The Clinical and Laboratory Phenotypes of Severe Asthma Patients in Clalit Health Services Haifa
The Clinical and Laboratory Phenotypes of Severe Asthma Patients in Clalit Health Services Haifa
Asthma is a chronic illness characterized by inflammation of the airways. Severe asthma is
 defined in the literature as asthma not controlled by medication. In recent years it has
 become known that severe asthma is a variable disease and has subtypes relating to the age of
 onset, type of inflammation and allergy, obesity, etc.

 Our aim is to characterize the phenotypes of severe asthma population in our clinic and
 compare the prevalent phenotypes to the phenotypes described before.
Study measures will include the following:

 -  asthma demographic and symptoms questionnaire

 -  Validation of proper inhaler technique

 -  Height, weight measurements

 -  Forced spirometry and reversibility testing

 -  DLCO

 -  Fractional excretion of NO in exhaled breath

 -  Chest and sinus CT

 -  Induced sputum analysis

 -  Complete blood count, electrolytes, immunoglobulin E, Aspergillus Specific IgE

 -  Skin allergy testing
Inclusion Criteria:

 1. Presence of Asthma- typical symptoms and signs accompanied by either: a. obstruction
 in Spirometry, OR- b. positive methacholine test

 2. Regular use of high dose of inhaled corticosteroids (1000 micrograms of fluticasone
 per day or equivalent) in addition to a long acting beta agonist (LABA).

 3. Lack of asthma control- 2 or more exacerbations in the past year- exacerbations
 defined by hospitalization or care in an emergency department or treatment with
 systemic glucocorticosteroids for exacerbation of asthma symptoms.

 Exclusion Criteria:

 1. Presence of another relevant respiratory illness, such as chronic obstructive
 pulmonary disease (COPD)

 2. lack of adherence to medical therapy