ArticleThe journal of allergy and clinical immunology. In practice
Lung Lavage Granulocyte Patterns and Clinical Phenotypes in Children with Severe, Therapy-Resistant Asthma.
Article in The journal of allergy and clinical immunology. In practice. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 69 citations in OpenAlex.
- Measures of ventilation heterogeneity mapped with hyperpolarized helium-3 MRI demonstrate a T2-high phenotype in asthma.Pediatric pulmonology · 2021Trial
- Race Adjusted for Social and Environmental Disparities Is the Principal Determinant of T2HIGH Inflammation in Children With Severe Asthma.The journal of allergy and clinical immunology. In practice · 2026Article
- Rhinovirus-infected preschool children with problematic wheeze have lung eosinophilic inflammation.The Journal of allergy and clinical immunology · 2026Article
- Bronchoalveolar Results in Young Children with Chronic Lung Symptoms: Lessons Learned from an Allergy-Pulmonology Project Guided by an Updated Mini Review of the Current Literature of Bronchoalveolar Lavage Eosinophilia and Neutrophilia in Normal Children.Children (Basel, Switzerland) · 2026Article
- Can a Peripheral Blood Marker for Airway Neutrophilia Be Identified in Children with Bronchiectasis?Children (Basel, Switzerland) · 2026Article
- Beyond the Usual Suspects: Unmasking Low-T2 Asthma in Children.Journal of clinical medicine · 2026Review
- Systemic immune programming in the life course of childhood asthma: a new perspective on monocyte pre-activation and trained immunity.Frontiers in immunology · 2026Review
- Neutrophilic Asthma-From Mechanisms to New Perspectives of Therapy.Journal of clinical medicine · 2025Review
- Rhinovirus as a driver of airway T cell dynamics in children with treatment-refractory recurrent wheeze.JCI insight · 2025Article
- Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study.Clinical and experimental pediatrics · 2025Article
- Integrative Roles of Pro-Inflammatory Cytokines on Airway Smooth Muscle Structure and Function in Asthma.Immunological reviews · 2025Review
- T1-T2 Interplay in the Complex Immune Landscape of Severe Asthma.Immunological reviews · 2025Review
- Advances in non-type 2 severe asthma: from molecular insights to novel treatment strategies.The European respiratory journal · 2024Review
- How we treat type 2 low asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2024Article
- Severe Asthma and Biological Therapies: Now and the Future.Journal of clinical medicine · 2023Review
- Childhood asthma phenotypes and endotypes: a glance into the mosaic.Molecular and cellular pediatrics · 2023Review
- CCL5 is a potential bridge between type 1 and type 2 inflammation in asthma.The Journal of allergy and clinical immunology · 2023Article
- Further evidence of a type 2 inflammatory signature in chronic obstructive pulmonary disease or emphysema.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2023Article
- Asthma with recurrent middle lobe syndrome in children: Clinical features and lung function patterns.Frontiers in pediatrics · 2023Article
- Utility of biomarkers in the diagnosis and monitoring of asthmatic children.The World Allergy Organization journal · 2023Review
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15 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundChildren with severe asthma have frequent exacerbations despite guidelines-based treatment with high-dose corticosteroids. The importance of refractory lung inflammation and infectious species as factors contributing to poorly controlled asthma in children is poorly understood.
objectiveTo identify prevalent granulocyte patterns and potential pathogens as targets for revised treatment, 126 children with severe asthma underwent clinically indicated bronchoscopy.
methodsDiagnostic tests included bronchoalveolar lavage (BAL) for cell count and differential, bacterial and viral studies, spirometry, and measurements of blood eosinophils, total IgE, and allergen-specific IgE. Outcomes were compared among 4 BAL granulocyte patterns.
resultsPauci-granulocytic BAL was the most prevalent granulocyte category (52%), and children with pauci-granulocytic BAL had less postbronchodilator airflow limitation, less blood eosinophilia, and less detection of BAL enterovirus compared with children with mixed granulocytic BAL. Children with isolated neutrophilia BAL were differentiated by less blood eosinophilia than those with mixed granulocytic BAL, but greater prevalence of potential bacterial pathogens compared with those with pauci-granulocytic BAL. Children with isolated eosinophilia BAL had features similar to those with mixed granulocytic BAL. Children with mixed granulocytic BAL took more maintenance prednisone, and had greater blood eosinophilia and allergen sensitization compared with those with pauci-granulocytic BAL.
conclusionsIn children with severe, therapy-resistant asthma, BAL granulocyte patterns and infectious species are associated with novel phenotypic features that can inform pathway-specific revisions in treatment. In 32% of children evaluated, BAL revealed corticosteroid-refractory eosinophilic infiltration amenable to anti-T
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.