A network of transcriptome modules demonstrates mechanistic pathways of both virus induced and non-viral asthma exacerbations in children [blood]

We leverage a systems-scale network analysis approach to demonstrate repertoires of cellular transcriptional pathways underlying loss of asthma control, and show how these pathways differ in viral associated and non-viral exacerbations. Overall design: 208 children with exacerbation prone asthma were enrolled according to the inclusion criteria. Each child had baseline samples collected and were prospectively monitored for the onset of cold symptoms (Events) during a 6 month period. 106/208 children came in during one or more events and had sufficient samples collected for analysis. Events were grouped as exacerbation associated (Ex+) or not exacerbation associated (Ex-) depending on whether the event lead to clinical symptoms that resulted in systemic corticosteroid use within 10 days of event onset or resolved without treatment with systemic corticosteroids. The primary endpoint compared Ex+ events to Ex- events. Based on nasal virus PCR results, events were further classified as virus associated (V+) or nonviral (V-). The secondary endpoint compared V+Ex+, V+Ex-, V-Ex+, and V-Ex- events.