Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Queensland, Australia.
Department of Paediatrics & Adolescent Medicine, United Christian Hospital, Hong Kong SAR.
Pediatr Pulmonol. 2021 Jun;56(6):1484-1489. doi: 10.1002/ppul.25347. Epub 2021 Mar 13.
Management strategies based on airway inflammation phenotypes are increasingly used for adults with asthma. While sputum-based phenotypes are relatively stable in adults with asthma, there is little such data in childhood asthma. Hence, we aimed to evaluate the stability of sputum inflammatory phenotypes in children with asthma both in the stable and during exacerbation phases.
Sputum cellularity data from two previous prospective studies involving children with asthma were re-evaluated and categorized into two inflammatory phenotypes: eosinophilic (>2.5% eosinophils) and noneosinophilic (≤2.5% eosinophils). Baseline values and follow-up sputum inflammatory phenotype classification were compared in children with asthma during stable and exacerbation phases.
Thirteen of 32 children (41%) with stable asthma demonstrated a change in sputum inflammatory phenotype 8 weeks later. In a different second cohort, both sputum eosinophils and neutrophils percentages increased and peaked on Day 1 of asthma exacerbation, but compared with baseline, 22% (2/9) and 13% (1/8) of these children had their sputum phenotype categorization changed on Day 1 and Day 3 of exacerbation, respectively.
In children with asthma, sputum inflammatory phenotypes are variable in both stable and exacerbation phases, in contrast to data in adults.
基于气道炎症表型的管理策略越来越多地用于成人哮喘。虽然成人哮喘中基于痰液的表型相对稳定，但儿童哮喘中此类数据很少。因此，我们旨在评估哮喘儿童在稳定期和加重期痰液炎症表型的稳定性。
重新评估了两项先前涉及哮喘儿童的前瞻性研究中的痰液细胞数据，并将其分为两种炎症表型：嗜酸性粒细胞（>2.5%嗜酸性粒细胞）和非嗜酸性粒细胞（≤2.5%嗜酸性粒细胞）。比较了哮喘儿童在稳定期和加重期的基础值和随访痰液炎症表型分类。
32 名稳定期哮喘儿童中有 13 名（41%）在 8 周后痰液炎症表型发生变化。在第二个不同的队列中，哮喘加重第 1 天痰液中的嗜酸性粒细胞和中性粒细胞百分比均增加并达到峰值，但与基线相比，分别有 22%（2/9）和 13%（1/8）的儿童在加重第 1 天和第 3 天痰液表型分类发生变化。
与成人数据相比，哮喘儿童在稳定期和加重期痰液炎症表型均不稳定。
