Newfound association a step towards creating cytokine profiles for asthma phenotypes.
Investigators focusing on associations between asthma outcomes and serum cytokine profiles have discovered that there are links between high levels of two anti-inflammatorily cytokine proteins. Interleukin-1 receptor antagonist (IL-1 RA) and interleukin-10 (IL10) reduced risk of worsening asthma in adult patients with asthma in the study.
This newfound association is a step towards creating serum cytokine profiles for specific asthma phenotypes, and may help with identifying targeted therapies in response to specific cytokine profiles, while predicting asthma burdens for adult patients with asthma.
The international study led by Zenia Akiki, MPH, PhD (pictured), with INSERM, the Ministry of Public Health in Lebanon, and Lebanese University, focused on determining to what degree serum cytokine levels might serve as predictors for asthma control outcomes in patients. Akiki remarks that although there is an increased understanding of the role cytokines play in asthma leading to developments of targeted therapies utilizing anti-Immunoglobeulin (IGE) and anti-interleukin (anti-IL), "little is known about the association between serum cytokine levels and asthma control outcomes."
The study, designed to build a "cytokine signature" to help diagnose asthma phenotypes, and recommend targeted therapies, drew on data from Epidemiological Study on the Genetics and
Environment of Asthma (EGEA2), a 7 year long study of asthma conducted by the French National Institute of Health and Medical Research (INSERM). The analysis of data by Akiki and colleagues focused on 283 asthma cases. The participants were selected for their available serum cytokine data, provided by an inflammation cytokine analysis. Data from the participants' serum cytokine profiles were then compared to cross sectional and longitudinal analyses of participants' symptom control evolution.
Patients with asthma were divided into two groups, those with "anti-inflammatory cytokine profiles" and those with "pro-inflammatory cytokine profiles." Researchers discovered that participants with high "anti-inflammatory cytokine profiles" had a lower risk of bronchial hyperresponsiveness (BHR), lower total IGE levels, lower neutrophil counts, and lower risk of worsening asthma symptoms . Participants with high "pro-inflammatory cytokine profiles" had, according to data results, "significantly higher neutrophil counts" and higher likelihood of eosinophilic and neutrophilic inflammation, but no association with asthma symptom control.
Akiki and colleagues suggest that this knowledge may assist clinicians in the use of targeted therapies, and that the analysis results "highlight the importance of including IL-1Ra and IL-10, and possibly other anti-inflammatory cytokines, in future studies of associations between cytokine profiles and asthma control outcomes." Further study of cytokine profiles as predictors of asthma control could, according to the study, assist clinicians in monitoring disease evolution and inflammatory mechanisms in patients with uncontrolled asthma.
The study also suggests that cytokine profiles, rather than individual assessment of cytokine levels, may serve as a more efficient means of determining targeted treatment course for patients with uncontrolled asthma. Akiki and colleagues suggest that further research to confirm and replicate the study's "surprising" findings are warranted.
The article "Serum Cytokine Profiles as Predictors of Asthma Control in Adults from the EGEA Study" was published in the April 2017 issue of Respiratory Medicine.