A multi-omics approach to delineate sputum microbiome-associated asthma inflammatory phenotypes

Asthma is a heterogeneous disease with multiple clinical presentations (phenotypes) [1]. Neutrophilic asthma is characterised by increased sputum neutrophils and generally has a poor response to corticosteroids and limited other therapeutic options. Neutrophilia originates from different factors, including the defective resolution of inflammation or bacterial infections [2]. An association between airway bacterial imbalance (disturbance) and the neutrophilic phenotype has been reported [3], suggesting that airway microbiota composition is involved in neutrophilic asthma. Rather than being a separate entity [4], neutrophilic asthma may be in part, an alliance between innate immunity and microbiota composition that prompts protective mechanisms against invading pathogens [2].