Pediatric asthma and eosinophilia: insights from nasal and blood smear analyses
DOI:
https://doi.org/10.18203/2349-3291.ijcp20241673Keywords:
Pediatric asthma, AR, Eosinophilia, Nasal cytological analysis, Hematological assessment, Asthma severity, Pediatric respiratory diseasesAbstract
Background: Allergic respiratory maladies, particularly pediatric asthma, pose substantial challenges in public health. This cross-sectional investigation endeavours to unravel the eosinophilic landscape within nasal cytological specimens and peripheral blood samples of pediatric asthma cohorts, with a keen focus on discerning the correlation between nasal and systemic eosinophilia.
Methods: Sixty-six pediatric asthma subjects, aged 6 to 18, under the care of Cheluvamba hospital in Mysuru, were meticulously recruited over an extensive 18-month period.
Results: Analysis unveiled a conspicuous preponderance of male participants, with a mean age range spanning 9 to 13 years. Intriguingly, the presence of allergic rhinitis (AR) exhibited no discernible statistically significant nexus with either asthma severity or eosinophilic markers. Noteworthy findings include peripheral eosinophilia detected in 56% of subjects, juxtaposed against nasal eosinophilia observed in 20%; however, no statistically meaningful correlation emerged between nasal and peripheral eosinophilia.
Conclusions: The inquiry culminated in a robust affirmation that mean nasal eosinophil count and blood absolute eosinophil count (AEC) exhibit a salient association with asthma severity and control in pediatric cohorts, irrespective of AR presence. Particularly, a discernible augmentation in mean AEC and nasal eosinophil count was discerned concomitant with exacerbating asthma severity and in cases of partial/ uncontrolled asthma.
References
Global strategy for asthma management and prevention. Global initiative for asthma (GINA). Available at: http://www.ginasthma.org. Accessed on 12 April 2024.
The Global Asthma Report 2022. Int J Tuberc Lung Dis. 2022;26(1):1-104.
Giavina-Bianchi P, Aun MV, Takejima P, Kalil J, Agondi RC. United airway disease: Current perspectives. J Asthma Allergy. 2016;9:93-100.
Ciprandi G, Caimmi D, Miraglia Del Giudice M, La Rosa M, Salpietro C, et al. Recent developments in United airways disease. Allergy Asthma Immunol Res. 2012;4(4):171-7.
Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A, et al. World Health Organization; GA(2)LEN; AllerGen. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update. Allergy. 2008;63(86):8-160.
Licari A, Caimmi S, Bosa L, Marseglia A, Marseglia GL, Caimmi D. Rhinosinusitis and asthma: a very long engagement. Int J Immunopathol Pharmacol. 2014;27(4):499-508.
Brambilla I, Pusateri A, Pagella F, Caimmi D, Caimmi S, Licari A, et al. Adenoids in children: Advances in immunology, diagnosis, and surgery. Clin Anat. 2014;27(3):346-52.
Moore WC, Fitzpatrick AM, Li X, Hastie AT, Li H, Meyers DA, et al. Clinical heterogeneity in the severe asthma research program. Ann Am Thorac Soc. 2013;10(1):S118-24.
Moore WC, Hastie AT, Li X, Li H, Busse WW, Jarjour NN, et al. Sputum neutrophil counts are associated with more severe asthma phenotypes using cluster analysis. J Allergy Clin Immunol. 2014;133(6):1557-63.e5.
Pavord ID, Korn S, Howarth P, Bleecker ER, Buhl R, Keene ON, et al. Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial. Lancet. 2012;380(9842):651-9.
Green RH, Brightling CE, McKenna S, Hargadon B, Parker D, Bradding P, et al. Asthma exacerbations and sputum eosinophil counts: a randomised controlled trial. Lancet. 2002;360(9347):1715-21.
Global strategy for asthma management and prevention. Global initiative for asthma (GINA). Available at: http://www.ginasthma.org. Accessed on 12 April 2024.
Centers for Disease Control and Prevention. Vital Signs. 2011;2013.
Naeem A, Silveyra P. Sex Differences in Paediatric and Adult Asthma. Eur Med J (Chelmsf). 2019;4(2):27-35.
Kynyk JA, Mastronarde JG, McCallister JW. Asthma, the sex difference. Curr Opin Pulm Med. 2011;17(1):6-11.
Kansal P, Nandan D, Agarwal S, Patharia N, Arya N. Correlation of induced sputum eosinophil levels with clinical parameters in mild and moderate persistent asthma in children aged 7-18 years. J Asthma. 2018;55(4):385-90.
Devi CG, Sabapathy S, Pabiyasree J. Correlation of serum IgE and absolute eosinophil count levels with the severity of childhood asthma. Int J Gen Med Pharm. 2014;4(1):79-82.
Forno E, Weiner DJ, Mullen J, Sawicki G, Kurland G, Han YY, Cloutier MM, Canino G, Weiss ST, Litonjua AA, Celedón JC. Obesity and Airway Dysanapsis in Children with and without Asthma. Am J Respir Crit Care Med. 2017;195(3):314-323.
Rudrappa S, Kumar R, Kumar V. Study of eosinophil count in nasal smear and peripheral blood smear in children with allergic rhinitis. Int J Contemp Pediatr. 2019;6(3):1158-62.
Choi Y, Jeon H, Yang EA, Yoon JS, Kim HH. Nasal eosinophilia and eosinophil peroxidase in children and adolescents with rhinitis. Korean J Pediatr. 2019;62(9):353-9.
Crobach M, Hermans J, Kaptein A, Ridderikhoff J, Mulder J. Nasal smear eosinophilia for the diagnosis of allergic rhinitis and eosinophilic non-allergic rhinitis. Scand J Prim Health Care. 1996;14(2):116-21.
Snehalatha G, Begum A, Raju N, Kumar RN. A study on correlation of serum IgE levels with diagnosis and severity of asthma in children. Int J Contemp Pediatr. 2018;5(6):2240-3.
Chaudhary GS, Kumar A, Shashtri M. Comparison of total serum immunoglobulin E and absolute eosinophil count levels among asthmatic and non-asthmatic children. Indian J Child Health. 2017;4(3):345-7.
Nadif R, Zerimech F, Bouzigon E, Matran R. The role of eosinophils and basophils in allergic diseases considering genetic findings. Curr Opin Allergy Clin Immunol. 2013;13(5):507-13.
Mubarak B, Shakoor H, Masood F. Eosinophilic asthma. Asthma Biological Evidences. Intechopen; 2019:11.