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Change in biomarkers of type-2 inflammation following severe exacerbations of asthma
  1. Ruth Semprini1,2,
  2. Nick Shortt1,2,
  3. Stefan Ebmeier1,
  4. Alex Semprini1,2,
  5. Rachel Varughese1,
  6. Cecile T J Holweg3,
  7. John G Matthews3,
  8. James Fingleton1,4,
  9. Mark Weatherall1,4,5,
  10. Richard Beasley1,2,4,
  11. Irene Braithwaite1,4
  1. 1 Medical Research Institute of New Zealand, Wellington, New Zealand
  2. 2 Victoria University Wellington, Wellington, New Zealand
  3. 3 Genentech Inc, South San Francisco, California, USA
  4. 4 Capital & Coast District Health Board, Wellington, New Zealand
  5. 5 University of Otago, Wellington, New Zealand
  1. Correspondence to Dr Irene Braithwaite, Medical Research Institute of New Zealand, Wellington 6242, New Zealand; irene.braithwaite{at}


We investigated the time course of change of type-2 asthma biomarkers after a severe asthma exacerbation. Blood eosinophils were lowest immediately after treatment was initiated (0.07 vs 0.33×109/L, p<0.001) while serum IgE levels were at their highest (339 vs 249 U/L, p<0.001). Fractional exhaled Nitric Oxide levels were lowest 2 weeks after treatment (23 vs 33 ppb, p=0.06) and serum periostin levels were lowest 1 week after treatment (45·9 vs 50·9 ng/mL, p<0.001). A delay of 4–8 weeks following a severe exacerbation is required if these biomarkers are used to guide the ongoing management of patients with asthma.

Trial registration number Post-results; The Australia New Zealand Trial Registry, >ACTRN12614000443695.

  • asthma

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  • Contributors CTJH, JF, MW, RB and IB conceived the idea for and designed the study. RS, NS, SB, AS and RV collected the data. MW did the analysis. RS, CTJH, JF, MW, RB and IB were involved in data interpretation. RS, NS, SE, AS, RV, CTJH, JF, MW, RB and IB drafted the report. RS, NS, SE, AS, RV, CTJH, JF, MW, RB and IB critically reviewed and revised the report.

  • Funding This study was funded by Genentech Inc, Members of Genentech were involved in study design, data interpretation and the drafting of this manuscript, but had no influence in the decision to publish the manuscript or disseminate the findings

  • Competing interests CH and JM are employees of Genentech Inc., a member of the Roche group. RB reports grants from Genentech during the conduct of the study; personal fees from Health Research Council of New Zealand, Glaxo Smith Kline, AstraZeneca, and Novartis outside the submitted work; grants from AstraZeneca, Chiese, Cephalon, Genentech, Novartis and Sanofi Aventis outside the submitted work. Other authors have no competing interests to declare.

  • Patient consent Not required.

  • Ethics approval Ethical approval was given by the New Zealand Health and Disability Ethics Committee (13/NTB/191).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement De-identified data are available from the corresponding author on reasonable request.

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