Evans J, Malliarou E, Jarup L, Harrington R, Svartengren M, Han IK, Ohman-Strickland P, et al. Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med. 2007;357(23):2348–58.PubMedCrossRef
46.
go back to reference Holgate ST, Sandström T, Frew AJ, Stenfors N, Nördenhall C, Salvi S, Blomberg A, Helleday R, Söderberg M. Health effects of acute exposure to air pollution. Part I: healthy and asthmatic subjects exposed to diesel exhaust. Res Rep (Health Effects Inst). 2003;112:1–30. Holgate ST, Sandström T, Frew AJ, Stenfors N, Nördenhall C, Salvi S, Blomberg A, Helleday R, Söderberg M. Health effects of acute exposure to air pollution. Part I: healthy and asthmatic subjects exposed to diesel exhaust. Res Rep (Health Effects Inst). 2003;112:1–30.
47.
go back to reference Wen X, Chen W, Chen B, Yang C, Tu G, Cheng T. Does the prohibition on open burning of straw mitigate air pollution? An empirical study in Jilin Province of China in the post-harvest season. J Environ Manag. 2020;264:110451.CrossRef Wen X, Chen W, Chen B, Yang C, Tu G, Cheng T. Does the prohibition on open burning of straw mitigate air pollution? An empirical study in Jilin Province of China in the post-harvest season. J Environ Manag. 2020;264:110451.CrossRef
48.
go back to reference Long W, Tate RB, Neuman M, Manfreda J, Becker AB, Anthonisen NR. Respiratory symptoms in a susceptible population due to burning of agricultural residue. Chest. 1998;113(2):351–7.PubMedCrossRef Long W, Tate RB, Neuman M, Manfreda J, Becker AB, Anthonisen NR. Respiratory symptoms in a susceptible population due to burning of agricultural residue. Chest. 1998;113(2):351–7.PubMedCrossRef
49.
go back to reference Youssouf H, Liousse C, Roblou L, Assamoi EM, Salonen RO, Maesano C, Banerjee S, Annesi-Maesano I. Non-accidental health impacts of wildfire smoke. Int J Environ Res Public Health. 2014;11(11):11772–804.PubMedPubMedCentralCrossRef Youssouf H, Liousse C, Roblou L, Assamoi EM, Salonen RO, Maesano C, Banerjee S, Annesi-Maesano I. Non-accidental health impacts of wildfire smoke. Int J Environ Res Public Health. 2014;11(11):11772–804.PubMedPubMedCentralCrossRef
50.
go back to reference Prasad R, Singh A, Garg R, Giridhar GB. Biomass fuel exposure and respiratory diseases in India. Biosci Trends. 2012;6(5):219–28.PubMedCrossRef Prasad R, Singh A, Garg R, Giridhar GB. Biomass fuel exposure and respiratory diseases in India. Biosci Trends. 2012;6(5):219–28.PubMedCrossRef
51.
go back to reference Torigoe K, Hasegawa S, Numata O, Yazaki S, Matsunaga M, Boku N, Hiura M, Ino H. Influence of emission from rice straw burning on bronchial asthma in children. Pediatr Int. 2000;42(2):143–50.PubMedCrossRef Torigoe K, Hasegawa S, Numata O, Yazaki S, Matsunaga M, Boku N, Hiura M, Ino H. Influence of emission from rice straw burning on bronchial asthma in children. Pediatr Int. 2000;42(2):143–50.PubMedCrossRef
52.
go back to reference Teng B, Zhang X, Yi C, Zhang Y, Ye S, Wang Y, Tong DQ, Lu B. The association between ambient air pollution and allergic rhinitis: further epidemiological evidence from Changchun, northeastern China. Int J Environ Res Public Health. 2017;14(3). Teng B, Zhang X, Yi C, Zhang Y, Ye S, Wang Y, Tong DQ, Lu B. The association between ambient air pollution and allergic rhinitis: further epidemiological evidence from Changchun, northeastern China. Int J Environ Res Public Health. 2017;14(3).
Metadata
Title
Distribution of inflammatory phenotypes among patients with asthma in Jilin Province, China: a cross-sectional study
Authors
Bingqing Shi
Wei Li
Hongna Dong
Mengting Xu
Yuqiu Hao
Peng Gao
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2021
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-021-01722-0

Other articles of this Issue 1/2021

BMC Pulmonary Medicine 1/2021 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine