Premium
Stability of sputum inflammatory phenotypes in childhood asthma during stable and exacerbation phases
Author(s) -
Tsang Yuk Ping,
Marchant Julie M.,
Li Albert M.,
Chang Anne B.
Publication year - 2021
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.25347
Subject(s) - medicine , sputum , exacerbation , asthma , asthma exacerbations , phenotype , intensive care medicine , immunology , pathology , genetics , tuberculosis , biology , gene
Background 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. Methods 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. Results 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. Conclusion In children with asthma, sputum inflammatory phenotypes are variable in both stable and exacerbation phases, in contrast to data in adults.