17 Asthma Subgroups

Listed here are all the asthma subgroups (Phenotypes) that I have discovered. As you read through this list, chances are pretty good one or more will describe your asthma. Click on the links if you want more information about each subgroup.

Subgroups of asthma

  1. Allergic Asthma. This used to be Extrinsic Asthma. It usually has an Early-Onset and responds well to inhaled corticosteroids (ICS). So, it's usually easy to control with traditional asthma medicines. But, sometimes it can be severe, especially if a person has lots of allergies. It's also often complicated by a duo diagnosis of Exercise or Rhinitis Induced Asthma.
  2. Exercise-Induced Asthma. It affects about 90% of asthmatics and is the most common asthma subgroup. Exercise, especially in cold air, triggers asthma. Asthma episodes are generally mild and go away with either time or treatment.
  3. Rhinitis Induced Asthma. It affects about 80% of asthmatics, making it the second most common asthma subgroup. It’s a stuffy nose caused by allergies. It may occur on its own, especially in late-onset asthma. But it's most often seen in people diagnosed with Allergic Asthma.
  4. Eosinophilic Asthma. It’s our first asthma subgroup named after a type of cell responsible for asthma. Like the above-listed subgroups, it's associated with eosinophilic inflammation. But, eosinophil levels do not decline to normal levels after asthma attacks. This makes it so asthma is persistent and hard to control. It does respond to ICS, but usually the highest doses. It’s usually combined with chronic sinusitis and nasal polyps. So, it’ usually Severe Asthma
  5. Severe Asthma. It is sometimes listed as an asthma subgroup of its own, so I’m listing it here. It’s when asthma that is difficult to control. It's defined as needing 2 or more asthma medicines to gain any degree of asthma control. It often requires systemic corticosteroids.
  6. Aspirin Exacerbated Respiratory Disease (AERD). Asthma is caused by Aspirin, Tylenol, or Ibuprofen. It's often complicated by a diagnosis of Eosinophilic Asthma. It responds well to ICS, although most likely the highest doses. So, it’s usually Severe Asthma.
  7. Premenstrual Asthma. It's the only subgroup of asthma that consists only of females. It's diagnosed after the age of 12, and so has a late-onset. It's when female hormones cause asthma. It usually occurs before menopause or during pregnancy. It's often combined with Allergic Asthma. It's sometimes combined with AERD, Neutrophilic, or Severe Asthma.
  8. Occupational Asthma.  It's asthma caused by your work. It's when you're inhaling substances at your work day after day and year after year. These substances can include flour, dust, wood dust, metals, chemicals, etc.  It has a late onset. It's usually Severe Asthma.
  9. GERD Asthma. It's asthma caused by acid reflux. It does not respond well to ICS, although it might respond to GERD treatment.
  10. Allergic Bronchopulmonary Aspergillosis. Airways are hypersensitive to a fungus called Aspergillus fumigatus. It responds well to ICS, although the highest doses. It's often complicated by allergies, sinusitis, rhinitis, and eczema. It tends to be Severe Asthma.
  11. Churg Strauss Syndrome. Along with inflamed airways, they also have inflamed blood vessels of certain organs. This is all complicated by rhinitis, sinusitis, neuropathy, rashes, and other symptoms.  It's treatable when diagnosed early. It responds well to ICS, although at the highest doses. It's Severe Asthma.
  12. Neutrophilic. It's another subgroup named after the types of cells that cause it. It's when airway inflammation is due to a high number of neutrophils in airways. Unlike eosinophils, this inflammation does not respond well to corticosteroids. So, it tends to be Severe Asthma. It is one of the least well-understood asthma subgroups.
  13. Combined Eosinophilic-Neutrophilic. This is when a person has a combination of Eosinophilic and Neutrophilic Asthma. It is rare, and is often thought to be the most severe subgroup of asthma.
  14. Asthma/ COPD Overlap Syndrome. It’s associated with a combination of features of both asthma and COPD. It may come with a duo diagnosis of Neutrophilic Asthma. It can also come with a duo diagnosis of Combined Eosinophilic-Neutrophilic Asthma. So, it usually tends to be Severe Asthma.
  15. Psychiatric Induced. It's asthma caused by stress, anxiety, and depression. It's treatable with asthma, anti-anxiety, or anti-depression medicine. Counseling may also help. It's another asthma subgroup that is not well understood. It's hard to diagnose. So, it often goes untreated and can lead to Severe Asthma.
  16. Smooth Muscle Mediated Paucigranulocytic. This a newer subgroup of asthma that is not well understood. It's when airway inflammation is neither eosinophilic nor neutrophilic. Since the cause is unknown, researchers have yet to identify ideal treatment options.

You may have a diagnosis of one or more of these subgroups already. If you do, great!  If not, please resist the temptation to diagnose yourself. A better idea is to use this information to further the discussion with your asthma doctor.

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