Moving Towards Precision Medicine in United Airways Disease: Unraveling Inflammatory Patterns in Asthmatic Patients With or Without Nasal Polyps

Inclusion Criteria: All patients who * 18-99 years of age * have a recorded clinical diagnosis of asthma (ICD-10 Code: J45) * undergo moderate-serve asthma treatment according to GINA/DAL treatment step 4 or step 5 without oral corticosteroid or monoclonal antibody therapy * Asthma treatment for a minimum of 12 weeks prior to screening visit * Group 1 and 2 - T2-high asthma with or without polyps: * FeNO \> 25 ppB * had either two times \>= 250 eosinophils /µl measured in the blood OR one measurement of blood eosinophils \>= 250 cells/µl (one of the two measurements at the screening visit) and/or one measurement of sputum eosinophils \> 2% within the last 12 months * Group with polyps: Presence of CRSwNP as confirmed by endoscopy or CT according to the European Position Paper on Rhinosinusitis and CRSwNP Guidelines) * Group 3 - CRSwNP in absence of asthma: * Presence of CRSwNP as confirmed by endoscopy or CT according to the European Position Paper on Rhinosinusitis and Nasal Polyps Guidelines * Evidence of Type 2 inflammation: eosinophils \>= 250 cells/µl measured in the blood OR total IgE \>100 kU/L at the screening visit * Absence of asthma and N-ERD * Patients with a history of treatment with monoclonal antibodies for asthma or polyps will only be included if at least a wash out period of 5 half-lives or at least 3 months have passed Exclusion Criteria: * Pregnancy (as determined by ß-HCG test) * Patients with severe anatomic variations or deviations that do not allow access to all areas in the nasal cavity * Patients undergoing chronic oral corticosteroid therapy * Patients with any other confounding underlying lung disorder including but not limited to: * Bronchiectasis, chronic obstructive pulmonary disorder (COPD), pulmonary fibrosis, emphysema, primary ciliary dyskinesia * Cystic fibrosis, any known parasitic infections, and lung cancer * Patients with pulmonary conditions with symptoms of asthma and blood eosinophilia including but not limited to: Eosinophilic granulomatosis with polyangiitis (EGPA), allergic bronchopulmonary aspergillus, and hypereosinophilic syndrome * A mental condition rendering the subject unable to understand the nature, scope, and possible consequences of the study * Patients with clinically meaningful comorbidity as determined by the evaluating committee * Patients with a history of exacerbation of chronic rhinosinusitis or asthma 4 weeks prior to any visit * Intake of a burst of systemic corticosteroids 4 weeks prior to any visit. * Immunosuppressive treatment (e.g. cyclosporine) * Drug and alcohol abuses * Current smoker * Former smoker if stopped smoking \<6 months and/or has \>10 pack-years