AzTrials
AzTrials

AsthmaVIRASTHMA2NCT03960359

Inflammatory and Immune Profiles During a Severe Exacerbation in Preschool Asthmatic Children (<5 Years)

An observational study of Asthma, run by University Hospital, Lille.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
Search all trials

Trial summary

Asthma/wheeze begins in the first years of life and is the most common chronic disease in preschool children (< 5 years). Different phenotypes have been suggested: Episodic-Viral Wheeze (EVW), absence of symptoms between exacerbations, among which Severe Intermittent Wheeze (SIW); and Multiple-trigger wheeze (MTW). Read more about this study

Who is it for?
Ages 1 year to 5 years
Conditions the study is for
Asthma
What is being tested?
Clinical, microbiological and inflammatory phenotype
How many people
150 participants
Where
No sites listed yet
Study dates
24 Feb 2015to Feb 2033
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 1 year to 5 years
  • All sexes
  • No healthy volunteers
  • Child

Study population: Preschool asthmatic children hospitalized for a severe exacerbation (requiring a course of systemic steroids), in a pediatric ward of one of the hospitals involved in the study, in the Hauts-de-France Region, France.

Who may be able to join

  • Preschool children aged 1 to < 5 years
  • Asthmatic / recurrent wheezers (≥ 3 discrete exacerbations since birth and/or symptoms between exacerbations, according to the definition from the French HAS and GINA guidelines)
  • Hospitalized (less than 3 days ago) for a severe exacerbation (requiring a course of oral steroids)
  • In a pediatric ward participating in the study (Hospital centers of Lille, Arras, Bethune, Douai, Lens, Roubaix, Tourcoing, Armentieres, Seclin)
  • Parental consent

Who cannot join

  • History of chronic disease (other than asthma)
  • History of preterm birth (inf 36 weeks of amenorrhea)
  • Lack of understanding from the parents

About this study

Official title: Inflammatory and Immune Profiles at the Time of a Severe Exacerbation in Preschool Asthmatic Children (<5 Years), According to the Phenotype

Asthma/wheeze begins in the first years of life and is the most common chronic disease in preschool children (< 5 years).

Different phenotypes have been suggested: Episodic-Viral Wheeze (EVW), absence of symptoms between exacerbations, among which Severe Intermittent Wheeze (SIW); and Multiple-trigger wheeze (MTW). The determinants of these different clinical phenotypes and their evolution have been poorly studied.

The purpose of this study is to assess preschool wheezers at the time of a severe exacerbation: clinical features and biological determinants (virus/bacteria, molecules and cells involved in the inflammation) and at steady state (8 weeks later) and to follow them up until the age of 7. The investigators hypothesize that the nature of the inflammation at the time of the exacerbation is different between these clinical phenotypes and may be associated with different clinical and functional trajectories

Read the detailed description

Asthma/wheeze begins in the first years of life and is the most common chronic disease in preschool children (< 5 years).

Different phenotypes have been suggested: Episodic-Viral Wheeze (EVW): wheezing during discrete time periods (exacerbations), absence of symptoms between exacerbations; among which Severe Intermittent Wheeze (SIW): EVW with ≥ 2 exacerbations over the last 6 months; and Multiple-trigger wheeze (MTW): wheezing during exacerbations but also symptoms (cough, exercise-induced symptoms,…) between episodes. The determinants of these different clinical phenotypes and their evolution have been poorly studied.

The purpose of this study is to assess preschool asthmatic children at the time of a severe exacerbation: clinical features and biological determinants (virus/bacteria, molecules and cells involved in the inflammation) and at steady state (8 weeks later) and to follow them up until the age of 7. The investigators hypothesize that the nature of the inflammation at the time of the exacerbation is different between these clinical phenotypes and may be associated with different clinical and functional trajectories.

The primary objective is to compare levels of IFNg, IL-5, IL-13, IL-33, TSLP in blood and induced sputum between the 2 main phenotypes: EVW and MTW.

