The Role of 14-3-3β in Acute Asthma in Children and Analysis of the Risk Factors for Asthma Exacerbation

To examine the role of 14-3-3β, a protein implicated in airway inflammation, as a predictor of acute asthma exacerbations in children.The study population included 101 children between the ages of 4 and 17 years with acute asthma exacerbations requiring hospital evaluation, 101 age-matched children with stable asthma, and 65 age-matched healthy children. The study was completed at a single center between October 2021 and January 2023. Patients were excluded if they had a severe chronic disease other than asthma, poor adherence to standard treatment, or a critical asthma exacerbation.This single-center, retrospective study used clinical data to identify demographics, allergy history, and family history of asthma across 3 groups: acute asthma group, stable asthma group, and healthy control group. Blood samples were collected within 24 hours of symptom onset for the acute asthma group and on the day of the clinic visit for the stable asthma and healthy control groups. For each participant, serum 14-3-3β protein concentration, total serum immunoglobulin E (IgE), environmental allergen–specific IgE, peripheral blood eosinophil count, fractional exhaled nitric oxide (FeNO), and forced expiratory volume in 1 second (FEV1) were measured. Multivariate logistic regression was used to identify risk factors associated with acute asthma exacerbations.Serum 14-3-3β concentrations were significantly higher in the acute asthma group (45.46 ng/mL) compared with the stable asthma group (31.38 ng/mL) and healthy controls, particularly among children with more severe asthma. Elevated 14-3-3β levels were significantly associated with increased odds of an acute asthma exacerbation (odds ratio 1.217, 95% CI 1.135-1.304). Additional factors associated with increased risk included respiratory tract coinfection, elevated FeNO, lower FEV1z scores, and higher total serum IgE levels. A 14-3-3β cutoff value of 39.79 ng/mL demonstrated a sensitivity of 69.3% and specificity of 94.1% in predicting asthma exacerbations.Serum 14-3-3β levels may be an effective biomarker for predicting acute asthma exacerbations in children.Identifying risk factors for asthma exacerbations in pediatric patients can be challenging. This study suggests that serum biomarkers, such as 14-3-3β levels, may help predict acute asthma exacerbations. Although the exact mechanism of action remains unclear, the protein may contribute to airway inflammation and remodeling. Randomized controlled trials are needed to confirm whether serum 14-3-3β levels are a reliable predictive parameter.