Severe asthma (SA) affects 2% to 5% of asthmatic children. Atopic dermatitis can affect up to 34% of children with SA (cwSA). Atopic dermatitis and asthma share common genetic and immunological features. However, not all children with SA suffer from AD, and it remains unclear whether the overall immune profiles of these children are similar. In this study, seventeen cwSA (9.8 [7.1–13.2] years; seven with and ten without AD) were enrolled. Bronchoalveolar lavage (BAL) and blood samples were collected from these patients. Seventy-three cytokines/chemokines and distinct immune T cell populations were evaluated in blood and BAL. We found that BAL and blood immune profiles of cwSA with and without AD were globally similar. However, specific differences were observed, namely lower frequency of Tc2, Th17 and IL-17-producing mucosal associated invariant T (MAIT-17) cells and higher CD8/CD4 ratio and IL-22 concentrations in BAL and of CCL19 concentrations in plasma from cwSA with AD. Further, in contrast with cwSA without AD, we found a positive correlation between a set of plasma cytokines and almost all cytokines in BAL in cwSA with AD. In conclusion, this study shows the major immune differences between cwSA with and without AD in BAL and blood suggesting that distinct endotypes may be implicated in the inflammatory responses observed in these pediatric patients.

中文翻译：

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根据特应性皮炎状态识别严重哮喘儿童的主要免疫差异

2% 至 5% 的哮喘儿童患有严重哮喘 (SA)。高达 34% 的特应性皮炎 (cwSA) 儿童会受到特应性皮炎的影响。特应性皮炎和哮喘具有共同的遗传和免疫学特征。然而，并非所有患有 SA 的儿童都患有 AD，并且尚不清楚这些儿童的整体免疫特征是否相似。在这项研究中，纳入了 17 名 cwSA（9.8 [7.1-13.2] 岁；7 名患有 AD，10 名未患有 AD）。从这些患者身上采集支气管肺泡灌洗液（BAL）和血液样本。在血液和 BAL 中评估了 73 种细胞因子/趋化因子和不同的免疫 T 细胞群。我们发现患有和不患有 AD 的 cwSA 的 BAL 和血液免疫特征在总体上相似。然而，观察到了特定的差异，即产生 Tc2、Th17 和 IL-17 的粘膜相关不变 T (MAIT-17) 细胞的频率较低，BAL 中的 CD8/CD4 比率和 IL-22 浓度以及血浆中的 CCL19 浓度较高。带有 AD 的 cwSA。此外，与没有 AD 的 cwSA 相比，我们发现在患有 AD 的 cwSA 中，一组血浆细胞因子与 BAL 中几乎所有细胞因子之间呈正相关。总之，这项研究显示了 BAL 和血液中患有和不患有 AD 的 cwSA 之间的主要免疫差异，表明不同的内型可能与这些儿科患者中观察到的炎症反应有关。