Preschool asthmatic children hospitalized for a severe exacerbation (requiring a course of systemic steroids) are included in a pediatric ward of one of the hospitals involved in the study, in the Hauts-de-France Region, France.

Clinical phenotype: temporal pattern of wheeze (EVW, SIW, MTW), history and clinical data, allergy diagnosis work-up Microbiological phenotype: viral status (PCR in nasal swab sample), bacteriological status (culture of induced sputum) Inflammatory phenotype: profile of cytokines, phenotype of immune cells in the blood and the sputum, cytokine response to TLR ligands by peripheral blood mononuclear cells will be assessed at the time of inclusion and at steady state 8 weeks later.

Children will be follow-up until the age of 7 (clinical data, control of asthma, lung function).

Conditions
Asthma
Being tested
Clinical, microbiological and inflammatory phenotype
Keywords
Asthma, wheeze, preschool, phenotype
Medical subject headings
Asthma, Respiratory Sounds

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clinical, microbiological and inflammatory phenotypeOther

    Clinical phenotype: temporal pattern of wheeze (EVW, SIW, MTW), history and clinical data, allergy diagnosis work-up Microbiological phenotype: viral status (PCR in nasal swab sample), bacteriological status (culture of induced sputum) Inflammatory phenotype: profile of cytokines, phenotype of immune cells in the blood and the sputum, cytokine response to TLR ligands by peripheral blood mononuclear cells.

Study groups in NCT03960359
Study groupRoleWhat they receive
Episodic viral wheezers (EVW)EVW: Wheezing during discrete time periods (exacerbations), absence of symptoms between exacerbations Among which SIW: EVW with ≥ 2 exacerbations over the last 6 months Clinical, microbiological and inflammatory phenotype
Receives: Other: Clinical, microbiological and inflammatory phenotype
Multiple trigger wheezers (MTW)MTW : wheezing during exacerbations but also symptoms between episodes. Clinical, microbiological and inflammatory phenotype
Receives: Other: Clinical, microbiological and inflammatory phenotype

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Inflammatory profile at exacerbation

    concentration levels of IFNg, IL-5, IL-13, IL-33, TSLP in blood and induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion

Secondary outcomes (28)
  1. Inflammatory profile at steady state

    concentration levels of IFNg, IL-5, IL-13, IL-33, TSLP in blood and induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: at baseline: consult at least 8 weeks after exacerbation

  2. Change of inflammatory profile between exacerbation and steady state

    concentration levels of IFNg, IL-5, IL-13, IL-33, TSLP in blood and induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  3. Levels of cytokines in blood

    Concentration levels of cytokines (IL-4, IL-17A, IL-22, TNF-alpha, IL-1beta, IL-6, IL-10) in blood (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  4. Levels of cytokines in induced sputum

    Concentration levels of cytokines (IL-4, IL-17A, IL-22, TNF-alpha, IL-1beta, IL-6, IL-10) in induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  5. Levels of interferons in blood

    Concentrations levels of interferons (IFN-beta, IL-29) in blood (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  6. Levels of interferons in induced sputum

    Concentration levels of interferons (IFN-beta, IL-29) in induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  7. Levels of chemokines in blood

    Concentration levels of chemokines (CXCL8, CXCL10, CCL5, CCL20) in blood (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  8. Levels of chemokines in induced sputum

    Concentration levels of chemokines (CXCL8, CXCL10, CCL5, CCL20) in induced sputum (all concentrations expressed in pg/ml, obtained with multiplex assays) between wheeze patterns: EVW (among which SIW) vs MTW

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  9. Expression patterns of mononuclear cells

    Percentage of mononuclear cells in peripheral blood and sputum (sorted by flow cytometry): lymphocytes, dendritic cells, innate lymphoid cells

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  10. Percentage of patients with tobacco exposure

    Percentage of tobacco exposure (qualitative data)

    Measured: At the time of the inclusion

  11. Percentage of patients with mould/moisture exposure

    Percentage of visible mould/moisture exposure (qualitative data, based on declaration by the parents)

    Measured: At the time of the inclusion

  12. Percentage of patients with pet ownership

    Percentage of pet ownership (qualitative data)

