Asthma and lower airway diseaseThe molecular phenotype of severe asthma in children
Section snippets
Sample
A convenience sample of asthmatic children 5 to 17 years of age undergoing bronchoscopy for clinical indications was obtained. All children met criteria for persistent asthma17 and had a history of at least a 12% change in FEV1 after bronchodilator administration.18 Severe asthma was diagnosed according to criteria developed by the Severe Asthma Research Program,1, 5 which were adapted from the American Thoracic Society's Report (see this article's Table E1 in the Online Repository at //www.jacionline.org
Results
Sixty children with asthma (severe asthma, n = 35) and 30 healthy adult controls participated in this study. However, 7 children (severe asthma, n = 4) infected with Streptococcus pneumoniae or Haemophilus influenzae were excluded from data analysis (see this article's Table E4 in the Online Repository at www.jacionline.org). The resulting sample included 30 controls, 22 subjects with moderate asthma, and 31 subjects with severe asthma. Children with moderate asthma had no evidence of
Discussion
To our knowledge, this is the first study to use high-dimensional data reduction techniques on BAL and AM inflammatory markers in children with severe asthma. By using the supervised method of linear discriminant analysis, we provide the first preliminary evidence of the molecular phenotype of severe asthma in children. Whereas cytokine and chemokine concentrations in the BAL and AM cell lysate did not differ between children with moderate and severe asthma, the linear combination of these
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Cited by (0)
Supported by NIH/NINRKO1 NR010548, NIH/NCRRK12 RR017643, and NIH/NHLBI SARPRO1 HL69170.
Disclosure of potential conflict of interest: W. G. Teague is on the speakers' bureau for Merck & Co and receives research support from the National Heart, Lung, and Blood Institute, the American Lung Association, and the Centers for Disease Control and Prevention. The rest of the authors have declared that they have no conflict of interest.
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Please refer to the acknowledgments for a complete listing of the Severe Asthma Research Program contributors.