Peripheral blood TSLP (thymic stromal lymphopoietin) in children as a biomarker?

Abstract

Introduction: There is substantial evidence that alarmin TSLP plays one of the key roles in driving type 2 inflammation and it is also thought that it has a role in neutrophilic, type 2-low airway inflammation. Much less is known about the role of alarmins in type 2-low asthma and its role in the heterogeneity of inflammation in acute asthma exacerbations.

Aims and objectives: The aim of the present study was to find out whether there are differences of TSLP concentrations in peripheral blood of children in different asthma phenotypes and healthy children and to find out whether there is a dynamic in TSLP during an asthma exacerbation.

Methods: We checked TSLP concentrations in peripheral blood in 207 children with asthma and 100 healthy controls (ages 1-13 years). In 23 children we measured TSLP also during an acute asthma exacerbation. Asthma phenotypes were defined as allergic (132 patients), nonallergic (30 patients) and virus infection induced (45 patients).

Results: There was statistically significant (p= 0.0035) difference in TSLP concentration among children with asthma (median; 486 pg/ml, IQR;117-1053) and healthy controls (median 302,5 pg/ml, IQR; 114,5-639,5). We did not find any significant differences in TSLP concentration among different asthma phenotypes (p=0.81) and no dynamic during asthma exacerbation (p=0.7).

Conclusion: Children with asthma have a higher concentration of TSLP in peripheral blood baseline compared to healthy controls. TSLP does not seem to be a biomarker of disease exacerbation in children. Different asthma phenotypes in children have similar TSLP concentration profile in peripheral blood and does not seem to be a useful biomarker in asthma phenotyping in children.