Department of Paediatric Pulmonology, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC), PO Box 5800, 6202 AZ, Maastricht, The Netherlands.
J Breath Res. 2012 Dec;6(4):046001. doi: 10.1088/1752-7155/6/4/046001. Epub 2012 Sep 18.
Wheeze is a common symptom in preschool children. The role of bacteria, regulatory T (T(reg)) cells and their association with airway inflammation in preschool wheeze is largely unknown. We evaluated inflammatory markers in exhaled breath condensate (EBC), bacterial colonization and circulating T(reg) cells in preschool children with and without recurrent wheeze. We recruited 252 children (aged two to four years) with (N = 202) and without (N = 50) recurrent wheeze. EBC was collected using an efficient closed glass condenser. Inflammatory markers in EBC (Interleukin(IL)-2, IL-4, IL-8, IL-10, IL-13) were assessed using multiplex immunoassay. Nasal and throat swabs were analysed for presence of Streptococcus pneumoniae, Haemophilus (para)influenzae and Staphylococcus aureus. Proportions of T(reg) cells (CD4(+)CD25(high)CD127(-)) were quantified by flow cytometry. Recurrent wheezing children had elevated EBC levels of IL-2, IL-4, IL-10 and IL-13 compared to non-wheezers (odds ratio (95% confidence interval): 1.67 (1.23-2.27): 1.58 (1.15-2.18): 1.47 (1.14-1.90): 1.55 (1.16-2.06), p <0.05, respectively). Bacteria were frequently present in children with and without wheeze, with no difference in prevalence (16-52% versus 16-50%, respectively). Moreover, the proportion of T(reg) cells did not differ between both groups. Wheezing children with bacterial colonization did not significantly differ in exhaled levels of inflammatory markers or proportion of T(reg) cells compared to wheezing children without colonization. The analysis of EBC might serve as a helpful non-invasive tool to early assess airway inflammation in wheezing children. The various elevated exhaled inflammatory markers indicate increased airway inflammation in wheezing preschool children. In the presence of wheeze, we found no evidence for bacterial induced airway inflammation.
喘息是学龄前儿童的常见症状。细菌、调节性 T（Treg）细胞及其与学龄前喘息气道炎症的关系在很大程度上尚不清楚。我们评估了有和无反复喘息的学龄前儿童呼出气冷凝物（EBC）中的炎症标志物、细菌定植和循环 Treg 细胞。我们招募了 252 名（年龄 2-4 岁）有（N=202）和无（N=50）反复喘息的儿童。使用高效闭式玻璃冷凝器收集 EBC。使用多重免疫测定法评估 EBC 中的炎症标志物（白细胞介素（IL）-2、IL-4、IL-8、IL-10、IL-13）。分析鼻和咽喉拭子中肺炎链球菌、流感嗜血杆菌（副）和金黄色葡萄球菌的存在情况。通过流式细胞术定量 Treg 细胞（CD4+CD25+高 CD127-）的比例。与非喘息者相比，反复喘息儿童的 EBC 中 IL-2、IL-4、IL-10 和 IL-13 水平升高（优势比（95%置信区间）：1.67（1.23-2.27）：1.58（1.15-2.18）：1.47（1.14-1.90）：1.55（1.16-2.06），p<0.05）。有和无喘息的儿童中细菌均频繁存在，且患病率无差异（分别为 16-52%和 16-50%）。此外，两组之间 Treg 细胞的比例也没有差异。与无细菌定植的喘息儿童相比，有细菌定植的喘息儿童的 EBC 中炎症标志物水平或 Treg 细胞比例无显著差异。EBC 分析可能是一种有用的非侵入性工具，可早期评估喘息儿童的气道炎症。各种升高的呼气炎症标志物表明喘息学龄前儿童的气道炎症增加。在存在喘息的情况下，我们没有发现细菌诱导气道炎症的证据。
