Data-driven disease phenotyping in asthma and COPD patients based on lung function fluctuations

Research questions/goals: Approaches to identifying phenotypes or endotypes in asthma have become increasingly relevant. However, in the majority of published approaches, the characterising parameters are only assessed at a single point in time, yielding phenotypes that might not remain stable as time progresses. We hypothesised that we could identify asthma and functional healthy phenotypes by investigating the patterns of fluctuation in airway function measured over a predetermined, sufficiently long time window of observation.
Current main results and/or publications: We have developed and applied a computational data-driven method that allows us to classify healthy individuals and different types of asthmatic patients according to the fluctuation patterns in their lung function. By applying this methodology to three different patient cohorts, we were able to explore the potential clinical usefulness of our approach. Indeed, we found evidence for the existence of subtypes of asthma patients, who, if properly identified, would benefit from therapeutic strategies that differ from the commonly used anti-inflammatory treatment schemes. More details regarding our main findings can be found in the following publications: Functional phenotypes determined by fluctuation-based clustering of lung function measurements in healthy and asthmatic cohort participants (in this paper our methodology is presented in full detail); Fluctuation-based clustering reveals phenotypes of patients with different asthma severity; and Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation.
Funding: Research Fund Junior Researchers at University of Basel.
Collaborators: Prof. Sven-Erik Dahlén, Dr. Anna James, and Dr. Maciej Kupczyk of the Experimental Asthma and Allergy Research Unit, The National Institute of Environmental Medicine, at Karolinska Institutet, Stockholm, Sweden. Prof. Andrew Bush and Dr. Louise Fleming of Imperial College London and the Royal Brompton and Harefield hospitals, London, UK. Prof. Erika von Mutzius, of the Dr. von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany.