Mixed granulocytic phenotype in asthmatic patients

<b>Introduction:</b> Patients with mixed granulocytic phenotype are included in published studies as eosinophilic or neutrophilic asthma. <b>Aim:</b> To evaluate whether the mixed granulocytic is more similar to eosinophilic or neutrophilic phenotype. <b>Methods:</b> Sputum was induced with hypertonic saline solution and inflammation was classified as neutrophilic (neutrophils ≥61%), eosinophilic (eosinophils ≥3%), mixed (neutrophilic+eosinophilic) or pauci (neutrophils &lt;61% and eosinophils &lt;3%). A P-value &lt;0.05 was considered statistically significant. <b>Results:</b> 108 asthmatic patients (57 females; moderate-severe: 77.8%) were recruited. Asthmatics with mixed granulocytic phenotype are older, had higher sputum cells and lower prevalence of nasal polyposis than eosinophilic subjects (P= 0.01, P= 0.0007, P= 0.01, respectively). They had higher blood eosinophils and lower GERD prevalence than neutrophilic patients (P= 0.007 and P= 0.003). Lung function variables and treatment with inhaled corticosteroids were not significantly different. <b>Conclusion:</b> Asthmatic patients with mixed granulocytic phenotype appear an intermediate phenotype, differing from the eosinophilic one mainly for the age and for the lower prevalence of comorbidities.