A Short Burst of Oral Corticosteroid for Children with Acute Asthma: Is There an Impact on Immunity?
Bibliographic record
Abstract
Background: We wished to examine the impact of a short course of oral corticosteroids on the immune function of children with acute asthma and explore the mechanism of immune suppression, if any. Methods: We conducted a prospective cohort study of children aged 3–17 years presenting with acute asthma to the emergency department. The exposure of interest was a short course of systemic corticosteroids. In emergency department, corticosteroid-treated and nonexposed children were immunized with 3 antigens, namely, a neoantigen (Bacteriophage φX 174) and 2 recall antigens (diphtheria and tetanus). After 5 ± 1 weeks, children were reimmunized with Bacteriophage φX 174. Antibody titers were measured 1, 2 (peak), and 5 weeks after the primary immunization, and 1 week (peak) after the secondary one. Results: We enrolled 41 children, 27 treated with and 14 unexposed to oral corticosteroids. Corticosteroid-treated children displayed an 85% lower adjusted total (IgG and IgM) peak titers to the primary Bacteriophage immunization compared to controls [ratio of geometric means (95% confidence interval): 15% (5% to 43%)]. There were no group differences in the rise of diphtheria or tetanus antibodies. After the secondary Bacteriophage immunization, corticosteroid-treated patients showed no significant group difference in peak total titers [ratio of geometric means (95% confidence interval): 1.84% (0.66%, 5.10%)], amplification and absolute, and percent IgG titers as compared to unexposed children. Conclusions: In children with acute asthma, a short course of oral corticosteroids may be associated with depressed immune response to a new antigen, with recovery within 6 weeks and no apparent impact on response to known antigens.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".