Blockade of GITRL/GITR signaling pathway attenuates house dust mite-induced allergic asthma in mice through inhibition of MAPKs and NF-κB signaling.

GITRL/GITR signaling pathway plays an important role in allergy, inflammation, transplantation and autoimmunity. However, its role in asthma remains unclear. Thus, the present study aimed to investigate changes in this pathway and observe the therapeutic effect of its blocking on asthma. By using house dust mite-induced asthma model, changes of GITRL/GITR and its downstream molecules MAPKs (e.g., p38 MAPK, JNK and Erk) and NF-κB were observed. After that, GITRL in lung of mice was knocked down by recombinant adeno-associated virus to observe the impact on its downstream molecules and assess the therapeutic effect on asthma. These results showed that GITRL/GITR and its downstream molecules MAPKs/NF-κB were activated in asthmatic mice. This activation was suppressed after GITRL knockdown, and allergic airway inflammation and airway hyperresponsiveness were alleviated. These results demonstrate that GITRL/GITR-MAPKs/NF-κB signaling pathway participates in the pathogenesis of asthma. Blockade of GITRL/GITR signaling pathway exhibits protective effects in a mouse model of house dust mite-induced allergic asthma.

GITRL on dendritic cells aggravates house dust mite-induced airway inflammation and airway hyperresponsiveness by modulating CD4+ T cell differentiation.

BACKGROUND: Glucocorticoid-induced tumor necrosis factor receptor family-related protein ligand (GITRL) plays an important role in tumors, autoimmunity and inflammation. However, GITRL is not known to modulate the pathogenesis of allergic asthma. In this study, we investigated whether regulating GITRL expressed on dendritic cells (DCs) can prevent asthma and to elucidate its mechanism of action. METHODS: In vivo, the role of GITRL in modulating house dust mite (HDM)-induced asthma was assessed in adeno-associated virus (AAV)-shGITRL mice. In vitro, the role of GITRL expression by DCs was evaluated in LV-shGITRL bone marrow dendritic cells (BMDCs) under HDM stimulation. And the direct effect of GITRL was observed by stimulating splenocytes with GITRL protein. The effect of regulating GITRL on CD4+ T cell differentiation was detected. Further, GITRL mRNA in the peripheral blood of asthmatic children was tested. RESULTS: GITRL was significantly increased in HDM-challenged mice. In GITRL knockdown mice, allergen-induced airway inflammation, serum total IgE levels and airway hyperresponsiveness (AHR) were reduced. In vitro, GITRL expression on BMDCs was increased after HDM stimulation. Further, knocking down GITRL on DCs partially restored the balance of Th1/Th2 and Th17/Treg cells. Moreover, GITRL stimulation in vitro inhibited Treg cell differentiation and promoted Th2 and Th17 cell differentiation. Similarly, GITRL mRNA expression was increased in the peripheral blood from asthmatic children. CONCLUSIONS: This study identified a novel role for GITRL expressed by DCs as a positive regulator of CD4+ T cells responses in asthma, which implicates that GITRL inhibitors may be a potential immunotherapy for asthma.

[Leukotriene D4 bronchial provocation test for detection of airway hyper-responsiveness in children].

OBJECTIVE: To explore the value of leukotriene D4 (LTD4) bronchial provocation test (BPT) in detection of airway hyper-responsiveness (AHR) in children. METHODS: A total of 151 children aged 6 to 14 years, including 86 in remission of asthma and 65 with acute bronchitis, who were followed up in our respiratory clinic between November, 2017 and August, 2018. The children were randomly divided into LTD4 group (78 cases) and methacholine (MCH) group (73 cases). In LTD4 group, the 78 children underwent LTD4-BPT, including 46 with asthma and 32 children having re-examination for previous episodes of acute bronchitis; in MCH group, the 73 children underwent MCH-BPT, including 40 with asthma and 33 with acute bronchitis. MCH-BPT was also performed in the asthmatic children in the LTD4 group who had negative responses to LTD4 after an elution period. The major adverse reactions of the children to the two BPT were recorded. The diagnostic values of the two BPT were evaluated using receiver-operating characteristic (ROC) curve. RESULTS: There was no significant difference in the results of basic lung function tests between LTD4 group and MCH group (P>0.05). The positive rate of BPT in asthmatic children in the LTD4 group was significantly lower than that in the MCH group (26.1% vs 72.5%; P < 0.05). The positive rate of BPT in children with previous acute bronchitis in the LTD4 group was lower than that in the MCH group (3.1% vs 15.2%). The positive rate of MCH-BPT in asthmatic children had negative BPT results in LTD4 group was 58.8%, and their asthma was mostly mild. The sensitivity was lower in LTD4 group than in MCH group (0.2609 vs 0.725), but the specificity was slightly higher in LTD4 group (0.9688 vs 0.8485).The area under ROC curvein LTD4 group was lower than that in MCH group (0.635 vs 0.787). In children with asthma in the LTD4 group, the main adverse reactions in BPT included cough (34.8%), shortness of breath (19.6%), chest tightness (15.2%), and wheezing (10.9%). The incidence of these adverse reactions was significantly lower in LTD4 group than in MCH group (P < 0.05). Serious adverse reactions occurred in neither of the two groups. CONCLUSIONS: LTD4-BPT had high safety in clinical application of children and was similar to the specificity of MCH-BPT. However, it had low sensitivity, low diagnostic value, and limited application value in children's AHR detection.

[Changes in pulmonary function in infants and young children with Mycoplasma pneumoniae pneumonia].

OBJECTIVE: To study the changes in pulmonary function in infants and young children with Mycoplasma pneumoniae pneumonia (MPP). METHODS: A total of 196 hospitalized children (at age of 0-36 months) who were diagnosed with MPP from January 2014 to June 2018 were enrolled as study subjects. A total of 208 children (at age of 0-36 months) with pneumonia not caused by Mycoplasma pneumoniae infection during the same period of time were enrolled as controls (non-MPP group). A retrospective analysis was performed for their clinical data. The two groups were compared in the pulmonary function on the next day after admission and on the day of discharge. The children with MPP were followed up to observe pulmonary function at weeks 2 and 4 after discharge. RESULTS: Compared with the non-MPP group, the MPP group had significant reductions in the ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), ratio of volume to peak tidal expiratory flow to total expiratory volume (VPTEF/VE), inspiratory-to-expiratory time ratio, and tidal expiratory flow at 25% remaining expiration on the next day after admission and on the day of discharge (P<0.05). In addition there were significant increases in the ratio of peak tidal expiratory flow to tidal expiratory flow at 25% remaining expiration, respiratory rate, effective airway resistance, and plethysmographic functional residual capacity per kilogram (P<0.05). Compared with the normal reference values of pulmonary function parameters, both groups had reductions in VPTEF/VE and TPTEF/TE on the next day after admission; on the day of discharge, the MPP group still had reductions in VPTEF/VE and TPTEF/TE, while the non-MPP group had normal values. The MPP group had increases in VPTEF/VE and TPTEF/TE from the day of discharge to weeks 2 and 4 after discharge (P<0.05), but TPTEF/TE still did not reach the normal value at week 4 after discharge. CONCLUSIONS: Airway obstruction is observed in infants and young children with acute MPP or non-MPP, and the children with MPP have a higher severity of airway obstruction and a longer time for improvement, with a certain degree of airway limitation in the recovery stage.

PM2.5 affects establishment of immune tolerance in newborn mice by reducing PD-L1 expression.

This study was conducted to determine whether exposure to particulate matter 2.5 (PM2.5) affects the immune tolerance of neonatal mice via the regulation of PD-L1 expression. One-week-old BALB/c mice were exposed to PM2.5 for 8 days. From day 8 to day 18, the mice were treated with 5 µg house dust mite (HDM) (i. n.) every two days. Adenovirus-carried PD-L1 overexpression vectors were infected into mice via nasal inhalation 6 days after exposure to PM2.5. Airway hyperresponsiveness (AHR) was examined in mice 19 days after exposure to PM2.5, and the related parameters of airway inflammation were studied on day 22. Co-exposure to PM2.5 and HDM reduced PD-L1 expression but greatly increased infiltration of inflammatory cells, which was reversed by PD-L1 overexpression. Co-exposure to PM2.5 and HDM also elevated serum IL-4, IL-5 and IL-13 levels and reduced TGF-ß level. Exposure to PM2.5 alone slightly increased the numbers of dendritic cells (DCs) but reduced the numbers of antigen-presenting cells expressing PD-L1 and Treg cells. Therefore, early exposure to PM2.5 reduced PD-L1 expression in the lungs of neonatal mice, which interfered with immune tolerance establishment and subsequently resulted in allergic airway inflammation.

Mediterranean diet during pregnancy and childhood for asthma in children: A systematic review and meta-analysis of observational studies.

OBJECTIVES: To evaluate the relationship between high adherence to the Mediterranean diet in pregnancy and childhood and the risk of asthma and wheeze in children. METHODS: We conducted searches of PubMed, EMBASE, and Cochrane Central Register of Controlled Trials from inception to 30 October 2018. Observational studies providing risk estimates and corresponding confidence intervals on the association of high adherence to the Mediterranean diet in pregnancy or childhood and the risk of asthma or wheeze in childhood were included. The methodological quality of all included studies was assessed. Summary odds ratios (OR) were calculated using a random-effects model. RESULTS: Eighteen observational studies were included in this review. All studies were of moderate to high quality. The pooled data suggested high adherence to the Mediterranean diet during pregnancy was associated with a reduced incidence of wheeze in the first 12 months (OR, 0.92; 95% confidence interval [CI], 0.88-0.95; P < 0.001), and there was an inverse association between the Mediterranean diet during childhood and the incidence of wheeze in the history (OR, 0.51; 95% CI, 0.37-0.70; P = 0.001) and current wheeze (OR, 0.97; 95% CI, 0.95-0.99; P = 0.013). However, there was no significant association between high adherence of the Mediterranean diet in pregnancy and childhood and any of the other meta-analysis end points including diagnosed asthma. CONCLUSION: High adherence to the Mediterranean diet during pregnancy and childhood may have short-term effects on wheeze in children in early life. However, these findings should be interpreted with caution owing to the heterogeneity of the studies.

PNS-R1 inhibits Dex-induced bronchial epithelial cells apoptosis in asthma through mitochondrial apoptotic pathway.

Dexamethasone (Dex) are widely used for the treatment of asthma. However, they may cause apoptosis of bronchial epithelial cells and delay the recovery of asthma. Therefore, it is an urgent problem to find effective drugs to reduce this side effects. Panax notoginseng saponins R1 (PNS-R1) is known to exhibit anti-oxidative and anti-apoptotic properties in many diseases. We aim to investigate whether PNS-R1 can reduce Dex-induced apoptosis in bronchial epithelial cells. In this study, the anti-apoptotic effects of PNS-R1 were investigated by conducting in vitro and in vivo. Annexin V-FITC/PI staining flow cytometry analysis and TUNEL assay were conducted to detect apoptotic cells. Mitochondrial membrane potential was detected by JC-1 analysis. Western blotting and immunohistochemical analysis were conducted to measure caspase3, Bcl-2, Bax, Cyt-c, Apaf-1, cleaved-caspase3 and cleaved-caspase9 levels in lung tissues and 16HBE cells. Our findings demonstrated that Dex could induce apoptosis of bronchial epithelial cells and upregulate caspase3 expression of lung tissues. Western blot showed that Dex increased Bax, Cyt-c, Apaf-1, cleaved-caspase9, cleaved-caspase3 expression and decreased Bcl-2 expression. PNS-R1 could suppress Dex-induced apoptosis of bronchial epithelial cells by inhibiting Bax, Cyt-c, Apaf-1, cleaved-caspase9, cleaved-caspase3 expression and upregulating Bcl-2 expression. Flow cytometry analysis showed PNS-R1 alleviated JC-1 positive cells induced by Dex in 16HBE cells. These results showed that PNS-R1 alleviated Dex-induced apoptosis in bronchial epithelial cells by inhibition of mitochondrial apoptosis pathway. Furthermore, our findings highlighted the potential use of PNS-R1 as an adjuvant drug to treat asthma.

High-flow nasal cannula therapy for children with bronchiolitis: a systematic review and meta-analysis.

OBJECTIVES: To review the effects and safety of high-flow nasal cannula (HFNC) for bronchiolitis. METHODS: Six electronic databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, CQ VIP Database and Wanfang Data were searched from their inception to 1 June 2018. Randomised controlled trials (RCTs) which investigated the effects of HFNC versus other forms of oxygen therapies for bronchiolitis were included. RESULTS: Nine RCTs with 2121 children met the eligibility criteria. There was no significant difference in length of stay in hospital (LOS), length of oxygen supplementation (LOO), transfer to intensive care unit, incidence of intubation, respiratory rate, SpO2 and adverse events in HFNC group compared with standard oxygen therapy (SOT) and nasal continuous positive airway pressure (nCPAP) groups. A significant reduction of the incidence of treatment failure (risk ratio (RR) 0.50, 95% CI 0.40 to 0.62, p<0.01) was observed in HFNC group compared with SOT group, but there was a significant increase of the incidence of treatment failure (RR 1.61, 95% CI 1.06 to 2.42, p0.02) in HFNC group compared with nCPAP group. In subgroup analysis, LOS was significantly decreased in HFNC group compared with SOT group in low-income and middle-income countries. CONCLUSION: The systematic review suggests HFNC is safe as an initial respiratory management, but the evidence is still lacking to show benefits for children with bronchiolitis compared with SOT or nCPAP.

[Readmission of children with bronchopulmonary dysplasia in the first 2 years of life: a clinical analysis of 121 cases].

OBJECTIVE: To investigate the clinical features of readmitted children with bronchopulmonary dysplasia (BPD) in the first 2 years of life. METHODS: A retrospective analysis was performed for the clinical data of 242 children with BPD who were readmitted due to recurrent lower respiratory tract infection (LRTI) in the first 2 years of life. RESULTS: Among all the 242 children with BPD, 115(47.5%) had wheezing, and the children aged 1-2 years had a significantly higher incidence rate of wheezing than those aged less than 1 year (P<0.05). Chest imaging was performed for 193 children, among whom 31 (16.1%) had hyperlucent areas. Pulmonary function examination showed that the BPD children had significantly lower TV/kg, TPEF/TE, VPEF/VE, TEF50 and TEF75, and significantly higher respiratory rate than the controls without respiratory disease (P<0.05). Bronchoscopy was performed for 28 children, among whom 21 (75%) had airway dysplasia. All the 242 children used inhaled corticosteroids (ICS) and experienced no treatment-related adverse reactions. Six children were given intravenous infusion of human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) and experienced no infusion-related events or adverse reactions, among whom one child successfully stopped oxygen therapy. CONCLUSIONS: The incidence rate of wheezing increases with the increase in age in children with BPD who are readmitted due to LRTI. Pulmonary function examination shows small airway obstruction, reduced expiratory flow rate in case of low lung capacity, and increased respiratory rate, and most children have airway dysplasia. ICS can be used to inhibit inflammatory response in the acute stage. Infusion of hUCB-MSCs is safe and feasible and may bring some benefits to the recovery from BPD.

Effect of inhaled magnesium sulfate on bronchial hyperresponsiveness.

OBJECTIVES: To determine the response of nebulized magnesium sulfate on the lung function of children with bronchial hyperresponsiveness. METHODS: Eighty-four children with asthma were divided into three groups randomly: magnesium sulfate (M), albuterol (A), and a combination of magnesium sulfate and albuterol (M + A). All patients were nebulized with acetylcholine, and then treated as designed. Lung function was compared between the three groups. RESULTS: Forced expiratory volume in first second (FEV1) significantly improved in all the three groups but it was better in (A) and (M + A) compared to (M) at 10 min and 20 min [10 min: 1.26 L ± 0.53 (A) vs. 1.10 L ± 0.27 (M), 1.35 L ± 0.59 (M + A) vs. 1.10 L ± 0.27 (M), p < 0.05; 20 min: 1.32 L ± 0.61 (A) vs. 1.17 L ± 0.30 (M), 1.42 L ± 0.59 (M + A) vs. 1.17 L ± 0.30 (M), p < 0.05]. Variation of FEV1, as absolute value at 10 min or 20 min over post-Ach FEV1 was significantly different in (A) or (M + A) compared to (M). CONCLUSIONS: Nebulized albuterol and magnesium sulfate + albuterol can more effectively improve FEV1 in children with bronchial hyperresponsiveness than nebulized magnesium sulfate at 10 min and 20 min after inhalation. It is further suggested that addition of magnesium sulfate to albuterol does not result in additional benefit.

[Significance of exhaled nitric oxide measurement in remitting childhood asthma with concurrent remitting rhinitis].

OBJECTIVE: To evaluate the value of exhaled nitric oxide in the severity evaluation of asthmatic children with remitting rhinitis. METHODS: A total of 214 asthmatic children were randomly allocated to a untreated control and a conventional treatment group. Patients in each of the two subclasses were classified as asthma with concurrent rhinitis and asthma without concurrent rhinitis. Values of the 20% fall in forced expiratory volume in 1 second (PC20FEV1) and fractional exhaled nitric oxide (FeNO) were measured. RESULTS: The PC20FEV1 level was significantly higher in untreated asthma patients without rhinitis than in those with concurrent rhinitis (P<0.05), while FeNO was not significantly different between these two groups (P>0.05). There were no significant differences in both FeNO and PC20FEV1 between treated asthma patients with and without concurrent rhinitis (P>0.05). PC20FEV1 was significantly increased (P<0.05) but FeNO was significantly decreased (P<0.05) in asthma patients with concurrent rhinitis after conventional treatment. In asthmatic children without concurrent rhinitis, treatment significantly decreased the level of FeNO (P<0.05) but had not effect on PC20FEV1 (P>0.05). CONCLUSIONS: Exhaled nitric oxide measurement may be useful in the severity evaluation of asthmatic children with remitting rhinitis.

