By Christopher Gaida | Fact checked by Patrick Campbell
https://www.patientcareonline.com/view/sputum-based-test-may-identify-drug-targets-in-asthma-copd
Sputum flow cytometry identifies biologic targets (CD124/CD125) to personalize asthma and COPD treatment.
New research suggesting noninvasive sputum analysis using flow cytometry can identify specific antibody drug receptors in patients with chronic respiratory diseases was presented at the American Academy of Allergy, Asthma and Immunology (AAAAI) 2026 annual meeting.1
The study, titled Sputum as a Diagnostic Tool for the Treatment of Asthma, demonstrates a potential pathway for transitioning from a trial-and-error approach to a precision medicine model in the management of asthma and chronic obstructive pulmonary disease (COPD).2,3
“Asthma and COPD impact approximately 650 million children and adults globally. The good news is that there are very effective treatments for asthma and COPD that work well for some sufferers. However, many patients must try a series of different types of treatments before finding an effective therapy,” said William Bauta, PhD, chief science officer of bioAffinity Technologies.
Asthma is characterized as a heterogeneous disease with multiple clinical phenotypes and endotypes, each involving distinct inflammatory etiologies and triggers. The study comes at a time of great advancement in pulmonary medicine. In 2018, dupilumab received approval for Asthma as an add-on maintenance therapy for patients aged 12 and older. In 2024, benralizumab received approval as an add-on maintenance for the treatment of severe eosinophilic asthma (SEA).4,5
While biologic treatment options are increasingly diverse, selecting the most appropriate therapy remains a clinical challenge. Current practices often rely on surrogate tissues; however, investigators argue that obtaining data directly from the lung via sputum provides a more accurate, noninvasive, and economical interrogation of a patient’s inflammatory state.1-3
Investigators utilized a proprietary flow cytometry platform to analyze sputum cells from patients with asthma and COPD, as well as smokers not diagnosed with these conditions. The process involved dissociating sputum into a single-cell suspension and staining cellular components with fluorescence-labeled antibodies.
Specifically, the study interrogated expression levels of receptors for 2 leading biologic therapies: dupilumab (targeting the CD124 receptor) and benralizumab (targeting the CD125 receptor). The analysis excluded dead cells through viability staining and utilized an antibody panel to differentiate cell types, including leukocytes, alveolar macrophages, T-cells, B-cells, granulocytes, and neutrophils.
Sputum samples were collected over 3 days, refrigerated (4 °C), and shipped overnight on cold packs for laboratory analysis. Upon receipt, samples were processed into single-cell suspensions, stained with a viability dye (FVS510), fixed, and labeled with fluorophore-conjugated dupilumab and benralizumab, along with antibodies targeting immune cells involved in type II inflammation.
Multicolor flow cytometry was then used to evaluate expression of the CD124 and CD125 receptors, key mediators of eosinophilic asthma.
The investigators reported receptor expression data from select cases across different patient profiles:
• Asthma: In 1 patient with asthma, 25.5% of leukocytes expressed the CD124 receptor, while 11.2% of non-leukocytes expressed the same receptor.
• COPD: In a patient with COPD, 25.5% of leukocytes expressed CD124, and 16.5% of leukocytes expressed the CD125 receptor.
• Smokers: In a smoker without a diagnosed respiratory condition, 31.5% of leukocytes expressed CD124. Another smoker showed 41.5% leukocyte expression for a measured biomarker
Leukocytes expressed these drug receptors at higher levels than non-leukocytes within the small sample set.
The diagnostic platform leverages technology similar to the commercially available CyPath® Lung test, which uses artificial intelligence to identify malignancy-indicating cell populations with 92% sensitivity and 87% specificity. The goal of this new research is to apply similar automated AI analysis to match patients with the most effective biologic therapies and monitor inflammatory changes over time.
“We are leveraging our expertise in using our proprietary flow cytometry platform equipped with automated AI analysis to develop tests that match asthma and COPD patients with the most appropriate biologic therapies and monitor their ongoing conditions,” Bauta stated.
According to Bauta, further work is planned to involve using machine learning to identify cell populations in a larger group of patient samples to refine the identification of select drug receptors.
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References:
1. Sputum as a Diagnostic Tool for the Treatment of Asthma Titone, Rossella et al. Journal of Allergy and Clinical Immunology, Volume 157, Issue 2, AB208
2. bioAffinity Technologies, Inc. bioAffinity Technologies, Inc. Published March 3, 2026. Accessed March 6, 2026. https://ir.bioaffinitytech.com/news-events/press-releases/detail/171/bioaffinity-technologies-presents-positive-research
3. Titone R, Pottaz D, Putnam, C, Jacob R, et al. Sputum as a Diagnostic Tool for the Treatment of Asthma. Presented at: 2026 American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting; February 27 – March 2, 2026; Philadelphia, Pennsylvania.
4. FDA Approves Asthma Indication for Dupixent® (dupilumab) | Regeneron Pharmaceuticals Inc. investor.regeneron.com. Accessed March 6, 2026. https://investor.regeneron.com/news-releases/news-release-details/fda-approves-asthma-indication-dupixentr-dupilumab
5. for. FASENRA approved for treatment of children aged 6 to 11 with severe asthma. Astrazeneca-us.com. Published April 11, 2024. Accessed March 6, 2026. https://www.astrazeneca-us.com/media/press-releases/2024/fasenra-approved-for-treatment-of-children-aged-6-to-11-with-severe-asthma.html
