Cytokine Responses to Rhinovirus and Development of Asthma, Allergic Sensitization, and Respiratory Infections during Childhood

• Published in: American journal of respiratory and critical care medicine Vol. 197; no. 10; pp. 1265 - 1274
• Main Authors: Custovic, Adnan, Belgrave, Danielle, Lin, Lijing, Bakhsoliani, Eteri, Telcian, Aurica G., Solari, Roberto, Murray, Clare S., Walton, Ross P., Curtin, John, Edwards, Michael R., Simpson, Angela, Rattray, Magnus, Johnston, Sebastian L.
• Format: Journal Article
• Language: English
• Published: United States American Thoracic Society 15.05.2018
• Subjects: Adolescent; Age; Allergies; Antiviral Agents - immunology; Antiviral Agents - therapeutic use; Artificial intelligence; Asthma; Asthma - drug therapy; Chemokines; Child; Child development; Child, Preschool; Clinical outcomes; Cluster analysis; Cytokines; Cytokines - immunology; Female; Follow-Up Studies; Hospitalization; Humans; Infant; Infections; Male; Original; Picornaviridae Infections - drug therapy; Picornaviridae Infections - immunology; Population; Respiratory Tract Infections - drug therapy; Respiratory Tract Infections - immunology; Rhinovirus - drug effects; Rhinovirus - immunology; asthma; cytokines; machine learning; rhinovirus
• ISSN: 1073-449X; 1535-4970; 1535-4970
• DOI: 10.1164/rccm.201708-1762OC

Immunophenotypes of antiviral responses, and their relationship with asthma, allergy, and lower respiratory tract infections, are poorly understood. We characterized multiple cytokine responses of peripheral blood mononuclear cells to rhinovirus stimulation, and their relationship with clinical outcomes. In a population-based birth cohort, we measured 28 cytokines after stimulation with rhinovirus-16 in 307 children aged 11 years. We used machine learning to identify patterns of cytokine responses, and related these patterns to clinical outcomes, using longitudinal models. We also ascertained phytohemagglutinin-induced T-helper cell type 2 (Th2)-cytokine responses (PHA-Th2). We identified six clusters of children based on their rhinovirus-16 responses, which were differentiated by the expression of four cytokine/chemokine groups: interferon-related (IFN), proinflammatory (Inflam), Th2-chemokine (Th2-chem), and regulatory (Reg). Clusters differed in their clinical characteristics. Children with an IFN Inflam Th2-chem Reg rhinovirus-16-induced pattern had a PHA-Th2 response, and a very low asthma risk (odds ratio [OR], 0.08; 95% confidence interval [CI], 0.01-0.81; P = 0.03). Two clusters had a high risk of asthma and allergic sensitization, but with different trajectories from infancy to adolescence. The IFN Inflam Th2-chem Reg cluster exhibited a PHA-Th2 response and was associated with early-onset asthma and sensitization, and the highest risk of asthma exacerbations (OR, 1.37; 95% CI, 1.07-1.76; P = 0.014) and lower respiratory tract infection hospitalizations (OR, 2.40; 95% CI, 1.26-4.58; P = 0.008) throughout childhood. In contrast, the IFN Inflam Th2-chem Reg cluster with a rhinovirus-16-cytokine pattern was characterized by a PHA-Th2 response, and a low prevalence of asthma/sensitization in infancy that increased sharply to become the highest among all clusters by adolescence (but with a low risk of asthma exacerbations). Early-onset troublesome asthma with early-life sensitization, later-onset milder allergic asthma, and disease protection are each associated with different patterns of rhinovirus-induced immune responses.