A novel treatment regimen for Duchenne muscular dystrophy.

Duchenne muscular dystrophy (DMD) is the most common, X-linked genetic, skeletal muscle disease, with various regimens of treatment. The objective of this study was to determine the safety and efficacy of a novel treatment regimen for this disease. Thirty boys with DMD were administered prednisone according to the following regimen: in the first year, 1.5 mg/kg/day for the first 3 months, 1.0 mg/kg/day for the next 3 months, 0.75 mg/kg/day for the next 3 months, and 0.5 mg/kg/day for the last 3 months. In the second year, prednisone was administered 0.5 mg/kg on the alternate day for 12 months. The muscle strength (Medical Research Council sum score and Gower's sign), serum enzymes (creatine kinase, creatine kinase isoenzyme-2, and lactate dehydrogenase), pulmonary function (forced vital capacity, maximum voluntary ventilation), body weight, height, and BMI were determined before treatment and 3, 6, 9, 12, and 24 months after treatment. The results showed that the patients' mean Medical Research Council sum score increased from 46.1 at the baseline to 53.6 at 12 months and was maintained at 24 months. Gower's sign disappeared in 22 (73.3%) patients at 12 months and 21 (70.0%) at 24 months. The serum levels of creatine kinase, creatine kinase isoenzyme-2, and lactate dehydrogenase decreased and pulmonary function improved after 24 months of treatment. Significantly increased weight gain, osteoporosis, and cushingoid features were not observed. Our results suggested that this novel prednisone regimen for DMD has similar efficacy and safety as other regimens.

[Effect of house dust mite vaccine on pulmonary function and inhaled corticosteroid doses in children with allergic asthma].

OBJECTIVE: To observe the dynamic changes of pulmonary function and inhaled corticosteroid (ICS) doses during subcutaneous immunotherapy (SCIT) with standardized house dust mite vaccine (Alutard) in children with mild to moderate allergic asthma. METHODS: One hundred children with mild to moderate allergic asthma were randomized into SCIT group and control group for treatment with SCIT plus ICS and with ICS only, respectively. The pulmonary function and ICS doses were evaluated before and every 3 months during the 2 years of treatment. RESULTS: No significant difference was found in the pulmonary functions between the two groups before the treatment (P>0.05). After 3 months of treatment, FEV1% and PEF% in SCIT group were significantly higher than those in the control group [(103.19∓2.07)% vs (97.52∓1.92)%, and (105.56∓3.21)% vs (96.35∓2.7)%, respectively]; at 21 months, FEF50% and FEF25% were significantly higher in SCIT group than in the control group [(105.69∓3.29)% vs (94.61∓3.12)%, and (106.60∓3.71)% vs (92.92∓3.31)%, respectively]. A significant difference was found in ICS doses between SCIT group and the control group after 9 months of treatment (147.14∓6.41 vs 170∓4.95 µg/day, P<0.05), and the difference increased as the treatment prolonged. CONCLUSION: SCIT combined with ICS can improve the ventilation function of the large airways early after the commencement of treatment, but its effect on small airways can be delayed. SCIT for 2 years shows a good therapeutic effect and can reduce the doses of ICS in children with mild to moderate allergic asthma.

[Association of FEV1 and PEF with small airway function in asthmatic children: cross-sectional analysis of 619 cases].

OBJECTIVE: To investigate the association of forced expiratory volume in 1 second (FEV1) and the maximum peak expiratory flow (PEF) with small airway function in asthmatic children of different ages and genders. METHODS: This cross-sectional study was conducted among 619 asthmatic children with disease remission aged 3 to 13 years. The children were divided into 3 age groups, namely 3 to 5 years group (314 cases), 6 to 9 years group (207 cases) and 10 to 13 years group (98 cases), and their respiratory physiological parameters such as FEV1 and PEF were measured. RESULTS: Of the airway function parameters, PEF showed the highest abnormality rate (>85%) in these asthmatic children. In male and female asthmatic children aged 6 to 9 years, abnormalities in forced expiratory flow rate 25% (MEF25) showed the highest frequency (56% and 63%, respectively). In 3-5 years and 10-13 years groups, MEF25 abnormalities were the most frequent in male children (43% and 71%, respectively), whereas abnormalities in MEF50 were the most common in female children (33% and 69%, respectively). FEV1 and PEF were positively correlated to all the parameters of small airway functions in these asthmatic children (r>0.5, P<0.01) except for MEF25 in female asthmatic children aged 3 to 5 years (r=0.19, P=0.168; r=0.086, P=0.535). CONCLUSION: In asthmatic children, FEV1 and PEF are positively correlated to the parameters of small airway function with only the exception of MEF25 in female children aged 3 to 5 years, suggesting the value of FEV1 in the diagnosis of asthma in children.

