Patients with uncontrolled (UC) severe allergic asthma display a unique fingerprint characterized by inflammatory-related metabolites and proteins, suggesting a pro-inflammatory environment, according to a study published in Allergy. Moreover, the integration of clinical and experimental data led to a deeper understanding of the mechanisms underlying the UC phenotype. To understand the mechanisms of poor asthma control and disease severity, María M. Escribese, PhD, and colleagues aimed to elucidate the metabolic and immunologic routes underlying this specific phenotype and the associated clinical features. A total of 87 patients with a clinical history of asthma were recruited and stratified in four groups according to their response to treatment: corticosteroid-controlled (ICS), immunotherapy-controlled (IT), biologicals-controlled (BIO), and UC. Metabolomic analysis showed that ICS and UC groups cluster separately from one another and display the highest number of significantly different metabolites among all comparisons. Metabolite identification and pathway enrichment analysis highlighted increased levels of lysophospholipids related to inflammatory pathways in patients with UC. Data also suggested a significant activation of T cells in patients with UC compared with those with ICS.
