Letter to the editor
Progressive airflow limitation is a feature of children with severe asthma

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Cited by (35)

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    2020, Journal of Allergy and Clinical Immunology: In Practice
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    Furthermore, although there are subsets of children with hyperinflation,119 these children tend to have less airway resistance than do adults130 and are generally reversible with bronchodilation.131 However, these features may worsen during adolescence,132 particularly in adolescents with worsening symptoms,133,134 and may increase the risk of more severe asthma, fixed airflow obstruction, or even chronic obstructive pulmonary disease in later adulthood.135,136 Indeed, in the Melbourne asthma cohort, 14% of all participants developed fixed airflow obstruction by the age of 50 years, defined as a postbronchodilator FEV1/forced vital capacity ratio of less than 0.7.

  • Children with Neutrophil-Predominant Severe Asthma Have Proinflammatory Neutrophils With Enhanced Survival and Impaired Clearance

    2019, Journal of Allergy and Clinical Immunology: In Practice
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    Studies in children are even more limited. In the few phenotypic8-10 and bronchoscopic11,12 pediatric studies that have been performed, most children with severe asthma had an eosinophil-predominant pattern of type 2 airway inflammation, raising questions about the relevance of neutrophils to pediatric disease.13 We have previously demonstrated that neutrophil elevations are present in the airways of a subpopulation of children with severe asthma and are associated with elevations in C-X-C motif chemokine ligand (CXCL) and C-C motif chemokine ligand (CCL) proteins responsible for neutrophil activation and chemotaxis, even in the absence of pathogenic bacteria or fungi.11

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Supported by National Institute of Health grants RO1HL069170 and RO1NR012021 and in part by the Center for Developmental Lung Biology, Children’s Healthcare of Atlanta, and PHS grants UL1 RR025008, KL2 RR025009, and TL1 RR025010 from the Clinical and Translational Science Award Program, National Institutes of Health, National Center for Research Resources.

Disclosure of potential conflict of interest: W. G. Teague receives speaker’s honoraria from Merck and Co and receives research support from the National Heart, Lung, and Blood Institute, the American Lung Association, and the Centers for Disease Control and Prevention. A. Fitzpatrick had declared that she has no conflict of interest.

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