[Case-control study of the relationship between children's moderate-severe asthma and development indicators].

OBJECTIVE: To investigate the relationship between moderate-severe asthma and development in children. METHODS: A total of 389 children in the state of moderate-severe persistent asthma were enrolled, which were divided into moderate (226 cases) and severe group (163 cases). According to age, each group was divided into three groups: 3-year-old (85 cases and 63 cases), 5-year-old (76 cases and 52 cases) and 7 to 10 year-old (65 cases and 48 cases). Meanwhile, 298 healthy children in the same age group were enrolled as control, of which 3-year-old were 96 cases, 5-year-old were 92 cases and 7 to 10 year-old were 110 cases. Height, weight and lung function were measured respectively. RESULTS: 3-year-old of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight [(98.54 ± 7.75) cm, (14.87 ± 2.46) kg, 50.30% ± 16.31%, 50.27% ± 18.29%, 0.11 ± 0.66, 0.06 ± 0.49, respectively] were lower than the moderate group of the same age group ((103.58 ± 5.48) cm, (16.60 ± 2.21) kg, 65.80% ± 18.54%, 65.10% ± 18.92%, 0.46 ± 0.53, 0.45 ± 0.54, respectively) and the control group ((105.60 ± 6.29) cm, (17.82 ± 2.82) kg, 72.37% ± 11.37%, 71.92% ± 2.82%, 0.66 ± 0.62, 0.66 ± 0.52), the difference was significant (F values were 7.295, 8.034, 15.246, 10.745, 8.026, 10.864, respectively, P < 0.05).5-years of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight ((110.10 ± 7.36) cm, (18.76 ± 3.20) kg, 45.86% ± 18.92%, 41.69% ± 12.50%, -0.95 ± 0.42, -0.23 ± 0.34, respectively) were lower than the moderate group of the same age group ((117.76 ± 6.35) cm, (21.63 ± 2.75) kg, 61.81% ± 20.75%, 61.79% ± 18.92%, 0.36 ± 0.62, 0.38 ± 0.56) and the control group ((119.90 ± 5.78) cm, (22.80 ± 3.07) kg, 68.97% ± 18.59%, 66.27% ± 18.35%, 0.57 ± 0.65, 0.48 ± 0.63), the difference was significant (F values were 8.351, 7.864, 15.037, 13.921, 12.116, 11.725, respectively, P < 0.05).7 to 10 years-old of severe group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight ((123.50 ± 9.52) cm, (23.82 ± 5.72) kg, 45.81% ± 15.51%, 42.63% ± 14.91%, -0.06 ± 0.48, -0.02 ± 0.61, respectively) were lower than the moderate group of the same age group ((129.1 ± 8.41) cm, (26.70 ± 5.72) kg, 66.84% ± 16.09%, 64.07% ± 18.58%, 0.48 ± 0.46, 0.42 ± 0.49) and the control group ((131.87 ± 7.71) cm, (28.06 ± 6.01) kg, 71.44% ± 12.70%, 69.64% ± 16.20%, 0.60 ± 0.43, 0.60 ± 0.51), the difference was significant(F values were 6.136, 6.678, 57.316, 37.893, 37.210, 34.152, respectively, P < 0.05). 3-, 5-, 7 to 10 year-old of moderate group, the value of height, the value of weight, the percentage of height, the percentage of weight, the SDS of height, the SDS of weight dropped compared to the control group of the same age, but no significant difference was found (t values were -2.008, -1.988, -1.810, -1.879, -1.713, -1.844, -1.904, -2.019, -1.605, -1.017, -1.411, -0.713, -1.881, -1.896, -1.746, -1.906, -1.523, -1.864, respectively, P > 0.05). CONCLUSION: The height and weight of children with severe asthma were lower than those of normal children or with moderate asthma.