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Open Access Research

Inhaled corticosteroid use is associated with increased circulating T regulatory cells in children with asthma

Anne Marie Singh15, Paul Dahlberg4, Kristjan Burmeister4, Michael D Evans2, Ronald Gangnon23, Kathy A Roberg1, Christopher Tisler1, Douglas DaSilva1, Tressa Pappas1, Lisa Salazar1, Robert F Lemanske14, James E Gern14 and Christine M Seroogy1*

Author Affiliations

1 Departments of Pediatrics, University of Wisconsin, 1111 Highland Avenue, 4139 WIMR, Madison, WI 53705-2275, USA

2 Departments of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA

3 Departments of Population Health Sciences, University of Wisconsin, Madison, WI, USA

4 Departments of Medicine, University of Wisconsin, Madison, WI, USA

5 Northwestern Feinberg School of Medicine, Chicago, IL, USA

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Clinical and Molecular Allergy 2013, 11:1  doi:10.1186/1476-7961-11-1

Published: 25 January 2013

Abstract

Background

T regulatory (Treg) cells are important in balancing immune responses and dysregulation of Treg cells has been implicated in the pathogenesis of multiple disease states including asthma. In this study, our primary aim was to determine Treg cell frequency in the peripheral blood of children with and without asthma. The secondary aim was to explore the association between Treg cell frequency with allergen sensitization, disease severity and medication use.

Methods

Peripheral blood mononuclear cells from healthy control subjects (Nā€‰=ā€‰93) and asthmatic children of varying disease severity (Nā€‰=ā€‰66) were characterized by multi-parameter flow cytometry.

Results

Our findings demonstrate that children with asthma had a significantly increased frequency of Treg cells compared to children without asthma. Using a multivariate model, increased Treg cell frequency in children with asthma was most directly associated with inhaled corticosteroid use, and not asthma severity, allergic sensitization, or atopic status of the asthma.

Conclusion

We conclude that low dose, local airway administration of corticosteroids is sufficient to impact the frequency of Treg cells in the peripheral blood. These data highlight the importance of considering medication exposure when studying Treg cells and suggest inhaled corticosteroid use in asthmatics may improve disease control through increased Treg cell frequency.

Keywords:
Asthma; CD127; Foxp3; Inhaled corticosteroids; T regulatory cell