From the Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, South Korea.
Allergy Asthma Proc. 2022 Mar 1;43(2):133-139. doi: 10.2500/aap.2022.43.210001.
Asthma is a heterogeneous disease, characterized by chronic airway inflammation. Asthma exacerbations (AE) are episodes characterized by a progressive increase in symptoms of shortness of breath, cough, wheezing, or chest tightness with a decrease in lung function. There have been previous studies that examined the role of eosinophil-derived neurotoxin (EDN) in asthma, but there have been no studies of the role of EDN in children experiencing AE. In this study, we aimed to examine the association of EDN with lung function and prognosis in children admitted for severe AE. We enrolled 82 children who were admitted for severe AE at two different university hospitals in South Korea between January 2018 and December 2019. Blood tests, including white blood cell count, myeloperoxidase (MPO), total eosinophil count, EDN, C-reactive protein (CRP) level, and interleukin (IL) 4, IL-5, IL-10 values, and lung function were measured on admission and at discharge in each patient. We observed significant decreases in the levels of MPO, EDN, CRP, and IL-4, with significant improvement in lung function after treatment. We then classified the subjects into two groups of different clinical phenotypes: eosinophilic asthma exacerbation (EAE) group and non-EAE group. EDN levels were higher and lung functions were lower in the EAE group. Also, we found that the EDN level was a significant biomarker useful for predicting the number of days for hospital stay. We found that EDN can act as a biomarker that reflects lung function, and that EDN could act as a prognostic biomarker, which demonstrated the complex role of EDN in children experiencing AE.
哮喘是一种异质性疾病，其特征为慢性气道炎症。哮喘加重（AE）是指以呼吸困难、咳嗽、喘息或胸闷症状进行性加重，肺功能下降为特征的发作。此前已有研究探讨了嗜酸性粒细胞衍生神经毒素（EDN）在哮喘中的作用，但尚无研究探讨 EDN 在经历 AE 的儿童中的作用。在这项研究中，我们旨在研究 EDN 与因严重 AE 入院的儿童的肺功能和预后的相关性。我们纳入了 2018 年 1 月至 2019 年 12 月在韩国的两家不同大学医院因严重 AE 入院的 82 名儿童。在每位患者入院和出院时，均进行了血液检查，包括白细胞计数、髓过氧化物酶（MPO）、总嗜酸性粒细胞计数、EDN、C 反应蛋白（CRP）水平和白细胞介素（IL）4、IL-5、IL-10 值以及肺功能检查。我们观察到治疗后 MPO、EDN、CRP 和 IL-4 水平显著下降，肺功能显著改善。然后，我们将受试者分为两组不同的临床表型：嗜酸性粒细胞性哮喘加重（EAE）组和非 EAE 组。EAE 组 EDN 水平更高，肺功能更差。此外，我们发现 EDN 水平是预测住院天数的一个有用的预测生物标志物。我们发现 EDN 可作为反映肺功能的生物标志物，并且 EDN 可作为预后生物标志物，这表明 EDN 在经历 AE 的儿童中具有复杂的作用。
