In:
Pediatric Allergy and Immunology, Wiley, Vol. 31, No. 6 ( 2020-08), p. 651-661
Abstract:
Preschool asthma/recurrent wheeze is a heterogeneous condition. Different clinical phenotypes have been described, including episodic viral wheeze (EVW), severe intermittent wheeze (SIW), and multiple‐trigger wheeze (MTW). Objective To compare clinical, viral, and inflammatory/immune profiling at exacerbation between MTW, SIW, and EVW phenotypes. Methods Multicenter, prospective, observational cohort (VIRASTHMA‐2). Children (1‐5 years) with preschool asthma were enrolled during hospitalization for a severe exacerbation. History and anamnestic data, plasma, and nasal samples were collected at exacerbation (T1) and at steady state, 8 weeks later (T2), and sputum samples were collected at T1. Results A total of 147 children were enrolled, 37 (25%) had SIW, 18 (12.2%) EVW, and 92 (63%) MTW. They were atopic (47%), exposed to mold (22%) and cigarette smoke (50%), and prone to exacerbations (≥2 in the previous year in 70%). At exacerbation, at least one virus was isolated in 94% and rhinovirus in 75%, with no difference between phenotypes. Children with MTW and SIW phenotypes displayed lower plasma concentrations of IFN‐γ ( P = .002), IL‐5 ( P = .020), TNF‐α ( P = .038), IL‐10 ( P = .002), IFN‐β ( P = .036), and CXCL10 ( P = .006) and lower levels of IFN‐γ ( P = .047) in sputum at exacerbation than children with EVW. At T2, they also displayed lower plasma levels of IFN‐γ ( P = .045) and CXCL10 ( P = .013). Conclusion Among preschool asthmatic children, MTW and SIW, prone to exacerbations, display lower systemic levels of Th1, Th2 cytokines, pro‐ and anti‐inflammatory cytokines, and antiviral responses during severe virus‐induced exacerbation.
Type of Medium:
Online Resource
ISSN:
0905-6157
,
1399-3038
Language:
English
Publisher:
Wiley
Publication Date:
2020
detail.hit.zdb_id:
2008584-9
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