Upper airway cell transcriptomics identify a major new immunological phenotype with strong clinical correlates in young children with acute wheezing

SK Khoo, J Read, K Franks, G Zhang… - The Journal of …, 2019 - journals.aai.org
SK Khoo, J Read, K Franks, G Zhang, J Bizzintino, L Coleman, C McCrae, L Öberg, NM Troy
The Journal of Immunology, 2019journals.aai.org
Asthma exacerbations are triggered by rhinovirus infections. We employed a systems
biology approach to delineate upper-airway gene network patterns underlying asthma
exacerbation phenotypes in children. Cluster analysis unveiled distinct IRF7 hi versus IRF7
lo molecular phenotypes, the former exhibiting robust upregulation of Th1/type I IFN
responses and the latter an alternative signature marked by upregulation of cytokine and
growth factor signaling and downregulation of IFN-γ. The two phenotypes also produced …
Abstract
Asthma exacerbations are triggered by rhinovirus infections. We employed a systems biology approach to delineate upper-airway gene network patterns underlying asthma exacerbation phenotypes in children. Cluster analysis unveiled distinct IRF7 hi versus IRF7 lo molecular phenotypes, the former exhibiting robust upregulation of Th1/type I IFN responses and the latter an alternative signature marked by upregulation of cytokine and growth factor signaling and downregulation of IFN-γ. The two phenotypes also produced distinct clinical phenotypes. For IRF7 lo children, symptom duration prior to hospital presentation was more than twice as long from initial symptoms (p= 0.011) and nearly three times as long for cough (p< 0.001), the odds ratio of admission to hospital was increased more than 4-fold (p= 0.018), and time to recurrence was shorter (p= 0.015). In summary, our findings demonstrate that asthma exacerbations in children can be divided into IRF7 hi versus IRF7 lo phenotypes with associated differences in clinical phenotypes.
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