Study of Clinical Characteristics and Cytokine Profiles of Asthmatic Children with Rhinovirus Infection during Acute Asthma Exacerbation at National Hospital of Pediatrics.

Thuy Nguyen-Thi-Dieu,Huong Le-Thi-Thu,An Pham-Nhat,Sy Duong-Quy,Huong Le-Thi-Minh

doi:10.1155/2018/9375967

Thuy Nguyen-Thi-Dieu, Huong Le-Thi-Thu + Show 3 more

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https://doi.org/10.1155/2018/9375967

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Abstract

Background In children with asthma, the viral infection of airways is usually a main cause of acute asthma exacerbation and hospitalization. However, few studies on clinical and biomolecular characteristics of asthmatic children in this field have been done, especially in emergent countries. Objective This study described the clinical and biological characteristics of asthmatic children who had acute asthma exacerbation and rhinovirus (RV) infection. Methods Children under 15 years of age hospitalized for acute asthma exacerbation were included. They underwent clinical examination and peripheral blood analyses for the cytokine profile. The severity of acute asthma exacerbation was evaluated by Pediatric Asthma Score (PAS). Healthy children under 15 years of age were also invited in this study. Results One hundred fifteen asthmatic children were included in this study. There were 18.2% of mild PAS, 37.4% of moderate PAS, and 44.4% of severe PSA. Among them, 63/115 (54.8%) asthmatic children had positive RV infection (RV+). The percentages of asthmatic children with RV+ had increased polymorphonuclear leucocytes were significantly higher than asthmatic children with RV−. There were no significant differences of the concentrations of non-Th2-related cytokines in asthmatic children with RV− and RV+. The concentration of Th2-related cytokines (IL-5 and IL-13) in asthmatic children with RV+ was significantly higher than those with RV−. However, there was no significant difference for the cytokine profile between mild, moderate, and severe asthma. Conclusion RV infection is a main cause of acute asthma exacerbation in children with asthma. The increase of Th2-related cytokines, especially IL-5 and IL-13, is a relevant biomarker for RV infection in asthmatic children with severe exacerbation.

Highlights

Acute asthma exacerbation (AAE) is usually triggered by viral infection of the airways, by rhinovirus (RV). e role of RV in the onset of AAE has been demonstrated in both children and adults these patients regularly used preventative treatment for asthma
Diagnosis of Asthma Severity. e diagnosis of asthma was based on international recommendations for children [3]. e severity of AAE was assessed according to the pediatric asthma score (PAS) [4, 5]; the examination consisted of five components: respiratory rate, oxygen requirement, respiratory muscle retractions, auscultation, and dyspnoea; each component was scored from 1 to 3 according to the severity of these symptoms; the total scores ranged from 5 to 7 for mild asthma exacerbation, 8 to for moderate asthma exacerbation, and to 15 for severe asthma exacerbation
Clinical and Biological Characteristics of Asthmatic Children Classified by RV Infection. e result showed that there were 63/115 (54.8%) asthmatic children with positive rhinovirus infection (RV+) versus 45.2% with negative rhinovirus infection (RV–). ere was not any significant difference between asthmatic children with RV+ versus RV− concerning male-female ratio, atopy, second-hand smoking, and domestic pest exposure (Table 2). e percentage of asthmatic children with RV+ was varied by age groups

Summary

Introduction

Acute asthma exacerbation (AAE) is usually triggered by viral infection of the airways, by rhinovirus (RV). e role of RV in the onset of AAE has been demonstrated in both children and adults these patients regularly used preventative treatment for asthma. Acute asthma exacerbation (AAE) is usually triggered by viral infection of the airways, by rhinovirus (RV). A previous study showed that 80–85% of AAE in children related to peak flow reduction and wheezing caused by a viral infection in the upper airway tract [1]. After RV infection, asthmatic patients have increased inflammatory cells located in their airways in response to the inflammatory process. The viral infection of airways is usually a main cause of acute asthma exacerbation and hospitalization. Is study described the clinical and biological characteristics of asthmatic children who had acute asthma exacerbation and rhinovirus (RV) infection. E increase of 2-related cytokines, especially IL-5 and IL-13, is a relevant biomarker for RV infection in asthmatic children with severe exacerbation RV infection is a main cause of acute asthma exacerbation in children with asthma. e increase of 2-related cytokines, especially IL-5 and IL-13, is a relevant biomarker for RV infection in asthmatic children with severe exacerbation

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Conclusion