Research ArticleAsthma

Distinct immune phenotypes in infants developing asthma during childhood

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Science Translational Medicine  05 Feb 2020:
Vol. 12, Issue 529, eaaw0258
DOI: 10.1126/scitranslmed.aaw0258

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Infant immunity and asthma

Asthma is traditionally thought of as a type 2 allergic disease, but its presentation and pathogenesis are quite heterogenous. To better understand early immune responses that are associated with asthma, Thysen et al. leveraged samples from a longitudinal cohort of hundreds of children. Blood cells collected at 18 months of age were stimulated in vitro with various ligands, and different immune phenotypes were related to clinical asthma outcomes. The investigators revealed sex differences, an influence of microbial exposure, and immune traits associated with transient or persistent asthma. This systems approach provides valuable information on early life immune profiles and how they relate to asthma development.

Abstract

Early exposure to environmental triggers may elicit trajectories to chronic inflammatory disease through deregulated immune responses. To address relations between early immune competence and development of childhood asthma, we performed functional immune profiling of 186 parameters in blood of 541 18-month-old infants and examined links between their response phenotype and development of transient or persistent disease at 6 years of age. An abnormal neutrophil-linked antiviral response was associated with increased risk of transient asthma. Children who exhibited persistent asthma at year 6 showed enhanced interleukin-5 (IL-5) and IL-13 production in stimulated T cells at 18 months of age, which was associated with early life bacterial colonization of the airways. These findings highlight the early appearance of distinct immune characteristics in infants developing different asthma endotypes during childhood.

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