Different inflammatory phenotypes in adults and children with acute asthma

被引:107
作者
Wang, F. [1 ,2 ,3 ]
He, X. Y. [2 ,3 ]
Baines, K. J. [2 ,3 ]
Gunawardhana, L. P. [2 ,3 ]
Simpson, J. L. [2 ,3 ]
Li, F. [1 ]
Gibson, P. G. [1 ,2 ,3 ]
机构
[1] Jilin Univ, Norman Bethune Coll Med, Dept Pathogenobiol, Changchun 130023, Peoples R China
[2] Univ Newcastle, Ctr Asthma & Resp Dis, Callaghan, NSW 2308, Australia
[3] John Hunter Hosp, Hunter Med Res Inst, Dept Resp & Sleep Med, New Lambton, NSW, Australia
关键词
Acute asthma; adults; asthma; children; Chlamydophila pneumoniae; phenotypes; CHLAMYDIA-PNEUMONIAE INFECTION; REAL-TIME PCR; AIRWAY INFLAMMATION; INDUCED SPUTUM; ACUTE EXACERBATIONS; PERSISTENT ASTHMA; BRONCHIAL-ASTHMA; IDENTIFICATION; VIRUSES; INTERLEUKIN-8;
D O I
10.1183/09031936.00170110
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
Inflammatory phenotypes are recognised in stable adult asthma, but are less well established in childhood and acute asthma. Additionally, Chlamydophila pneumoniae infection as a cause of noneosinophilic asthma is controversial. This study examined the prevalence of inflammatory phenotypes and the presence of current C. pneumoniae infection in adults and children with stable and acute asthma. Adults with stable (n=29) or acute (n=22) asthma, healthy adults (n=11), children with stable (n=49) or acute (n=28) asthma, and healthy children (n=9) underwent clinical assessment and sputum induction. Sputum was assessed for inflammatory cells, and DNA was extracted from sputum cell suspensions and supernatants for C. pneumoniae detection using real-time PCR. The asthma phenotype was predominantly eosinophilic in children with acute asthma (50%) but neutrophilic in adults with acute asthma (82%). Paucigranulocytic asthma was the most common phenotype in both adults and children with stable asthma. C. pneumoniae was not detected in 99% of samples. The pattern of inflammatory phenotypes differs between adults and children, with eosinophilic inflammation being more prevalent in both acute and stable childhood asthma, and neutrophilic inflammation being the dominant pattern of acute asthma in adults. The aetiology of neutrophilic asthma is unknown and is not explained by the presence of current active C. pneumoniae infection.
引用
收藏
页码:567 / 574
页数:8
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