<div>Background：Wheezing is an important respiratory symptom in the
diagnosis of asthma. However, wheezing is common in children and often
related to viral infection. This and the lack of reliable biological
indicators for asthma create difficulty in diagnosing asthma early in
children. Objective: In this study, the levels of CD4+CCR6+CRTh2+ memory
Th2 cells in wheezing children with different diagnostic outcomes were
investigated to determine correlation with a diagnosis of asthma and to
assess their potential clinical value as a biological indicator for this
disease. Methods: A prospective study was performed with a cohort of
wheezing children aged 3 months to 6 years hospitalized in the Division
of Pulmonary Pediatrics at Shanghai Xinhua hospital and Shanghai
children’s medical center affiliated to Shanghai Jiao Tong University
School of Medicine from July 2017 to March 2018. After inclusion, the
level of serum IgE, presence of allergen-specific serum IgE (sIgE) and
proportion of circulating CD4+CCR6+CRTh2+ memory Th2 cells were counted.
In addition, the patients’ personal and family histories of allergic
disease were acquired by questionnaire. The children were followed up
annually over 2 years by telephone call with a guardian to record
whether the child had been diagnosed with asthma. The accuracy of an
increased proportion of CD4+CCR6+CRTh2+ memory Th2 cells as an indicator
of asthma was assessed. Results: A total of 43 children completed
follow-up. The median of circulating CD4+CCR6+CRTh2+ memory Th2 cells in
wheezing children diagnosed with or without asthma was
1.2%(0.8%~2.9%) and
0.6%(0.1%~0.9%), respectively, and was significantly
higher in children diagnosed with asthma (P&lt;0.01). The median
of circulating CD4+CCR6+CRTh2+ memory Th2 cells in atopic children was
also significantly higher in children diagnosed with asthma than in
children without asthma, at 1.3%(0.8%~2.9%) and
0.6%(0.3%~1.0%), respectively, (P&lt;0.01).
Furthermore, the level of serum IgE was significantly higher in children
with asthma (P&lt;0.05). Logistic regression analysis indicated
that the level of circulating CD4+CCR6+CRTh2+ memory Th2 cells were
independent risk factors for asthma. The area under the receiver
operating characteristic curve (ROC) was 0.922. There was no significant
difference in the positive rate of memory Th2 cells in the context of
allergic rhinitis (AR) or atopic dermatitis (AD) (P&gt;0.05).
Conclusion: Our exploratory study found that an increase in the level of
circulating CD4+CCR6+CRTh2+ memory Th2 cells could be used as a
biological indicator for early diagnosis of asthma, especially in
predicting the risk of asthma in atopic children.</div>