Alterations of T-lymphocyte subsets, soluble IL-2 receptor, and IgE in peripheral blood of children with acute asthma attacks

Background: T-cell activation and alteration of cytokines are involved in t he pathogenesis of atopic asthma. However, the profile of circulating T-lym phocyte subsets, related cytokines, and plasma IgE during acute asthma atta cks is still unclear. Objective: In an attempt to illustrate the dynamics o f these parameters in asthma attacks, He investigated the changes of T-cell subsets, lymphocyte activation, soluble IL-2R, and IgE in peripheral blood in children during and after acute asthma attach. Methods: This study was carried out in a cohort of Chinese children (n = 59 ) with acute asthma attacks. Immunoassays were performed when the patients had acute attacks before treatment, and the patients were reexamined in the 3 weeks after the resolution of acute attacks with therapy. Paired t tests were used for the statistical analysis of these patients to compare the da ta obtained during and after the acute attacks. Twenty healthy, age-matched subjects sere used as normal control subjects. Nine children with long-ter m stable asthma were used as control subjects with stable asthma. Results: CD3+, CD4+, CD8+, and IL-2R+ (CD25+) cells; plasma soluble IL-2 re ceptor; and IgE were significantly higher in patients with acute attacks th an in control subjects. (P <.05, P <.05, P <.001, P <.05, P <.0001, and P<. 0001, respectively). Immunoelectron microscopy exhibited an increased expre ssion of IL-2R on lymphocytes in acute attacks as compared to control subje cts. The abnormalities returned to normal, with the exception of IgE, when clinical remission was achieved after treatment. Correlation analyses revea led a positive relationship between plasma IgE and soluble IL-2R in asthma attacks (r = 0.83, P=.0001). plasma IgE and soluble IL-2R of those who Here in remission positively correlated with their production in acute attacks (r = 0.58, P =.001 and r = 0.71, P =.0001, respectively). Conclusion: This study suggests that (1) the percentage of CD4+, CD8+, or I L-2R+ lymphocytes in peripheral blood was significantly elevated during acu te attacks and returned to normal ranges after complete remission was achie ved; (3) plasma soluble IL-2R is a sensitive marker for asthma activity; an d (3) atopic asthmatic children seem to have a hereditary predisposition of having higher revels of soluble IL-2R in asthma attacks, coinherited with the trait of IgE.