Different inflammatory pathways linked to childhood severe wheeze and asthma

Published online: March 28, 2017

Little is known about the physiopathology of severe recurrent wheeze in preschool children and severe asthma in children.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Guiddir and colleagues studied a cluster analysis of 350 children with moderate to severe asthma or moderate to severe recurrent wheeze. The children underwent standardized clinical and blood work-up and a bronchoscopy.

Two main clusters emerged: a “Neutrophilic steroid-refractory obstructive disease” cluster in preschool children with severe recurrent wheeze with a higher likelihood of a history of pneumonia and gastroesophageal reflux disease; and an “Eosinophilic steroid-refractory asthma phenotype” cluster in children with severe asthma and multiple allergic comorbidities.

The emergence of these two clusters indicating different inflammatory pathways of severe recurrent wheeze and severe asthma in children could improve personalized treatments.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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