A pilot study to evaluate the role of circulation CD4+ CCR6+ CRTh2+ cell in predicting risk of asthma in wheezing children

Jingyang Li,Jianhua Zhang,Jinhong Wu,Li Hua,Quanhua Liu,Yi Chen,Haipei Liu,Ruoxu Ji,Dingzhu Fang,Wenwei Zhong

doi:10.1186/s12887-021-02746-5

Jingyang Li, Jianhua Zhang + Show 8 more

Open Access

https://doi.org/10.1186/s12887-021-02746-5

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Abstract

BackgroundWheezing is common in younger children and often related to viral infection. It is lack of reliable indicators for asthma prediction.ObjectiveTo evaluate the relationship between circulation CD4+CCR6+CRTh2+ memory Th2 cells and asthma diagnosis in wheezing children.MethodsA prospective study was performed in children under 5 years old presented with wheezing or at last one episode of documented wheezing history. After inclusion, the level of serum allergen-specific serum IgE (sIgE) and circulating CD4+CCR6+CRTh2+cells were detected. The patients’ personal and family histories of allergic disease were acquired by questionnaire. The children were followed up over 2 years. Diagnosis of asthma was assessed at the end follow-up. The risk factors in predicting asthma diagnosis were evaluated.ResultsA total of 43 children completed follow-up. Higher wheezing frequency were found in children with asthma diagnosis. The mean of circulating CD4+CCR6+CRTh2+cells in children diagnosed with or without asthma was 1.6 %±0.8 and 0.8 %±0.6 %, respectively, and was significantly higher in children diagnosed with asthma (p < 0.01). There was no significant difference between children with and without allergic diseases history or family allergic diseases in level of circulating CD4+CCR6+CRTh2+ cells. Logistic regression analysis indicated that circulating CD4+CCR6+CRTh2+ cells (EXP, 8.986; 95 % CI,1.886–42.816) and wheezing frequency(EXP, 0.127; 95 % CI, 0.023–0.703)were high risk factors for asthma.ConclusionsOur exploratory study shown that circulating CD4+CCR6+CRTh2+ memory Th2 cells increased in asthma diagnosed children and it was a high-risk factor for asthma. Detection of this type of cells could be helpful in predicting the risk of asthma in wheezing children.

Highlights

Wheezing is common in younger children and often related to viral infection
The median age of children at followup was 3.0 years and the age distribution was as follows: cases were aged under 3-year-old (48.8 %) and cases were 3–5 years old (51.2 %). 22 cases (51.2 %) presented lower respiratory tract infection (LRTI). 10 cases (23.3 %) of the children used systemic glucocorticoid because of wheezing
We further explored the relationship between the level of CD4+CCR6+CRTh2+ memory Th2 cells and history of allergic diseases such as Allergic rhinitis (AR) and Atopic dermatitis (AD)

Summary

Introduction

Wheezing is common in younger children and often related to viral infection. It is lack of reliable indicators for asthma prediction. Wheezing is common in younger children which is commonly related to acute respiratory tract infection. Pathogenic memory type Th2 cells play an important role in allergic airway inflammation. Inhibition of memory Th2 cells can alleviate allergic airway inflammation and improve the symptoms of asthma [4]. Those studies suggest that memory Th2 cells reflect previous allergic inflammation and can distinguish wheezing caused by non-allergic inflammation versus an immunological mechanism. CD4+ CCR6+ CRTh2+ cell is an important pathogenic memory type Th2 cells which is mainly resident in airway [5]

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