{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:05:06Z","timestamp":1790348706368,"version":"4.1.0"},"posted":{"date-parts":[[2026,9,15]]},"group-title":"Respiratory Medicine","reference-count":31,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"award":["HL152475, HL129949, HL104608"],"award-info":[{"award-number":["HL152475, HL129949, HL104608"]}],"id":[{"id":"https:\/\/ror.org\/01cwqze88","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,15]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>IMPORTANCE<\/jats:title>\n                  <jats:p>CD4+ T helper (T) 1, T2 and T17 cells have helped identify asthma endotypes in predominantly non-Hispanic White adults. Identifying asthma endotypes in diverse subgroups should help develop personalized medicine in asthma.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To characterize asthma endotypes and their association with selected variables and asthma severity\/control in adults.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>DESIGN, SETTING, AND PARTICIPANTS<\/jats:title>\n                  <jats:p>Cross-sectional and longitudinal analyses of nasal samples from the SOL-Asthma study of Puerto Rican and Dominican adults with (cases, n=313) and without (controls, n=371) asthma in the Bronx (NY) and Chicago (IL), with replication of selected findings in 376 adults of African ancestry in CAAPA.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>MAIN OUTCOMES AND MEASURES<\/jats:title>\n                  <jats:p>Our primary outcome was asthma endotypes identified through nasal expression of \u201csignature genes\u201d for 3 T2, 5 T1, and 5 T17 pathways. Multinomial logistic regression was used for the analysis of asthma endotypes (with controls as the reference outcome category) at a baseline visit, as well as for the analysis of severe asthma exacerbations (SAEs) at baseline and during a 1-year follow-up. We attempted to replicate the identified profiles in CAAPA.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>\n                    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\n                    <jats:sup>HIGH<\/jats:sup>\n                    (n=16 [5.1%]), T1\n                    <jats:sup>HIGH<\/jats:sup>\n                    (n=71 [22.7%]), T17\n                    <jats:sup>HIGH<\/jats:sup>\n                    (n=96 [30.7%]), T1\n                    <jats:sup>HIGH<\/jats:sup>\n                    \/T17\n                    <jats:sup>HIGH<\/jats:sup>\n                    (n=53 [16.9%]), and T2\n                    <jats:sup>LOW<\/jats:sup>\n                    \/T1\n                    <jats:sup>LOW<\/jats:sup>\n                    \/T17\n                    <jats:sup>LOW<\/jats:sup>\n                    (n=77 [24.6%]). In a multivariable analysis, Puerto Ricans were more likely to have a T17\n                    <jats:sup>HIGH<\/jats:sup>\n                    profile than Dominicans (odds ratio [OR]=2.48, 95% confidence interval [CI]=1.08-5.74) and female sex was associated with T1\n                    <jats:sup>HIGH<\/jats:sup>\n                    (OR=3.44, 95% CI=1.33-8.88), T1\n                    <jats:sup>HIGH<\/jats:sup>\n                    \/T17\n                    <jats:sup>HIGH<\/jats:sup>\n                    and T2\n                    <jats:sup>LOW<\/jats:sup>\n                    \/T1\n                    <jats:sup>LOW<\/jats:sup>\n                    \/T17\n                    <jats:sup>LOW<\/jats:sup>\n                    profiles, while COPD was associated with profiles other than T2\n                    <jats:sub>HIGH<\/jats:sub>\n                    or T1\n                    <jats:sub>HIGH<\/jats:sub>\n                    The Ti\n                    <jats:sub>HIGH<\/jats:sub>\n                    profile was associated with &gt;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.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>CONCLUSIONS AND RELEVANCE<\/jats:title>\n                  <jats:p>\n                    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\n                    <jats:sup>HIGH<\/jats:sup>\n                    (T2\n                    <jats:sup>LOW<\/jats:sup>\n                    ) asthma endotypes, and T1\n                    <jats:sup>HIGH<\/jats:sup>\n                    asthma was strongly associated with SAEs.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>KEY POINTS<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Question<\/jats:title>\n                    <jats:p>Can nasal transcriptomics identify asthma endotypes and associated variables and outcomes in high-risk adults?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>\n                      Five transcriptomic profiles were identified in Puerto Rican and Dominican adults: T helper (T)2\n                      <jats:sup>HIGH<\/jats:sup>\n                      , T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      , T17\n                      <jats:sup>HIGH<\/jats:sup>\n                      , T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      \/T17\n                      <jats:sup>HIGH<\/jats:sup>\n                      , and T2\n                      <jats:sup>LOW<\/jats:sup>\n                      \/T1\n                      <jats:sup>LOW<\/jats:sup>\n                      \/T17\n                      <jats:sup>LOW<\/jats:sup>\n                      . Puerto Ricans were more likely to have a T17\n                      <jats:sup>HIGH<\/jats:sup>\n                      profile than Dominicans and female sex was associated with T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      , T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      \/T17\n                      <jats:sup>HIGH<\/jats:sup>\n                      and T2\n                      <jats:sup>LOW<\/jats:sup>\n                      \/T1\n                      <jats:sup>LOW<\/jats:sup>\n                      \/T17\n                      <jats:sup>LOW<\/jats:sup>\n                      profiles, while COPD was associated with profiles other than T2\n                      <jats:sup>HIGH<\/jats:sup>\n                      or T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      . The T1\n                      <jats:sup>HIGH<\/jats:sup>\n                      profile was strongly associated with severe asthma exacerbations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Meaning<\/jats:title>\n                    <jats:p>\n                      Women and Puerto Ricans were more likely to have T2\n                      <jats:sup>LOW<\/jats:sup>\n                      asthma endotypes, for which there is no specific treatment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                <\/jats:sec>","DOI":"10.64898\/2026.09.14.26363037","type":"posted-content","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:05:11Z","timestamp":1789520711000},"source":"Crossref","is-referenced-by-count":0,"title":["Nasal transcriptomics characterize T-helper (T)2-low asthma endotypes in a study of Puerto Rican and Dominican adults living in the U.S."],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3657-8771","authenticated-orcid":false,"given":"Sheng","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center Children\u2019s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8409-3077","authenticated-orcid":false,"given":"Yueh-Ying","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh Medical Center Children\u2019s Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soheil Farid","family":"Azar","sequence":"additional","affiliation":[{"name":"Genomics and Precision Health Section, Laboratory of 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