Han Peng, Yin Ju, Zou Huimin, Jiao Anxia, Liu Yuliang, Shen Kunling
Department of Respiratory, Shenzhen Children's Hospital, Shenzhen, China.
Respiratory Department, Beijing Children's Hospital, China National Clinical Research Center of Respiratory Diseases, Capital Medical University, National Center for Children's Health, No.56 Nanlishi Road, Xicheng District, Beijing, 100045, China.
BMC Pediatr. 2025 May 7;25(1):359. doi: 10.1186/s12887-025-05596-7.
Asthma is a heterogeneous disease. Precise and personalized treatment is urgently needed to reduce the disease's burden. Thus, exploring the different types of airway inflammation in hospitalized children with asthma is beneficial for accurately managing childhood asthma.
This retrospective study was conducted on children and adolescents with asthma who were hospitalized for asthma exacerbations. The classification cut-off values of blood eosinophil (EOS) were 150 (Standard 1), 300 (Standard 2), and 470/µL (Standard 3), respectively. Combined with specific IgE (sIgE, 0.7 kU/L), these individuals were divided into four airway inflammation types. We compared the proportion and characteristics of different airway inflammation. The P value < 0.05 indicated statistical significance.
A total of 351 children were enrolled in our study. Based on standard 1, 39.3% of the subjects were classified as Only-atopy group, 11.7% displayed Only-EOS group, 29.6% exhibited Type 2 (T2)-high group, and 19.4% exhibited T2-low group. Under standard 2, 51.3% of the subjects were classified as the Only-atopy group, 5.4% displayed the Only-EOS group, 17.7% exhibited the T2-high group, and 25.6% exhibited the T2-low group. In standard 3, 57.8% of the subjects were classified as the Only-atopy group, 2.9% displayed the Only-EOS group, 11.1% exhibited the T2-high group, and 28.2% exhibited the T2-low group. Furthermore, our findings indicate that patients with T2 low airway inflammation have a longer time from onset to admission, a longer hospitalization time, a lower proportion of atopic dermatitis, and a higher proportion of siblings.
Regardless of the classification standard employed, the distribution of Only-atopy and Only-EOS was similar in different age periods. Moreover, the types of airway inflammation exhibited a consistent temporal pattern. The classification of airway inflammation in children based on peripheral blood and sIgE levels is a valuable tool for accurately treating asthma.
The study was registered at https://clinicaltrials.gov/ with the number: NCT05800379 on 05/04/2023.
哮喘是一种异质性疾病。迫切需要精确且个性化的治疗以减轻该疾病的负担。因此，探究住院哮喘儿童气道炎症的不同类型，有助于准确管理儿童哮喘。
本回顾性研究针对因哮喘急性发作而住院的儿童及青少年。血液嗜酸性粒细胞（EOS）的分类临界值分别为150（标准1）、300（标准2）和470/µL（标准3）。结合特异性IgE（sIgE，0.7 kU/L），将这些个体分为四种气道炎症类型。我们比较了不同气道炎症的比例及特征。P值<0.05表示具有统计学意义。
本研究共纳入351名儿童。依据标准1，39.3%的受试者被归类为单纯特应性组，11.7%表现为单纯EOS组，29.6%表现为2型（T2）高表达组，19.4%表现为T2低表达组。依据标准2，51.3%的受试者被归类为单纯特应性组，5.4%表现为单纯EOS组，17.7%表现为T2高表达组，25.6%表现为T2低表达组。在标准3中，57.8%的受试者被归类为单纯特应性组，2.9%表现为单纯EOS组，11.1%表现为T2高表达组，28.2%表现为T2低表达组。此外，我们的研究结果表明，T2低气道炎症患者从发病到入院的时间更长、住院时间更长、特应性皮炎比例更低且兄弟姐妹比例更高。
无论采用何种分类标准，单纯特应性和单纯EOS在不同年龄段的分布相似。此外，气道炎症类型呈现出一致的时间模式特征。基于外周血和sIgE水平对儿童气道炎症进行分类，是准确治疗哮喘的一项有价值的工具。
该研究于2023年4月5日在https://clinicaltrials.gov/注册，注册号为NCT05800379。
