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Increased Interleukin-4 and Decreased Interferon- in Exhaled Breath Condensate of Children with Asthma

Department of Thoracic Medicine, National Heart and Lung Institute, and Department of Pediatrics, Royal Brompton Hospital, London, United Kingdom

Correspondence and requests for reprints should be addressed to Peter J. Barnes, Department of Thoracic Medicine, National Heart and Lung Institute, Dovehouse Street, London SW3 6PY, UK. E-mail: p.j.barnes{at}ic.ac.uk

Exhaled breath condensate analysis for noninvasive quantification of airway inflammation in asthma is a potentially useful research tool in children. There is an imbalance between T-helper (Th)-2 cells, which secrete interleukin (IL)-4, and Th1 cells, which secrete interferon (IFN)-, in asthma. We measured concentrations of IL-4 and IFN- in breath condensates of 37 children (11 normal, 12 steroid-naive, and 14 steroid-treated children with asthma). Exhaled IFN- was significantly lower in steroid-naive and steroid-treated children with asthma compared with normal control subjects (3.7 ± 0.2 versus 5.1 ± 0.4 pg/ml, p < 0.01 and 4.1 versus 5.1 pg/ml, p < 0.05). By contrast, mean exhaled IL-4 was elevated in asthma (53.7 ± 4.2 pg/ml) compared with normal children (35.7 ± 6.2 pg/ml, p < 0.05) and concentrations were lower with steroid treatment (37.5 ± 5.6 pg/ml, p < 0.05). Exhaled IL-4 was significantly lower in children with asthma on more than 600 µg inhaled steroid/day. The IL-4/IFN- ratio was significantly greater in children with asthma compared with control children and the children with asthma on inhaled steroid therapy. We have shown for the first time that IFN- and IL-4 can be assayed in exhaled breath condensate and shows an increased ratio of IL-4/IFN-, consistent with predominance of Th2 cells in airways of children with asthma. Exhaled breath condensate analysis may have a useful role in studying allergic inflammation in childhood asthma.

Key Words: asthma • exhaled breath condensate • interferon- • interleukin-4 • Th2 cells

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