An analysis of circulating T lymphocytes among asthmatic children with different sensitized patterns / 中国免疫学杂志

Objective:To investigate the difference in circulating T lymphocyte subsets among asthmatic children with different sensitized patterns.Methods:A total of 374 asthmatic children were enrolled in present study,and the sensitized patters were identified using skin prick testing.The numbers of circulating T cells (CD3+,CD19+),CD4+T cells (CD3+,CD4+),CD8+ T cells (CD3 + CD8 +),Tregs(CD4+ CD25+ FOXP3+),Th1 (CD4+IFN-γ+T),Th2 (CD4+ IL-4+ T)and Th17 cells(CD4+ IL-17+ T)in peripheral blood were measured by flow cytometry.Results:According to positive skin responses detected by SPT,patients with asthma were divided into three groups:un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio (all P ＜ 0.05).A further pairwise comparison indicated that the statistically significant difference in Tregs,Th17 cells and Tregs/Th17 were found among un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group(all P＜0.05).According to the type of allergens detected by SPT,the asthmatic patients were divided into the dust mite group,mould group,animal dander group,pollen group and other groups.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio(all P＜0.05).Similarly,a pairwise comparison indicated that the numbers of Th1 cells,T h2 cells,Th2 cells,Th1/Th2 ratios,Tregs,Th17 cells and Tregs/Th17 ratios were found significant among these 5 groups(all P＜0.05).Conclusion:The finding highlights the importance of paying attention to the differences in the distribution of T lymphocyte subgroups among asthmatic patients with different sensitization patterns.

Distribution characteristics of serum specific IgE for inhaled allergens in children with different airway allergic diseases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution characteristics of serum specific IgE (sIgE) for inhaled allergens in children with different airway allergic diseases.</p><p><b>METHODS</b>Fluorescent enzyme-linked immunosorbent assay on the UniCAP250 system was performed to measure serum sIgE for 9 common inhaled allergens in 256 children aged 3-14 years with different airway allergic diseases. According to the clinical diagnosis, these children were divided into rhinitis group (37 children with allergic rhinitis), asthma group (82 children with bronchial asthma), and rhinitis-asthma group (137 children with allergic rhinitis complicated by bronchial asthma). The three groups were compared in terms of the detection rates of 9 inhaled allergens, sensitization level, and number of allergens.</p><p><b>RESULTS</b>The detection rate of serum sIgE for inhaled allergens was 57.3% (47/82) in the asthma group, 86.5% (32/37) in the rhinitis group, and 82.5% (113/137) in the rhinitis-asthma group (P<0.05). The most common allergen in the asthma, rhinitis, and the rhinitis-asthma groups was mould fungi (32.9%, 54.1%, and 48.9% respectively), followed by dust mites (30.5%, 45.9%, and 46.0% respectively), pollen (26.8%, 35.1%, and 32.8% respectively), pets (12.2%, 27.0%, and 18.2% respectively), and cockroach (9.8%, 5.4%, and 5.8% respectively). The rhinitis group and the rhinitis-asthma group had a significantly higher detection rate of mould fungi (mx2) than the asthma group (P<0.0166). There were no significant differences in the sensitization level of 9 allergens and number of allergens between the three groups.</p><p><b>CONCLUSIONS</b>In children with either bronchial asthma, allergic rhinitis, or bronchial asthma complicated by allergic rhinitis, the three most common inhaled allergens are mould fungi, dust mites, and pollens. Compared with bronchial asthma, allergic rhinitis may be more closely associated with sensitization by mould fungi. The three common airway allergic diseases have similar distribution characteristics of inhaled allergens.</p>

Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To assess the quality control for the maximal expiratory flow-volume (MEFV) curve in school-age children.</p><p><b>METHODS</b>Eight hundred and sixty-two children who had two or more MEFV manoeuvres were classified into ≥6-year-old (n=379), ≥8-year-old (n=210), ≥10-year-old (n=64), and 12-17-year-old groups (n=109). The parameters of quality control and concordance with quality control criteria for MEFV were compared between the two groups. In addition, patients who were diagnosed with asthma were classified into two groups, one with normal pulmonary function (n=155) and the other with abnormal pulmonary function (n=62), based on the results of spirometry. Differences in the parameters of quality control for spirometry were compared between the two groups.</p><p><b>RESULTS</b>Eight hundred and sixty-two children underwent 2 367 MEFV manoeuvres, 97.8% of which met the start of test criterion for backward extrapolated volume (VBE) of less than 0.15 L, with the highest concordance in the ≥6-year-old group and the lowest concordance in the 12-17-year-old group. Three hundred and eighty-one children (44.2%) met the end of test criterion for forced expiratory time (FET) and the concordance in children over 10 years of age was lower than that in children under 10 years of age (P<0.05). Differences in two best forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) manoeuvres were within 150 mL in 91.9% and 84.8%, respectively, of the children. The parameters of quality control for spirometry were better for asthmatic children with abnormal pulmonary function compared with asthmatic children with normal pulmonary function (P<0.05).</p><p><b>CONCLUSIONS</b>Concordance with the start of test criteria and the manoeuvre repeatability criteria is high, whereas the concordance with the end of test criteria is low. It is suggested that the concordance with the FET criteria should be improved.</p>

