{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:59:04Z","timestamp":1787504344376,"version":"build-2736575974"},"reference-count":31,"publisher":"European Respiratory Society (ERS)","issue":"5","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013995","name":"Sanofi Genzyme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013995","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020870","name":"Facult\u00e9 de m\u00e9decine et des sciences de la sant\u00e9, Universit\u00e9 de Sherbrooke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020870","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022110","name":"bioM\u00e9rieux","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022110","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Qu\u00e9bec Air-Intersectorialit\u00e9-Respiratoire-Son (AIRS) Network"},{"name":"Association Pulmonaire du Qu\u00e9bec"}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2025,1,21]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Asthma attacks are heterogeneous. It is not known whether the response to oral corticosteroids (OCS) in acute asthma varies according to type 2 (T2) inflammatory biomarkers, blood eosinophil count (BEC) and fractional exhaled nitric oxide (\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      ). We aimed to explore the relationship between T2 biomarkers and response to OCS in acute asthma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a longitudinal observational study of people experiencing an asthma attack evaluated before and after a 7-day OCS course. The primary outcome was post-bronchodilator change in forced expiratory volume in 1\u2005s (FEV\n                      <jats:sub>1<\/jats:sub>\n                      ) according to ordinal BEC-\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      three-group categories (T2-Low\/Low: BEC &lt;0.15\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \u2005cells\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      and\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      &lt;25\u2005ppb; T2-High\/High: BEC \u22650.30\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \u2005cells\u00b7L\n                      <jats:sup>\u22121<\/jats:sup>\n                      and\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      \u226535\u2005ppb; T2-Mid: not meeting Low\/Low or High\/High criteria). A key secondary outcome was the change in Asthma Control Questionnaire-5 score. Exploratory outcomes included OCS-attributable adverse events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      53 people were enrolled, with 16 (30%) T2-Low\/Low, 27 (51%) T2-Mid and 10 (19%) T2-High\/High asthma attacks. Post-bronchodilator FEV\n                      <jats:sub>1<\/jats:sub>\n                      changes increased with combined BEC-\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      elevation (p for interaction=0.007), peaking in the T2-High\/High phenotype (0.390\u00b10.512\u2005L, p for trend&lt;0.0001). Conversely, T2-Low\/Low attacks showed nonsignificant FEV\n                      <jats:sub>1<\/jats:sub>\n                      changes (0.017\u00b10.153\u2005L). In univariable and multivariable analyses, only ordinal BEC-\n                      <jats:italic>F<\/jats:italic>\n                      <jats:sub>ENO<\/jats:sub>\n                      stratification, not symptoms nor FEV\n                      <jats:sub>1<\/jats:sub>\n                      , predicted subsequent post-bronchodilator FEV\n                      <jats:sub>1<\/jats:sub>\n                      improvement. All patients had improved Asthma Control Questionnaire-5 score, numerically peaking in the T2-High\/High phenotype (\u22121.58\u00b10.60, p for trend=0.08). All groups experienced similar OCS-attributable adverse events, with 33 patients (62%) reporting at least one event.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that objective improvement following OCS is confined to T2-High events. As in chronic asthma, greater T2 burden identifies a distinct clinical and therapeutic trajectory, whereas OCS\u2011related adverse events are uniformly distributed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1183\/13993003.02391-2024","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T10:26:03Z","timestamp":1739442363000},"page":"2402391","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":34,"title":["Phenotyping the responses to systemic corticosteroids in the management of asthma attacks (PRISMA)"],"prefix":"10.1183","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8405-4513","authenticated-orcid":false,"given":"Carlos","family":"Celis-Preciado","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0936-5647","authenticated-orcid":false,"given":"Simon","family":"Leclerc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4289-2518","authenticated-orcid":false,"given":"Martine","family":"Duval","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2274-2758","authenticated-orcid":false,"given":"Dominic O.","family":"Cliche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Brazeau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1675-0531","authenticated-orcid":false,"given":"F\u00e9lix-Antoine","family":"V\u00e9zina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryl\u00e8ne","family":"Dussault","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9600-9533","authenticated-orcid":false,"given":"Pierre","family":"Lariv\u00e9e","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Lemaire-Paquette","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4356-9702","authenticated-orcid":false,"given":"Simon","family":"L\u00e9vesque","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9290-1823","authenticated-orcid":false,"given":"Philippe","family":"Lachapelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4057-6886","authenticated-orcid":false,"given":"Simon","family":"Couillard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"2025091110501494000_65.5.2402391.1","unstructured":"Global Initiative for Asthma (GINA) . 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