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Serum and Nasal Lavage Fluid Eosinophil-Derived Neurotoxin Levels in Clinically Defined Asthma Phenotypes

Özuygur Ermis, Saliha Selin ; Malmhäll, Carina ; Borres, Magnus P. ; Movérare, Robert ; Lisik, Daniil ; Abohalaka, Reshed ; Ercan, Selin ; Schmeisser, Susanne ; Basna, Rani LU orcid and Mincheva, Roxana , et al. (2026) In Clinical and Translational Allergy 16(6).
Abstract

Background: As a surrogate for eosinophilic activation, eosinophil-derived neurotoxin (EDN) is a potential clinical biomarker. However, EDN levels and discriminatory ability in different asthma phenotypes are unknown. We quantified serum and nasal lavage fluid (NLF) EDN levels and assessed the potential to differentiate clinically defined asthma phenotypes in an adult-representative sample. Methods: A total of 1499 serum and 386 NLF samples from individuals with current asthma obtained from the West Sweden Asthma Study were analyzed for EDN. Eosinophilic asthma was defined as blood eosinophil count of ≥ 300 cells/mm3, T2-high asthma was defined as blood eosinophil count of ≥ 300 cells/mm3 or fractional exhaled... (More)

Background: As a surrogate for eosinophilic activation, eosinophil-derived neurotoxin (EDN) is a potential clinical biomarker. However, EDN levels and discriminatory ability in different asthma phenotypes are unknown. We quantified serum and nasal lavage fluid (NLF) EDN levels and assessed the potential to differentiate clinically defined asthma phenotypes in an adult-representative sample. Methods: A total of 1499 serum and 386 NLF samples from individuals with current asthma obtained from the West Sweden Asthma Study were analyzed for EDN. Eosinophilic asthma was defined as blood eosinophil count of ≥ 300 cells/mm3, T2-high asthma was defined as blood eosinophil count of ≥ 300 cells/mm3 or fractional exhaled nitric oxide (FeNO) levels of ≥ 25 ppb. Other asthma phenotypes were defined based on presence of atopy, chronic rhinosinusitis (CRS), nasal polyposis, and obesity. Results: Subjects with eosinophilic asthma had higher serum and NLF EDN levels than those with non-eosinophilic asthma. In ROC analyses, serum EDN provided excellent discrimination between eosinophilic and non-eosinophilic asthma (area under curve [AUC] = 0.84, 95% CI = 0.82–0.86); the corresponding AUC for NLF EDN was 0.67 (95% CI = 0.62–0.73). Serum and NLF EDN were higher in atopic asthma, T2-high asthma, and asthma with nasal polyposis compared to their counterparts, but not in asthma with CRS. The highest absolute values of serum and NLF EDN were observed in the high eosinophil + FeNO group, followed by the high-eosinophil-only and high-FeNO-only groups. Conclusion: Both serum and NLF EDN were higher in those with eosinophilic compared to non-eosinophilic asthma. However, only serum EDN appears to distinguish eosinophilic asthma in ROC analyses.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adult, asthma, biomarker, eosinophil, eosinophil-derived neurotoxin
in
Clinical and Translational Allergy
volume
16
issue
6
article number
e70183
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:42337952
  • scopus:105042618872
ISSN
2045-7022
DOI
10.1002/clt2.70183
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2026 The Author(s). Clinical and Translational Allergy published by John Wiley & Sons Ltd on behalf of European Academy of Allergy and Clinical Immunology.
id
be9eba42-9490-414e-b5a4-8af617978257
date added to LUP
2026-07-21 14:28:08
date last changed
2026-09-01 17:34:00
@article{be9eba42-9490-414e-b5a4-8af617978257,
  abstract     = {{<p>Background: As a surrogate for eosinophilic activation, eosinophil-derived neurotoxin (EDN) is a potential clinical biomarker. However, EDN levels and discriminatory ability in different asthma phenotypes are unknown. We quantified serum and nasal lavage fluid (NLF) EDN levels and assessed the potential to differentiate clinically defined asthma phenotypes in an adult-representative sample. Methods: A total of 1499 serum and 386 NLF samples from individuals with current asthma obtained from the West Sweden Asthma Study were analyzed for EDN. Eosinophilic asthma was defined as blood eosinophil count of ≥ 300 cells/mm<sup>3</sup>, T2-high asthma was defined as blood eosinophil count of ≥ 300 cells/mm<sup>3</sup> or fractional exhaled nitric oxide (FeNO) levels of ≥ 25 ppb. Other asthma phenotypes were defined based on presence of atopy, chronic rhinosinusitis (CRS), nasal polyposis, and obesity. Results: Subjects with eosinophilic asthma had higher serum and NLF EDN levels than those with non-eosinophilic asthma. In ROC analyses, serum EDN provided excellent discrimination between eosinophilic and non-eosinophilic asthma (area under curve [AUC] = 0.84, 95% CI = 0.82–0.86); the corresponding AUC for NLF EDN was 0.67 (95% CI = 0.62–0.73). Serum and NLF EDN were higher in atopic asthma, T2-high asthma, and asthma with nasal polyposis compared to their counterparts, but not in asthma with CRS. The highest absolute values of serum and NLF EDN were observed in the high eosinophil + FeNO group, followed by the high-eosinophil-only and high-FeNO-only groups. Conclusion: Both serum and NLF EDN were higher in those with eosinophilic compared to non-eosinophilic asthma. However, only serum EDN appears to distinguish eosinophilic asthma in ROC analyses.</p>}},
  author       = {{Özuygur Ermis, Saliha Selin and Malmhäll, Carina and Borres, Magnus P. and Movérare, Robert and Lisik, Daniil and Abohalaka, Reshed and Ercan, Selin and Schmeisser, Susanne and Basna, Rani and Mincheva, Roxana and Wennergren, Göran and Lötvall, Jan and Ekerljung, Linda and Rådinger, Madeleine and Kankaanranta, Hannu and Nwaru, Bright I.}},
  issn         = {{2045-7022}},
  keywords     = {{adult; asthma; biomarker; eosinophil; eosinophil-derived neurotoxin}},
  language     = {{eng}},
  number       = {{6}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Clinical and Translational Allergy}},
  title        = {{Serum and Nasal Lavage Fluid Eosinophil-Derived Neurotoxin Levels in Clinically Defined Asthma Phenotypes}},
  url          = {{http://dx.doi.org/10.1002/clt2.70183}},
  doi          = {{10.1002/clt2.70183}},
  volume       = {{16}},
  year         = {{2026}},
}