title: The relation of innate and adaptive immunity with viral-induced acute asthma attacks: Focusing on IP-10 and cathelicidin.
abstract: BACKGROUND
  Despite growing evidence suggesting potential association between innate and adaptive immunity in viral-induced acute asthma, there is paucity of data in this area.
  
  
  OBJECTIVE
  This study aimed to investigate the association of innate and adaptive immunity with acute asthma attacks by analysing the role of IFN-γ-inducible protein 10 (IP-10), TLR2, cathelicidin, vitamin D and cytokines.
  
  
  METHODS
  This prospective study included 33 patients with viral-induced acute asthma and 30 children with controlled asthma. Nasopharyngeal swab samples were collected for virus identification and asthma attack scores assessed in acute asthma group. Blood sampling for IP-10, TLR2, cathelicidin, vitamin D levels, and spirometric indices were employed.
  
  
  RESULTS
  Serum IP-10 and cathelicidin levels of acute asthma group were significantly higher and vitamin D levels were lower than controlled asthma group (IP-10; p=0.006, cathelicidin; p=0.002, vitamin D; p<0.001). Serum IP-10 levels showed a significant negative correlation with age (p=0.009), TLR2 (p=0.05) and spirometric indices (p=0.002) in all asthmatics and a significant positive correlation with parameters of asthma attack severity (p=0.03) in acute asthma group. Higher cathelicidin values showed significant positive relation to IP-10 (beta coefficient: 33, p=0.02). Serum IP-10 levels higher than 38.9pg/ml (sensitivity: 85%, specificity: 47%, p=0.002) were predictive of virus-induced asthma. Serum IP-10 and vitamin D levels were found to be significantly related to viral-asthma attacks (IP-10; aOR: 8.93, p=0.03 and vitamin D; aOR: 0.82, p=0.001).
  
  
  CONCLUSIONS
  Innate immunity biomarkers such as serum IP-10 and cathelicidin can be used to predict viral-induced acute asthma. These biomarkers may provide potential new treatment targets for acute asthma.
authors.affiliation: Mersin University, Faculty of Medicine, Department of Pediatric Allergy and Immunology, Mersin, Turkey. Electronic address: arikoglutugba@yahoo.com.
authors.forename: T
authors.initials: T
authors.lastname: Arikoglu
authors.affiliation: Mersin University, Faculty of Medicine, Department of Pediatrics, Mersin, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Akyilmaz
authors.affiliation: Mersin University, Faculty of Medicine, Department of Biostatistics, Mersin, Turkey.
authors.forename: D D
authors.initials: DD
authors.lastname: Yildirim
authors.affiliation: Mersin University, Faculty of Medicine, Department of Pediatric Allergy and Immunology, Mersin, Turkey.
authors.forename: S B
authors.initials: SB
authors.lastname: Batmaz
authors.affiliation: Mersin University, Faculty of Medicine, Department of Medical Microbiology, Mersin, Turkey.
authors.forename: S T
authors.initials: ST
authors.lastname: Ulger
authors.affiliation: Mersin University, Faculty of Medicine, Department of Medical Microbiology, Mersin, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Aslan
authors.affiliation: Mersin University, Faculty of Medicine, Department of Pediatric Allergy and Immunology, Mersin, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kuyucu
mesh_terms: D056704:Adaptive Immunity; D000293:Adolescent; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D001249:Asthma / Q000175:diagnosis* / Q000209:etiology; D015415:Biomarkers / Q000097:blood*; D054357:Chemokine CXCL10 / Q000097:blood*; D002648:Child; D016207:Cytokines / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D051195:Toll-Like Receptor 2 / Q000378:metabolism; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis*; D014807:Vitamin D / Q000097:blood*; D054804:Cathelicidins
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D054357:Chemokine CXCL10; D016207:Cytokines; C495342:TLR2 protein, human; D051195:Toll-Like Receptor 2; D014807:Vitamin D; D054804:Cathelicidins
keywords: Acute asthma attack; Cathelicidin; Cytokines; IP-10; TLR2; Virus; Vitamin D