PII-005 - A NOVEL ENDOTYPE OF ADULT ASTHMA SUGGESTED BY PLASMA METABOLITE PROFILING OF THE COHORT FOR REALITY AND EVOLUTION OF ADULT ASTHMA IN KOREA (COREA)

W. Chae¹, J. Lee², T. Kim², J. Cho¹; ¹Seoul National University, ²Asan Medical Center.

Background: Asthma is a heterogenous respiratory disease affecting 1-18% of the population in different countries, which is characterized by variable symptoms such as wheeze, chest tightness and expiratory airflow limitation. In order to control asthma, many expensive drugs should be used for a long period of time. By realizing personalized medicine for asthma patients, medical expenses can be reduced and effect of treatment can be maximized. This observational study aimed to explore plasma metabolic differences between asthma subgroups of cohort for reality and evolution of adult asthma in Korea (COREA), and to suggest novel endotypes of asthmatic status.

Methods: Among adult asthma patients recruited by COREA, 407 adult participants selected for this study. We performed plasma metabolite profiling using Biocrates AbsoluteIDQ p400 kit with an ultra-high performance liquid chromatography coupled with Q-orbitrap mass spectrometer and minimized batch effect of 1-point calibrated metabolites quality control sample-based algorithm. 409 metabolites were quantified and 307 metabolites were selected after filtering process. With this data, we clustered the study population based on unsupervised k-means, k-medoids and Gaussian Mixture Model algorithm.

Results: Metabolite profile-based clustering using k-means and Gaussian Mixture Model showed consistent results among the algorithms (k=3): glyceride and phosphocholine-enriched, biogenic amines-enriched, and ether-linked phosphatidylcholine-enriched clusters. The clusters were also associated with clinical characteristics including age, weight, eosinophils (%) in blood and sputum and lung function parameters (ANOVA, false discovery rate-adjusted p-value < 0.05).

Conclusion: Although additional validation studies in external cohorts are required, this study suggested that plasma metabolome may represent endotype of asthma and contribute to establish strategies for optimal asthma treatment.