Asthma severity and inflammation markers in children.
The relationship of airway inflammation with asthma severity remains unclear. Our aim was to correlate the results of recommended methods of assessment of inflammation with measures of asthma control, in children with a wide range of asthma severity. The study was a cross-sectional investigation of 58 children receiving a wide range of treatment, including 10 treated without regular maintenance therapy and 29 treated with high-dose inhaled corticosteroids (CS). Exhaled nitric oxide (NO), serum eosinophil cationic protein (ECP), and induced sputum (processed for eosinophil count and ECP level) were related to recent symptoms, lung function, and bronchial responsiveness. There was no significant correlation between the results of any


METHODS
Neither did any marker of airway inflammation relate to recent symptoms, unlike PC20, which did. There was a significant, inverse correlation between the forced expiratory volume in 1 s (FEV1) and both NO and sputum ECP (r=-0.46, p=<0.001; r=-0.48, p=0.004, respectively). Sputum eosinophils were inversely related to the dose of methacholine that corresponded to a 20% fall in FEV1 (PC20) (r=-0.57, p=0.02). Serum ECP did not relate to any measure of asthma control. There was no association of any recommended inflammation markers with current symptoms and only a weak relationship between them and physiological measures. The place of these markers remains unclear and their use in clinical practice needs further investigation by long-term longitudinal studies.
Wilson
N M
NM
Department of Paediatrics, Royal Brompton and Harefield NHS Trust, Chelsea Wing, Sydney St., London SW3 6NP, UK. n.wilson@rbh.nthames.nhs.uk
James
A
A
Uasuf
C
C
Payne
D N
DN
Hablas
H
H
Agrofioti
C
C
Bush
A
A
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000097:blood / Q000276:immunology / Q000503:physiopathology*; D015415:Biomarkers / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D001944:Breath Tests; D001985:Bronchial Provocation Tests; D001991:Bronchitis / Q000276:immunology / Q000503:physiopathology; D016085:Bronchoconstrictor Agents; D002648:Child; D003430:Cross-Sectional Studies; D047091:Eosinophil Granule Proteins; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D016210:Methacholine Chloride; D009569:Nitric Oxide / Q000032:analysis; D012260:Ribonucleases; D013183:Sputum / Q000737:chemistry / Q000276:immunology
D015415:Biomarkers; D001798:Blood Proteins; D016085:Bronchoconstrictor Agents; D047091:Eosinophil Granule Proteins; D016210:Methacholine Chloride; D009569:Nitric Oxide; D012260:Ribonucleases