Repeated measurement of nasal lavage fluid chemokines in school-age children with asthma.
BACKGROUND
Inflammatory processes at the mucosal surface may play a role in maintenance of asthma pathophysiology. Cross-sectional studies in asthmatic patients suggest that chemokines such as interleukin 8 (IL-8) are overproduced by respiratory epithelium.


OBJECTIVE
To test the hypothesis that chemokine levels are persistently elevated in the respiratory secretions of asthmatic children at a stable baseline.


METHODS
We measured nasal lavage fluid (NLF) levels of chemokines and other mediators at 3- to 4-month intervals in a longitudinal study of asthmatic children, with nonasthmatic siblings as controls.


RESULTS
In a linear mixed-model analysis, both family and day of visit had significant effects on nasal mediators. Thus, data for 12 asthmatic-nonasthmatic sibling pairs who had 3 or more same-day visits were analyzed separately. For sibling pairs, median eosinophil cationic protein levels derived from serial measurements in NLF were elevated in asthmatic patients compared with nonasthmatic patients, with a near-significant tendency for elevation of total protein and eotaxin levels as well. However, no significant differences were found for IL-8 or several other chemokines. Ratios of IL-13 or IL-5 to interferon-gamma released by house dust mite antigen-stimulated peripheral blood mononuclear cells, tested on a single occasion, were significantly increased for asthmatic patients.


CONCLUSIONS
Substantial temporal and family-related variability exists in nasal inflammation in asthmatic children. Although higher levels of eosinophil cationic protein are usually present in NLF of patients with stable asthma compared with patients without asthma, chemokines other than eotaxin are not consistently increased. Eosinophil activation at the mucosal surface is a more consistent predictor of asthmatic symptoms than nonspecific elevation of epithelium-derived inflammatory chemokine levels.
Department of Pediatrics, School of Medicine, The University of North Carolina at Chapel Hill, 27599-7220, USA. terry_noah@med.unc.edu
Terry L
TL
Noah
Gail E
GE
Tudor
Sally S
SS
Ivins
Paula C
PC
Murphy
David B
DB
Peden
Frederick W
FW
Henderson
D000293:Adolescent; D001249:Asthma / Q000276:immunology*; D018925:Chemokines / Q000032:analysis*; D002648:Child; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D017817:Nasal Lavage Fluid / Q000737:chemistry* / Q000166:cytology / Q000276:immunology; D015203:Reproducibility of Results; D035781:Siblings; D013997:Time Factors
D018925:Chemokines