Can inflammatory markers in induced sputum be used to detect phenotypes and endotypes of pediatric severe therapy-resistant asthma?

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorELLER, Miriam C. N.
dc.contributor.authorVERGANI, Karina P.
dc.contributor.authorSARAIVA-ROMANHOLO, Beatriz M.
dc.contributor.authorANTONANGELO, Leila
dc.contributor.authorLEONE, Claudio
dc.contributor.authorRODRIGUES, Joaquim C.
dc.date.accessioned2018-11-21T17:06:23Z
dc.date.available2018-11-21T17:06:23Z
dc.date.issued2018
dc.description.abstractBackgroundThe phenotypes and endotypes of severe therapy-resistant asthma (STRA) have not been fully elucidated in children. The aim of the present study was to investigate inflammatory markers in the induced sputum of children with STRA and to compare them with those present in a group of children who achieved control. MethodsA prospective cohort of children (6-18 years of age) diagnosed with severe asthma (GINA criteria) who had undergone treatment for at least 6 months was comprehensively followed for 3 months. Inhalation technique, adherence to treatment, ACT score, and main comorbidities were assessed. Induced sputum samples were collected for cytology analysis and quantitative assessment of cytokines; the participants also underwent spirometry, plethysmography, and fractional exhaled nitric oxide (FeNO) measurement. ResultsForty patients were included (average age 12.8 years; 62.5% male); of these, 13 (32.5%) were classified as STRA at the end of follow-up. There were no significant differences between the STRA and control groups in demographic data, functional test results, or FeNO levels. The eosinophilic inflammatory pattern predominated in both groups; however, the STRA group showed a proportionally higher percentage of sputum neutrophils (P<0.05). The median sputum levels of the cytokines IL-10, GM-CSF, IFN-, and TNF- were significantly higher in the STRA group (P<0.05). GM-CSF and TNF- levels showed inverse correlations with ACT scores. ConclusionThe presence of neutrophils, the cytokines IL-10, and IFN- and, more particularly, TNF-, and GM-CSF in the sputum may play an important role in the pathophysiological mechanism of STRA in children and adolescents. Specific antagonists for these cytokines may represent a future therapeutic strategy.
dc.description.indexMEDLINE
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo [2012/20532-4]
dc.identifier.citationPEDIATRIC PULMONOLOGY, v.53, n.9, p.1208-1217, 2018
dc.identifier.doi10.1002/ppul.24075
dc.identifier.eissn1099-0496
dc.identifier.issn8755-6863
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/29576
dc.language.isoeng
dc.publisherWILEY
dc.relation.ispartofPediatric Pulmonology
dc.rightsrestrictedAccess
dc.rights.holderCopyright WILEY
dc.subjectchildren
dc.subjectcytokines
dc.subjectendotypes
dc.subjectinduced sputum
dc.subjectinflammatory markers
dc.subjectsevere asthma
dc.subject.otherexhaled nitric-oxide
dc.subject.otherlung-function
dc.subject.otherairway inflammation
dc.subject.otherreference values
dc.subject.othergm-csf
dc.subject.otherchildren
dc.subject.othercytokines
dc.subject.otherstandardization
dc.subject.otheradolescents
dc.subject.otherneutrophils
dc.subject.wosPediatrics
dc.subject.wosRespiratory System
dc.titleCan inflammatory markers in induced sputum be used to detect phenotypes and endotypes of pediatric severe therapy-resistant asthma?
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalLEONE, Claudio:Univ Sao Paulo, Maternal & Child Hlth Dept, Sch Publ Hlth, Sao Paulo, Brazil
hcfmusp.citation.scopus20
hcfmusp.contributor.author-fmusphcMIRIAM CARDOSO NEVES ELLER
hcfmusp.contributor.author-fmusphcKARINA PIERANTOZZI VERGANI
hcfmusp.contributor.author-fmusphcBEATRIZ MANGUEIRA SARAIVA RAMANHOLO
hcfmusp.contributor.author-fmusphcLEILA ANTONANGELO
hcfmusp.contributor.author-fmusphcJOAQUIM CARLOS RODRIGUES
hcfmusp.description.beginpage1208
hcfmusp.description.endpage1217
hcfmusp.description.issue9
hcfmusp.description.volume53
hcfmusp.origemWOS
hcfmusp.origem.pubmed29870159
hcfmusp.origem.scopus2-s2.0-85052199390
hcfmusp.origem.wosWOS:000442593900007
hcfmusp.publisher.cityHOBOKEN
hcfmusp.publisher.countryUSA
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