Abstract
Asthma affects over 8% of the pediatric population in the United States, and Memphis, Tennessee has been labeled an asthma capital. Plasma samples were analyzed for biomarker profiles from 95 children with severe asthma and 47 age-matched, hospitalized nonasthmatic controls at Le Bonheur Children’s Hospital in Memphis, where over 4000 asthmatics are cared for annually. Asthmatics exhibited significantly higher levels of periostin, surfactant protein D, receptor for advanced glycation end products and β-hexosaminidase compared to controls. Children with severe asthma had lower levels of IgG1, IgG2 and IgA, and higher levels of IgE compared to controls, and approximately half of asthmatics exhibited IgG1 levels that were below age-specific norms. Vitamin A levels, measured by the surrogate retinol-binding protein, were insufficient or deficient in most asthmatic children, and correlated positively with IgG1. Which came first, asthma status or low levels of vitamin A and immunoglobulins? It is likely that inflammatory disease and immunosuppressive drugs contributed to a reduction in vitamin A and immunoglobulin levels. However, a nonmutually exclusive hypothesis is that low dietary vitamin A caused reductions in immune function and rendered children vulnerable to respiratory disease and consequent asthma pathogenesis. Continued attention to nutrition in combination with the biomarker profile is recommended to prevent and treat asthma in vulnerable children.
Highlights
Asthma affects approximately 340 million people worldwide and is the leading noncommunicable lung disease in children [1]
Five samples from the asthma group were excluded from analyses due to insufficient plasma volume or due to the patient’s postpartum status
Bonheur Children’s Hospital were enrolled along with 47 hospitalized, nonasthmatics in the same age range. This pilot, observational, cross-sectional study was approved by the Institutional Review Board of the University of Tennessee Health Science Center and patient enrollment occurred between June 2011 and December 2014
Summary
Asthma affects approximately 340 million people worldwide and is the leading noncommunicable lung disease in children [1]. Because asthma is a multifactorial syndrome, there is a heterogenous response to current controller therapies such as corticosteroids. Additional biologics such as IL-5 receptor-alpha blocker (benralizumab) and IL-4 receptor-alpha blocker (dupilumab) have been approved for treatment of patients with moderate to severe eosinophilic asthma [6]. In addition to heterogeneous endotypes, variations in triggers (both environmental and psychological) and socioeconomic factors, including poor access to care, further complicate asthma management. The discovery of new biomarker profiles that correlate with disease severity in children may help customize treatments and provide better long-term care to patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
