Airway IRF7hi versus IRF7lo molecular response patterns determine clinical phenotypes in children with acute wheezing

Asthma exacerbations are triggered by rhinovirus infections. We employed a systems biology approach to delineate upper airway gene network patterns underlying asthma exacerbation phenotypes in children. Cluster analysis unveiled distinct IRF7hi versus IRF7lo molecular phenotypes, the former exhibiting robust upregulation of Th1/type I interferon responses and the latter an alternative signature marked by upregulation of cytokine and growth factor signalling and downregulation of interferon gamma. The two phenotypes also produced distinct clinical phenotypes. For IRF7lo versus IRF7hi: symptom duration prior to hospital presentation was more than twice as long from initial symptoms (p=0.011) and nearly three times as long for cough (p