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Published on: April 16, 2019

Bronchodilator response is linked with uncontrolled moderate-to-severe childhood asthma and elevated IL-4 and IL-13

Nariman K A Metwally1,2,3,4,5, Simone Hashimoto1,2,3,4, Susanne J H Vijverberg1,2,3

  • 1Department of Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.

Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology
|June 8, 2026
PubMed

Insights

High bronchodilator response (BDR) in children with moderate-to-severe asthma is linked to poorer disease control and specific inflammatory markers. This finding suggests BDR could help in asthma phenotyping.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Pathophysiology
  • Immunology

Background:

  • Bronchodilator response (BDR) is crucial in childhood asthma but its link to disease mechanisms remains unclear.
  • This study investigates BDR's association with disease control and systemic inflammation in children with moderate-to-severe asthma (MSA).

Purpose of the Study:

  • To examine the relationship between BDR and asthma control in children.
  • To identify serum cytokine and chemokine profiles associated with high BDR in pediatric asthma.

Main Methods:

  • 140 children with moderate-to-severe asthma (6-17 years) were assessed for BDR using ERS/ATS 2022 guidelines.
  • Logistic regression analyzed uncontrolled asthma risk related to BDR; Luminex assay measured 39 serum proteins.
  • Linear regression compared protein levels between high and low BDR groups, with FDR correction.

Main Results:

  • Children with high BDR (21%) had significantly higher odds of uncontrolled asthma (aOR ≈ 3.22) and more exacerbations.
  • Elevated serum levels of IL-13, IL-4, TNF-α, IL-6, IL-7, IL-8, IL-1β, and MMP-1 were observed in high-BDR children (q < 0.05).

Conclusions:

  • High BDR in pediatric moderate-to-severe asthma is independently associated with poorer control and a unique inflammatory signature.
  • BDR may function as a valuable biomarker for phenotyping asthma in children.
Abstract

Keywords:
asthma controlbronchodilator responsemoderate‐to‐severe pediatric asthmanon‐invasive phenotypingtype 2 inflammation

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