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Multicenter Study
. 2020 Aug;31(6):651-661.
doi: 10.1111/pai.13268. Epub 2020 May 17.

Severe preschool asthmatics have altered cytokine and anti-viral responses during exacerbation

Stéphanie Lejeune  1   2 , Muriel Pichavant  2 , Ilka Engelmann  3 , Laurent Béghin  4 , Elodie Drumez  5   6 , Olivier Le Rouzic  2 , Rodrigue Dessein  2   7 , Stéphanie Rogeau  8 , Timothée Beke  2 , Gwenola Kervoaze  2 , Céline Delvart  9 , Héloïse Ducoin  10 , Guillaume Pouessel  11 , Armelle Le Mée  12 , Sophie Boileau  13 , Juliette Roussel  14 , Cécile Bonnel  15 , Clémence Mordacq  1   2 , Caroline Thumerelle  1   2 , Philippe Gosset  2 , Antoine Deschildre  1   2
Affiliations
Multicenter Study

Severe preschool asthmatics have altered cytokine and anti-viral responses during exacerbation

Stéphanie Lejeune et al. Pediatr Allergy Immunol. 2020 Aug.

Abstract

Background: Preschool asthma/recurrent wheeze is a heterogeneous condition. Different clinical phenotypes have been described, including episodic viral wheeze (EVW), severe intermittent wheeze (SIW), and multiple-trigger wheeze (MTW).

Objective: To compare clinical, viral, and inflammatory/immune profiling at exacerbation between MTW, SIW, and EVW phenotypes.

Methods: Multicenter, prospective, observational cohort (VIRASTHMA-2). Children (1-5 years) with preschool asthma were enrolled during hospitalization for a severe exacerbation. History and anamnestic data, plasma, and nasal samples were collected at exacerbation (T1) and at steady state, 8 weeks later (T2), and sputum samples were collected at T1.

Results: A total of 147 children were enrolled, 37 (25%) had SIW, 18 (12.2%) EVW, and 92 (63%) MTW. They were atopic (47%), exposed to mold (22%) and cigarette smoke (50%), and prone to exacerbations (≥2 in the previous year in 70%). At exacerbation, at least one virus was isolated in 94% and rhinovirus in 75%, with no difference between phenotypes. Children with MTW and SIW phenotypes displayed lower plasma concentrations of IFN-γ (P = .002), IL-5 (P = .020), TNF-α (P = .038), IL-10 (P = .002), IFN-β (P = .036), and CXCL10 (P = .006) and lower levels of IFN-γ (P = .047) in sputum at exacerbation than children with EVW. At T2, they also displayed lower plasma levels of IFN-γ (P = .045) and CXCL10 (P = .013).

Conclusion: Among preschool asthmatic children, MTW and SIW, prone to exacerbations, display lower systemic levels of Th1, Th2 cytokines, pro- and anti-inflammatory cytokines, and antiviral responses during severe virus-induced exacerbation.

Keywords: asthma; infection; inflammation; phenotype; preschool children.

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References

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