Asthma and lower airway diseaseIdentification of novel immune phenotypes for allergic and nonallergic childhood asthma
Section snippets
Study population
Two hundred seventy-five children (age, 4-15 years) were recruited in the Munich Clinical Asthma Research Association study during a visit to an asthma clinic (January 2009-July 2014), which was registered at the DRKS German study registry (no. DRKS00004635; http://drks-neu.uniklinik-freiburg.de/drks_web/). Parents completed a detailed questionnaire assessing health data on allergy, asthma, and socioeconomic factors. The study population contained healthy control subjects (HCs) and patients
Clinical differentiation between HCs, patients with AA, and patients with NA
For the Clinical Asthma Research Association study, 275 children were recruited, and 202 children with complete epidemiologic and core immunologic data were included in this article (Fig 1). After exclusion of 12 children because of infections or pulmonary or autoimmune diseases, 13 because of transient or episodic wheeze, and 4 because of allergy without asthma, 74 patients with AA, 18 patients with NA, and 81 HCs were finally analyzed (Fig 1).
The 3 groups were significantly different
Discussion
Patients with AA, as characterized by pulmonary obstruction and allergic inflammation indicated by increased eosinophil counts and specific IgE levels, exhibited increased Treg cells compared with those seen in HCs but not those seen in patients with NA, with efficient suppression of TH2 and TH1 cytokines compared with insufficient suppression by patients with NA. In parallel, expression of CLIC4 and TSC1, 2 important regulators of innate immunity, was decreased in patients with AA. In
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Supported by the German Research Foundation (DFG, TRR 22/2 and 22/3, SFB-TR22; to D.R., N.B., E.K., A.B., B.S., O.P.d.C., and T.B.), GPA, WAO (to B.S.), a grant from GlaxoSmithKline, Forschungsstipendium für Klinische Pneumologie 2013 (D.R.), FöFoLe Reg.Nr. 839 (DR), and the German Centre for Lung Research (DZL) as part of the Comprehensive Pneumology Centre in Munich (CPC-M; to D.R., B.S., and E.v.M.).
Disclosure of potential conflict of interest: T. Buch has received research support from DFG, is employed by the Technical University of Munich, and has stock in biotechs within ETFs. E. von Mutius is an Associate Editor for the Journal of Allergy and Clinical Immunology; has consultant arrangements with GlaxoSmithKline, Novartis, ALK-Abelló, and Astellas Pharma Europe Ltd; has provided expert testimony for the UK Research Excellence Framework; and has received research support from FrieslandCampina. B. Schaub has received research support from DFG and is employed by University Children's Hospital Munich. The rest of the authors declare that they have no relevant conflicts of interest.