Allergy Asthma Respir Dis.  2014 Jul;2(3):165-170. 10.4168/aard.2014.2.3.165.

Heterogeneity of asthma according to systemic inflammatory pattern in children

• Sol IS
• Kim YH
• Lee HS
• Kim MJ
• Han YK
• Park YA
• Kim KW
• Sohn MH
• Kim KE

• KMID: 2262515
• DOI: http://doi.org/10.4168/aard.2014.2.3.165

Abstract

PURPOSE
Asthma is a chronic airway inflammation. We evaluated whether systemic inflammatory patterns could reflect the nature of airway inflammation. We assessed characteristics of asthma according to systemic inflammatory patterns.
METHODS
A total of 413 children with asthma were enrolled in the study. Four systemic inflammatory patterns were classified according to eosinophil and neutrophil counts in peripheral blood. Children with neutrophil count> or =5,000/microL were defined as the NEU(hi) group, those with neutrophil count <2,720/microL as the NEU(lo) group. The intermediate group with neutrophil count between 2,720/microL and 5,000/uL was excluded from the study. Children with eosinophil> or =650/microL were defined as the EOS(hi) group, those with eosinophil count<240/microL as the EOS(lo) group. The remaining patients were excluded from the study. The characteristics of asthma include pulmonary function test results, bronchodilator response, airway hyperresponsiveness, and atopy.
RESULTS
The EOS(hi) group had a lower PC20 (provocative concentration of methacholine causing a 20% fall in forced expiratory volume in 1 second [FEV1]), a lower FEV1, and a higher immunoglobulin E level rather than the EOS(lo) groups, although there were no significant differences between the NEU(hi) and NEU(lo) groups. The eosinophil percentages of the induced sputum samples were higher in the EOS(hi) group than the EOS(lo) group and correlated with blood eosinophil counts.
CONCLUSION
Eosinophilic inflammation was related to characteristics of asthma and sputum eosinophils. However, neutrophilic inflammation reflected neither asthma features, sputum neutrophils, nor eosinophilic inflammation. Further studies on blood neutrophils involving asthma phenotypes in terms of more specific characteristics of asthma should be needed in children.

Keyword

Asthma; Inflammation; Eosinophils; Neutrophils

MeSH Terms

Asthma*
Child*
Eosinophils
Forced Expiratory Volume
Humans
Immunoglobulin E
Immunoglobulins
Inflammation
Methacholine Chloride
Neutrophils
Phenotype
Population Characteristics*
Respiratory Function Tests
Sputum
Immunoglobulin E
Immunoglobulins
Methacholine Chloride

Figure

• 

  Fig. 1 The correlation of blood neutrophil counts and sputum neutrophil concentration (A), blood eosinophil counts and sputum eosinophil concentration (B) in children with asthma. Blood eosinophil counts show a tendency to be correlated with sputum eosinophil concentration, while blood neutrophil counts were not correlated with sputum neutrophil concentration. r=Spearman correlation coefficient.

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