[Characterization of asthma phenotypes in children of the tropics].

María Camila Guzmán, María de Vivero, Isabel Gil, Victoria Marrugo, Dilia Mercado, Josefina Zakzuk, Leonardo Puerta, Nathalie Acevedo, Luis Caraballo
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Abstract

Objective: Determine the main asthma phenotypes in a population of asthmatic children in Cartagena, Colombia.

Methods: 107 children (7 to 17 years old) with a previous diagnosis of asthma were recruited. Biomarkers of T2 inflammation were evaluated by measuring FeNO, eosinophil count in peripheral blood by hemocytometry, and determination of specific IgE to mite allergens by ELISA. The study was approved by the ethics committee of the University of Cartagena (SGR, Grant BPIN2020000100405).

Results: The average age of patients was 10,9 years. 19,6% of the children did not show elevation of any of the T2 inflammation biomarkers evaluated (FeNO<20ppb, eos<300/ul, negative specific IgE), so they were considered patients with non-allergic asthma (non-T2). 71,9% of all patients were sensitized to at least one allergen, this phenotype was considered allergic asthma. 30,8% of the patients presented the three elevated biomarkers (FeNO>20ppb + eos >300/ul + positive specific IgE), this phenotype was classified as high T2 allergic asthma. A moderate correlation (Spearman rho=0,44, p<0,0001) was found between FeNO values and eosinophil counts.

Conclusion: In this study, the following phenotypes were found: allergic asthma, high T2 asthma, and non-allergic asthma. Most patients presented a type 2 inflammatory phenotype with allergic sensitization. In addition to the measurement of specific IgE, the use of FeNO and eosinophil count in peripheral blood help to accurately determine those patients with high T2 asthma phenotypes.

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[热带地区儿童哮喘表型的特征]。
目的:确定哥伦比亚卡塔赫纳哮喘儿童的主要哮喘表型:方法:招募 107 名曾被诊断为哮喘的儿童(7 至 17 岁)。通过测量 FeNO、血球计数法检测外周血中的嗜酸性粒细胞数量以及酶联免疫吸附法测定螨虫过敏原的特异性 IgE,评估 T2 炎症的生物标志物。该研究获得了卡塔赫纳大学伦理委员会(SGR,Grant BPIN2020000100405)的批准:患者平均年龄为 10.9 岁。19.6%的儿童没有出现任何T2炎症生物标志物升高(FeNO20ppb + eos >300/ul + 特异性 IgE 阳性),这种表型被归类为高T2过敏性哮喘。中度相关性(Spearman rho=0,44,pConclusion):本研究发现了以下几种表型:过敏性哮喘、高 T2 哮喘和非过敏性哮喘。大多数患者表现为具有过敏致敏性的 2 型炎症表型。除了测量特异性 IgE 外,使用 FeNO 和外周血中的嗜酸性粒细胞计数有助于准确判断高 T2 哮喘表型患者。
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