Materials and MethodsThis study is a cross-sectional, case-control study, comprising 20 controls (10 (7-14) years) and 82 uncontrolled atopic asthmatic children (9.5 (8-13) years). Cases and controls were recruited from Mansoura University Children Hospital, Mansoura, Egypt from 2010 to 2013. Asthma diagnosis and assessment of asthma control were done according to guidelines of global initiative for asthma management and prevention [11]. Informed consents for all participating children were obtained from their parents. The protocol of the study was approved by Ethical Committee of the Research of Mansoura Faculty of Medicine, Egypt.The inclusion criteria for children to be part of the research were:
AbstractObjectives: Circulating cytokines and genetic patterns may help to discriminate certain asthma phenotypes.Methods: Eighty two uncontrolled asthmatic children and twenty controls were enrolled in the study. After validation of asthma symptoms, three proposed phenotypes were formed: cough, Shortness Of Breath (SOB), and cough with SOB. Measurement of pulmonary function tests, Fractional Exhaled Nitric Oxide (FENO), eosinophilic percentage, serum levels of total IgE, IL-17 and IL-9 were done. Two Single-Nucleotide Polymorphisms (SNPs) in IL4 and IL4RA were genotyped using PCR-RFLP method.Results: Regarding SNP IL4RA-175V, cases showed heterozygous AG predominance whereas controls showed more homozygous GG genotype. Cough group showed significant decrease in both FEV1/FVC ratio in comparison to SOB and cough with SOB groups. Also, this group showed strong inverse relationship between FEV1 values and serum IL-9. In addition, there was significant increase in serum levels of IL-17 among homozygous CC compared to CT heterozygous patients of SNP IL-4C 590T in both cough group and SOB group. Cough with SOB group showed significant increase of serum levels of IL-9 when compared to cough group. Also, it showed elevated serum level of IL-9 compared to the other two phenotypes among individuals with IL4RA 175V AA and GG genotypes. SOB group showed higher prevalence of TT genotype of SNP IL-4C 590T in comparison to the cough group.
Conclusions:Our data show diversity in genotyping and cytokine profiles between asthma as a group and the proposed clinical phenotypes. This diversity clarifies the importance of classifying asthma depending on the proposed symptomatology.