Distinct transcriptional profile in CD4+ T-lymphocytes among obese children with asthma

Obesity is a risk factor for asthma severity and morbidity, displaying a distinct clinical phenotype that is less responsive to inhaled corticosteroids. CD4+ T-cells are central to the immunologic pathways of asthma and may contribute to the unique obese asthma phenotype. We sought to characterize the single cell CD4+ transcriptional profile among obese children with asthma compared to matched normal weight children with asthma. From the AIRWEIGHS study cohort of 160 participants, we selected 8 normal weight and 8 obese participants after excluding those taking systemic steroids in the last 30 days or on biologics. Of the 8 participants from each weight category, 4 were poorly controlled (defined as Asthma Therapy Assessment Questionnaire [ATAQ] score≥3) and 4 were well controlled (ATAQ score<3). Normal weight was defined as BMI percentile between 5th and 85th percentile and obese as BMI≥ 95th percentile.