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Sputum biomarkers during acute severe asthma attacks in children-a case-control study

Manisha Ramphul1, Kathryn G Welsh1,2, Richard D May3

  • 1Department of Paediatric Respiratory Medicine, Leicester Children's Hospital, Leicester Royal Infirmary, Leicester, UK.

Acta Paediatrica (Oslo, Norway : 1992)
|November 13, 2021
PubMed

Insights

Acute severe asthma attacks in children show elevated sputum biomarkers linked to bacterial and viral infections. These findings help understand asthma exacerbation mechanisms.

Area of Science:

  • Pediatric Pulmonology
  • Immunology
  • Respiratory Medicine

Background:

  • The immunological mechanisms underlying acute severe asthma attacks in children remain poorly understood.
  • Identifying specific biomarkers can elucidate the pathways involved in asthma exacerbations.

Purpose of the Study:

  • To investigate sputum mediator profiles in children experiencing acute severe asthma attacks.
  • To compare these profiles with those in children with stable asthma and healthy controls.

Main Methods:

  • A prospective observational case-control study involving children aged 5-17 years.
  • Sputum samples were analyzed for mediator profiles and leukocyte differential cell counts.
  • Participants included children with acute severe asthma, stable asthma, and healthy controls.

Main Results:

  • Children with acute severe asthma exhibited elevated levels of acute-phase biomarkers and neutrophil attractants (e.g., IL-6, IL-8).
  • Cytokines associated with bacterial infections (TNF-R1, TNF-R2) and viral infections (CCL-5, CXCL-10, CXCL-11, CXCL-9) were also increased.
  • These elevated mediators were observed in comparison to stable asthma and healthy control groups.

Conclusions:

  • Sputum mediator profiles in acute severe asthma attacks indicate the presence of both bacterial and viral respiratory infections.
  • T2 inflammation markers were also found to co-exist in the sputum of these children.
  • These findings provide insights into the complex immunological responses during severe pediatric asthma exacerbations.
Abstract

Keywords:
airway obstructionelectrochemiluminescenceexacerbationpediatricphenotyping

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