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Identification of the major immune differences in severe asthmatic children according to their atopic dermatitis

Guillaume Lezmi1, Clément Poirault1, Marta Grauso2

  • 1Université de Paris, Institut Necker Enfants Malades, Equipe Immunorégulation et Immunopathologie, Inserm UMR1151, CNRS UMR8253, F-75015, Paris, France; AP-HP, Hôpital Necker-Enfants Malades, Service de Pneumologie et Allergologie Pédiatriques, F-75015, Paris, France.

Cellular Immunology
|March 1, 2024
PubMed

Insights

Children with severe asthma (SA) and atopic dermatitis (AD) show distinct immune profiles in airway and blood samples compared to those without AD. These differences suggest unique inflammatory pathways in pediatric severe asthma.

Area of Science:

  • Pediatric Immunology
  • Respiratory Medicine
  • Allergy and Immunology

Background:

  • Severe asthma (SA) affects 2-5% of asthmatic children, with up to 34% also having atopic dermatitis (AD).
  • Both conditions share genetic and immunological links, but distinct immune profiles in children with SA, with or without AD, remain unclear.
  • Understanding these differences is crucial for identifying potential endotypes in pediatric SA.

Purpose of the Study:

  • To compare the immune profiles in bronchoalveolar lavage (BAL) and blood of children with severe asthma (cwSA) with and without atopic dermatitis (AD).
  • To investigate specific immune cell populations and cytokine/chemokine differences between these two groups of pediatric patients.
  • To explore correlations between plasma and BAL cytokines in cwSA with and without AD.

Main Methods:

  • Seventeen children with severe asthma (cwSA) were enrolled: seven with AD and ten without AD.
  • Bronchoalveolar lavage (BAL) and blood samples were collected for analysis.
  • Seventy-three cytokines/chemokines and immune T cell populations were quantified in both BAL and blood.

Main Results:

  • Overall immune profiles in BAL and blood were similar between cwSA with and without AD.
  • Specific differences observed: lower frequencies of Tc2, Th17, and IL-17-producing MAIT cells in BAL.
  • Higher CD8/CD4 ratio and IL-22 in BAL, and increased CCL19 in plasma were noted in cwSA with AD.
  • Positive correlations between plasma and BAL cytokines were found only in cwSA with AD.

Conclusions:

  • Significant immune differences exist in BAL and blood between pediatric severe asthma patients with and without atopic dermatitis.
  • These findings suggest distinct endotypes may contribute to the inflammatory responses in these pediatric populations.
  • Further research into these immune variations could lead to more targeted therapeutic strategies for pediatric severe asthma.

Keywords:
AsthmaAtopic dermatitisBronchoalveolar lavageChildrenT cells

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