A comparision of the effects of subcutaneous and sublingual immunotherapy on immunological responses in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the difference in the effects of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on immunological responses in children with asthma.</p><p><b>METHODS</b>A total of 86 children with asthma caused by dust mites were enrolled and divided into a SLIT group (n=29), a SCIT group (n=13), a group receiving complete SCIT course (complete SCIT group; n=14), and a group receiving conventional medication (control group, n=30). Peripheral blood mononuclear cells were isolated and stimulated with house dust mite extract for 48 hours in vitro, and the percentage of regulatory T cells (Treg%) in CD4+ T cells was measured by flow cytometry. Analysis of variance with repeated measures was applied to compare the changes in humoral immunological indices and therapeutic effects in the SCIT and SLIT groups before treatment and after 6 and 12 months of treatment.</p><p><b>RESULTS</b>Before antigenic stimulation, Treg% in CD4(+) T cells in the SCIT group was significantly higher than that in the SLIT and control groups; after antigenic stimulation was given, Treg% in the four groups decreased significantly. After 6 and 12 months of immunotherapy, the SCIT group had significant changes in serum sIgE and sIgG4 levels, while the SLIT group only showed a significant change in serum sIgE level.</p><p><b>CONCLUSIONS</b>Temporal difference exists in different immunotherapies to cause immunological responses in children with asthma, and immunological responses induced by SCIT may occur earlier.</p>

Related factors for asthmatic children's responses to long-term treatment / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath (FeNO) in asthmatic children who have different responses to regular treatment.</p><p><b>METHODS</b>A total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded.</p><p><b>RESULTS</b>At three follow-up points (months 3, 6, and 9), the percentage of asthmatic children who used the first or the second level of control treatment in the stable group (with stable response to the treatment) was significantly higher than in the unstable group (with unstable response to the treatment) (P<0.05), while the percentage of asthmatic children who used the third level of control treatment in the stable group was significantly lower than in the unstable group (P<0.05). At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) than the unstable group (P<0.05); at the 3-month and 9-month follow-up points, the stable group had a significantly higher percentage of predicted maximum mid-expiratory flow (MMEF%) than the unstable group (P<0.05); at the initial evaluation and 3-month follow-up point, the stable group had a significantly higher FeNO than the unstable group (P<0.05).</p><p><b>CONCLUSIONS</b>Continuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.</p>

Value of fractional nitric oxide concentration in exhaled breath in assessing level of asthma control in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the value of fractional nitric oxide concentration in exhaled breath (FeNO) in assessing the level of asthma control in children.</p><p><b>METHODS</b>A total of 226 asthmatic children were divided into controlled asthma (n= 86), partially controlled asthma (n=63), and uncontrolled asthma groups (n=77). Ninety healthy children were enrolled as controls. FeNO was measured for both asthmatic and healthy children using the Swedish-designed NIOX system.</p><p><b>RESULTS</b>The control group had an FeNO of 14±6 ppb, the controlled asthma group had an FeNO of 29±26 ppb, the partially controlled asthma group had an FeNO of 32±30 ppb, and the uncontrolled asthma group had an FeNO of 40±32 ppb. The three asthma groups showed significantly higher FeNO than the control group (P<0.05). The uncontrolled asthma group showed significantly higher FeNO than the controlled asthma group (P<0.05), but there were no significant differences in FeNO between the partially controlled and uncontrolled asthma groups and between the partially controlled and controlled asthma groups (P>0.05).</p><p><b>CONCLUSIONS</b>Asthmatic children have significantly higher FeNO than healthy children, and FeNO is correlated with the level of asthma control.</p>

Combined Use of Allergen Skin Prick Test and Specific Immunoglobulin E Antibody on Allergen Diagnosis in Asthmatic Children / 实用儿科临床杂志

Objective To analyze the advantages of combined analysis of allergen skin prick test(SPT)and phadiatop/specific IgE antibody on the allergen diagnosis in asthmatic children.Methods Inhalant allergen SPT and Phadiatop test were done in 57 asthmatic children.Thirty-three cases of those asthmatic children were measured serum specific IgE antibody against dermatophagoids pteronyssinus.Results Dermatophagoids,molds and pets were the main inhalant allengens in asthmatic children.The positive rates of SPT and Pha-(diatop) in 57 asthmatic children were 86% and 79%,respectively,and the consistence rate between SPT and Phadiatop was 86%.Five cases with negative Phadiatop were confirmed to have molds allergy via SPT and molds specific IgE test.The consistence rate of dermatophagoids pteronyssinus SPT and specific IgE was 97%.Conclusion It is helped to improve the sensitivity and specificity of allergen diagnosis in asthmatic children when doctors combined analyze the results of allergen skin prick test and specific IgE test.