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Background: Recent studies have shown that B7-H3, a recently identified B7 family member, plays a critical role in the development of asthma. Objective: This study is to explore the expression of B7-H3 in children with asthma exacerbation. Methods: Twenty-one Chinese children with asthma exacerbation as well as 18 nonasthmatic control Chinese children were enrolled. B7-H3 level and cytokines (interferon [IFN]-γ, interleukin [IL]-4, and IL-10) determination were performed by enzyme-linked immunosorbent assay (ELISA) technique. Meanwhile, clinical parameters including laboratory findings, forced expiratory volume in one second (FEV1) and fractional exhaled nitric oxide were obtained. Results: Children with asthma exacerbation had significantly higher levels of B7-H3 than controls (4.46 ± 1.33 versus 3.42 ± 1.48 ng/mL; p = 0.027). Plasma IL-4 level was significantly higher in asthma exacerbation subjects than controls (157.98 ± 21.57 versus 121.92 ± 24.37 pg/mL; p < 0.0001), and IFN-γ level was significantly lower in asthma exacerbation subjects (292.73 ± 152.47 versus 421.78 ± 145.84 pg/mL; p = 0.0107). Level of B7-H3 in asthma exacerbation subjects with inhaled corticosteroid (ICS) treatment recently was significantly lower than subjects without ICS treatment (t = 2.706; p = 0.0136). Additionally, levels of B7-H3 decreased remarkably after prednisone treatment. Level of sB7-H3 in asthma exacerbation subjects was inversely correlated with level of IFN-γ (rp = -0.605; p = 0.005) after adjustment. Conclusion: B7-H3 may play an important role in asthma exacerbation and was a useful clinical biomarker to evaluate asthma exacerbation. [ABSTRACT FROM AUTHOR]

Summary Objectives The purpose of this study was to explore the clinical and laboratory characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP). Methods Seventy-six children with RMPP and 26 children with non-refractory M. pneumoniae pneumonia (NRMPP), confirmed by both serology and fluorescent quantitation PCR in bronchoalveolar lavage fluid (BALF), were evaluated retrospectively. Results Compared to those with NRMPP, children with RMPP were older (66.6 ± 39.0 vs. 48.4 ± 35.4 months, p = 0.038) and had a longer duration of fever (12.7 ± 2.6 vs. 7.5 ± 1.8 days) and hospital stay (12.1 ± 3.2 vs. 7.4 ± 2.9 days). Children with RMPP presented neutrophil infiltration both in serum and BALF, as well as severe pulmonary lesions with pleural effusion. Children with RMPP had a significantly higher M. pneumoniae DNA load in BALF compared to NRMPP patients, and the M. pneumoniae load in BALF was significantly correlated with neutrophils and inversely correlated with macrophages for both the NRMPP and RMPP groups. The serum concentrations of tumor necrosis factor alpha (median 114.5 pg/ml, range 49.1–897.9 pg/ml) and interferon gamma (median 376.9 pg/ml, range 221.4–1997.6 pg/ml) were significantly higher in children with RMPP compared to children with NRMPP. Conclusions This study indicates that a direct microbe effect and the subsequent induced excessive host immune response contribute in part to the progression of RMPP. [ABSTRACT FROM AUTHOR]