Related Experiment Video
Updated: Jun 24, 2025
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Innate immune responses are increased in children with acute asthma exacerbation
Shahid Sheikh1,2,3, Mariah Eisner3,4, Joshua Walum5
1Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Insights
Pediatric asthma exacerbations show increased innate immune responses and blunted adaptive immunity, regardless of the trigger. This suggests new therapies targeting persistent innate immunity are needed for better asthma outcomes.
Area of Science:
- Pediatric immunology
- Respiratory medicine
- Allergy and clinical immunology
Background:
- Immune responses during acute asthma exacerbations in children are not well understood.
- This study investigated immune profiles in pediatric patients experiencing acute asthma exacerbations.
Purpose of the Study:
- To examine immune responses, including cytokine levels and gene expression, in children with acute asthma exacerbation.
- To differentiate between viral and non-viral triggers of asthma exacerbations.
Main Methods:
- Evaluated pro-inflammatory cytokine levels (IL-1RA, IL-10, TNF-α) and gene expression profiles in blood samples from pediatric asthma patients.
- Utilized viral Polymerase chain reaction (PCR) to identify triggers.
- Compared immune profiles of 20 children with asthma to 14 healthy controls.
Main Results:
- Asthma patients showed significantly increased IL-1RA and IL-10, and decreased TNF-α compared to controls.
- RNA-sequencing revealed 852 differentially expressed genes, with upregulated innate immune pathways and downregulated T helper cell-related pathways.
- Twelve of 20 children had viral infections (rhinovirus or RSV); 5 required CPAP in the PICU.
Conclusions:
- Acute asthma exacerbations in children are characterized by persistent innate immune activation.
- Adaptive immune responses, specifically T helper cell pathways, are blunted.
- Findings suggest a need for novel therapies targeting innate immune pathways to improve acute asthma outcomes.
Background:
Little is known about the immune responses during acute asthma exacerbation. In this study, we examined immune responses in children following an acute asthma exacerbation.
Methods:
We evaluated pro-inflammatory cytokine levels and gene expression profiles in blood samples from pediatric patients admitted for acute asthma exacerbation. Viral PCR was performed to differentiate between viral or non-viral-associated exacerbations.
Results:
Following informed consent, clinical data were obtained from 20 children with asthma (median [interquartile range, IQR]: age 11.5 [8.0, 14.2]) years and 14 healthy age-matched controls (10.5 [7.0, 13.0]). Twelve had positive nasopharyngeal Polymerase chain reaction (PCR) for viral infection (11 rhinoviruses and 1 respiratory syncytial virus (RSV)). Nine were in the pediatric intensive care unit (PICU) and among them five required continuous positive airway pressure (CPAP). Mean (±SD) days on systemic steroids before drawing blood sample were 2.5 ± 1.6. Twelve had history of environmental allergies with 917 (274, 1396) IU/mL total IgE (median (IQR)). Compared with controls, IL-1RA and IL-10 levels were significantly increased and TNF-α significantly decreased in asthma subjects (p < .05 for all). RNA-seq analysis revealed 852 differentially expressed genes in subjects with asthma. Pathway analysis found upregulated genes and pathways involved in innate immune responses in subjects with asthma. Significantly reduced genes included pathways associated with T helper cell differentiation and activation.
Conclusions:
In acute asthma exacerbation, innate immune pathways remained increased while adaptive immune responses related to T helper cells are blunted and are independent of trigger or asthma severity. Our novel findings highlight the need to identify new therapies to target persistent innate immune responses to improve outcomes in acute asthma.
More Related Videos
11:54Absorption of Nasal and Bronchial Fluids: Precision Sampling of the Human Respiratory Mucosa and Laboratory Processing of Samples
Published on: January 21, 2018
10:39Advanced Imaging of Lung Homing Human Lymphocytes in an Experimental In Vivo Model of Allergic Inflammation Based on Light-sheet Microscopy
Published on: April 16, 2019
Related Concept Videos
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:25Antiasthma Drugs: Mast Cell Stabilizers and Anti-IgE Drugs
Mast cell stabilizers, such as cromolyn (also known as sodium cromoglycate) and nedocromil (Tilade), are effective drugs in asthma management. These stabilizers hinder histamine release by skillfully obstructing the activation of mast cells and other cellular entities. Notably, they navigate this task without...
02:06Allergic Reactions
01:24Asthma-III: Symptoms and Complications
Classification of Asthma