    Measured: At the time of the inclusion

  13. Percentage of patients living in urban area

    Percentage of urban living (qualitative data)

    Measured: At the time of the inclusion

  14. number of asthma exacerbations in the previous year

    number of asthma exacerbations in the previous year (quantitative data)

    Measured: At the time of the inclusion

  15. Percentage of patients with associated atopic diseases

    Percentage of associated atopic disorders: atopic dermatitis, atopic rhinitis, food allergy (qualitative data)

    Measured: At the time of the inclusion

  16. Control of asthma

    Control of asthma based on symptoms (breath, cough, breathlessness, impact on activity and social behavior) and previous exacerbations in the past year, and classified according to GINA criteria: well-controlled, partly controlled, uncontrolled (semi-quantitative)

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  17. Features of the exacerbation: severity

    Severity assessed during the first hour in the emergency department (before treatment), using PRAM severity score: mild asthma (0-3), moderate asthma (4-7), severe asthma (8-12) (quantitative data)

    Measured: At the time of the inclusion

  18. Features of the exacerbation: length

    Length of stay and length of oxygen need (in days)

    Measured: At the time of the inclusion

  19. Atopy

    Atopy: positivity of skin prick tests (≥ 3 mm diameter) and/or specific IgE (≥ 0,35 ku/l), mono or polysensitized status (qualitative data)

    Measured: At the time of the inclusion and at the age of 7

  20. Blood leukocyte count

    Count of neutrophils and eosinophils (number/mm3)

    Measured: At the time of the inclusion and at the age of 7

  21. ImmunoCAP ISAC (Thermo Fisher Scientific)

    Levels of component specific IgE antibodies will be expressed in ISAC standardized units (ISU). We will categorized the raw data into 4 sIgE semiquantitative discrete groups, according to the manufacturer's guidelines: no (<0.3 ISU), low (0.3-1 ISU), medium (1-15 ISU), and high (>15 ISU) sensitization

    Measured: At the time of the inclusion and at the age of 7

  22. Microbiological phenotype: viral status

    Virus identification by PCR in nasal swab sample (qualitative data)

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  23. Microbiological phenotype: bacteriological status

    Positive identification of bacteria (positive if titer >= 10.4/ml) by culture of induced sputum (qualitative data)

    Measured: At the time of the inclusion and at baseline (consult at least 8 weeks after exacerbation)

  24. History at the age of 7

    History of asthma exacerbations in the previous year, presence of other atopic diseases: atopic dermatitis, atopic rhinitis, food allergy (qualitative data)

    Measured: At the age of 7

  25. Control of asthma at the age of 7

    Control of asthma based on symptoms (breath, cough, breathlessness, impact on activity and social behavior) and previous exacerbations in the past year, and classified according to GINA criteria: well-controlled, partly controlled, uncontrolled (semi-quantitative)

    Measured: At the age of 7

  26. Atopy at the age of 7

    Atopy: positivity of skin prick tests (≥ 3 mm diameter) and/or specific IgE (≥ 0,35 ku/l), mono or polysensitized status (qualitative data)

    Measured: At the age of 7

  27. Lung function at the age of 7: forced expiratory volume in one second

    Forced expiratory volume in one second (FEV1) after administration of short acting beta agonists, obtain with spirometry test (expressed in Z-score)

    Measured: At the age of 7

  28. Lung function at the age of 7 : forced vital capacity

    Forced vital capacity (FVC) after administration of short acting beta agonists, obtain with spirometry test (expressed in Z-score)

    Measured: At the age of 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 May 2019
  2. Study start24 Feb 2015
  3. Primary completion12 Apr 2023
  4. Study completionFeb 2033 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03960359
Sponsor's protocol ID
2014_20
Other IDs
2014-A01687-40
Acronym
VIRASTHMA2
Status last verified
Dec 2025
First submitted
17 Jan 2019
Last updated
16 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Asthma, run by University Hospital, Lille.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 16 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Inflammatory profile at exacerbation (time frame: At the time of the inclusion). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Dec 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in