{
  "abstract": "Background: Asthma is a heterogeneous inflammatory airway disease traditionally classified into T2 high (eosinophilic) and T2 low inflammatory phenotypes. Fractional exhaled nitric oxide (FeNO) is commonly used as a biomarker of T2 inflammation, although nitric oxide also regulates monocyte maturation and T cell polarization. We hypothesized that FeNO identifies distinct systemic immune phenotypes in asthma. Methods: Peripheral immune cell subsets were characterized using OMIP - 69, a 40 - color high dimensional immunophenotyping panel encompassing innate and adaptive immune populations. Adults with asthma and healthy controls underwent peripheral blood immunophenotyping. FeNO was dichotomized at 25 ppb (FeNO - high [≥] 25 vs FeNO - low <25). Immune-cell subset proportions were summarized as medians (IQRs) and compared using the Wilcoxon rank-sum test. Logistic regression was used to evaluate associations between immune subsets and FeNO status. Results: Eighteen participants with asthma and seven healthy controls were enrolled. Asthmatic participants had higher BMI than healthy controls (median [IQR] asthma: 35.1 [28.9 - 37.7] vs healthy: 25.4 [22.6 - 26.7] kg/m2; p=0.003), although demographics were otherwise similar. Among asthmatics, 10 participants had FeNO - low asthma, and eight had FeNO - high asthma. FeNO - high asthma demonstrated increased classical monocytes (CD14++CD16 -) and compared with healthy controls (p=0.027), whereas FeNO - low asthma more closely resembled healthy controls. Intermediate monocytes (CD14++CD16+) were increased in FeNO - high versus FeNO - low (p= 0.08); a similar association was noted for classical monocytes (p = 0.13). In contrast, CCR7+ TCR; T - cells were significantly enriched in FeNO - low asthma (p=0.002). Logistic regression demonstrated positive associations between high - FeNO and classical monocytes (OR 16.06, 95% CI 1.56 - 1304.69; p=0.007) and intermediate monocytes (OR 4.19, 1.22 - 132.30; p=0.017), whereas CCR7+ {gamma} {delta} T - cells were negatively associated with high FeNO (OR 0.06, 0.00 - 0.47; p=0.001). Conclusions: Distinct systemic immune signatures identified by high-dimensional cytometry support the existence of biologically divergent FeNO - defined asthma endotypes and may inform future biomarker-driven approaches to patient stratification and precision therapy.",
  "abstract_shown": true,
  "affiliations": [
    "Cleveland Clinic"
  ],
  "article_type": "New results",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "N. Solanki"
    },
    {
      "name": "N. Wanner"
    },
    {
      "name": "J. Thomas"
    },
    {
      "name": "Y. Wang"
    },
    {
      "name": "S. Erzurum"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2zp8y3w2t6csc.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.09.04.749390",
  "fulltext_url": "https://www.biorxiv.org/content/10.64898/2026.09.04.749390v1.full",
  "id": "2zp8y3w2t6csc",
  "issns": [],
  "landing_url": "https://www.biorxiv.org/content/10.64898/2026.09.04.749390v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "biorxiv",
      "immunology"
    ],
    [
      "openalex",
      "2737|Asthma and respiratory diseases"
    ]
  ],
  "openalex": "W7212069797",
  "pdf_url": "https://www.biorxiv.org/content/10.64898/2026.09.04.749390v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-04",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2zp8y3w2t6csc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:25Z",
      "native_id": "10.64898/2026.09.04.749390",
      "source": "biorxiv",
      "url": "https://www.biorxiv.org/content/10.64898/2026.09.04.749390v1"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "biorxiv:immunology",
      "subfield": "immunology"
    }
  ],
  "title": "High-Dimensional Immunophenotyping Identifies Circulating Immune Signatures Associated with FeNO-Defined Asthma Phenotypes",
  "title_text": "High-Dimensional Immunophenotyping Identifies Circulating Immune Signatures Associated with FeNO-Defined Asthma Phenotypes",
  "type": "preprint",
  "updated_at": "2026-10-30T12:20:25Z",
  "url": "https://research.draconitic.com/paper/2zp8y3w2t6csc",
  "venue": "bioRxiv",
  "versions": []
}