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T‐cell cytokine profiles are altered in childhood asthma exacerbation
Author(s) -
CALDERON Czarina,
RIVERA Luis,
HUTCHINSON Paul,
DAGHER Hayat,
VILLANUEVA Elmer,
GHILDYAL Reena,
BARDIN Philip G.,
FREEZER Nicholas J.
Publication year - 2009
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2008.01464.x
Subject(s) - medicine , cytokine , immunology , asthma , exacerbation , cd8 , convalescence , immune system
Background and objective: Stable asthma is characterized by the production of Th2 cytokines, although Th1 cytokines may play a key role in aspects such as airway hyper‐responsiveness. This study explored cytokine profiles associated with asthma exacerbation. Methods: Intracellular T‐cell cytokine production was measured in 16 children with acute severe asthma (emergency department), after convalescence (6 weeks, n = 13), with stable disease (after 6 months, n = 7) and in 14 age‐matched hospital controls. Flow cytometry was used to identify CD4+ and CD8+ cells and to quantify intracellular T‐cell production of the cytokines interferon (IFN)‐γ, IL‐4 and IL‐13. Cytokine production was compared using analysis of variance and random‐effects generalized linear models and associations were examined using Pearson's correlation. Results: Cytokine production was evident in CD4+ and CD8+ cells, and compared with asthmatic children, non‐asthmatics had a higher percentage of IFN‐γ+CD4+ cells ( P = 0.01). The percentage of CD8+IFN‐γ+ cells was increased in the convalescent phase compared with acute ( P = 0.009) and stable asthma ( P = 0.004). IL‐4+ cells were not significantly altered. IL‐13 levels were higher in acute disease than in stable asthma ( P = 0.009 in CD4+ cells) and IFN‐γ/IL‐13 ratios indicated a Th2 profile during exacerbation ( P = 0.005 in CD4+ cells). Conclusions: IL‐13, rather than IL‐4, may play a pro‐inflammatory role during acute severe asthma, whereas IFN‐γ responses were associated with recovery from acute severe asthma. These results suggest that altered T‐cell cytokine profiles may contribute to the pathogenesis of and recovery from asthma exacerbations.