NEUTROPHILIC BRONCHIAL ASTHMA: UNRAVELING CLINICAL AND SOCIODEMOGRAPHIC FEATURES

Abstract

Background/Objectives- Neutrophilic Bronchial Asthma (NBA) is a distinct asthma phenotype characterized by neutrophilic airway inflammation, frequent exacerbations, and poor corticosteroid responsiveness. Data on the clinical, occupational, and environmental profile of NBA in the Indian population are limited. This study evaluated demographic characteristics, clinical features, occupational and environmental exposures, and inflammatory associations in NBA. Methods- This cross-sectional observational study was conducted at a tertiary care hospital in India from May 2023 to November 2024. Of 562 patients with bronchial asthma screened, 150 were diagnosed with NBA based on sputum neutrophilia (>61%). Demographic details, body mass index, clinical symptoms, socioeconomic status, occupational history, and environmental exposures were recorded. Sputum cytology was analyzed, and statistical analyses assessed correlations between clinical variables and sputum neutrophil percentages. Results- The mean age was 38.9 ± 13.5 years, with a slight female predominance (52%) and a mean body mass index of 25.3 kg/m². Dyspnea was the most common symptom (91.33%), followed by dry cough (33%) and nasal stuffiness (22.67%). Nearly half of patients (48.6%) belonged to the upper-lower socioeconomic class. Occupational exposure was common among farmers (24%), painters (12.7%), and bakery workers (12.7%). Common environmental exposures included house dust (52%), smoke (39.33%), and air fresheners (24.67%). A moderate positive correlation was observed between age and sputum neutrophil percentage (r = 0.449, p < 0.01) and significant associations between socioeconomic class, occupation, and elevated neutrophilic inflammation. Conclusions- Neutrophilic Bronchial Asthma is an under-recognized phenotype in India, linked to occupational and environmental exposures. Phenotypic identification and management may improve outcomes.