Clinical and atopic parameters and airway inflammatory markers in childhood asthma: a factor analysis.
BACKGROUND
Recent studies have repeatedly shown weak correlations among lung function parameters, atopy, exhaled nitric oxide level (Feno), and airway inflammatory markers, suggesting that they are non-overlapping characteristics of asthma in adults. A study was undertaken to determine, using factor analysis, whether the above features represent separate dimensions of childhood asthma.


METHODS
Clinically stable asthmatic patients aged 7-18 years underwent spirometric testing, methacholine bronchial challenge, blood sampling for atopy markers and chemokine levels (macrophage derived chemokine (MDC), thymus and activation regulated chemokine (TARC), and eotaxin), Feno, and chemokines (MDC and eotaxin) and leukotriene B(4) measurements in exhaled breath condensate (EBC).


RESULTS
The mean (SD) forced expiratory volume in 1 second (FEV1) and Feno of 92 patients were 92.1 (15.9)% predicted and 87.3 (65.7) ppb, respectively. 59% of patients received inhaled corticosteroids. Factor analysis selected four different factors, explaining 55.5% of total variance. The Kaiser-Meyer-Olkin measure of sampling adequacy was 0.587. Plasma total and specific IgE levels, peripheral blood eosinophil percentage, and Feno loaded on factor 1; plasma TARC and MDC concentrations on factor 2; MDC, eotaxin and leukotriene B4 concentrations in EBC on factor 3; and plasma eotaxin concentration together with clinical indices including body mass index and disease severity score loaded on factor 4. Post hoc factor analyses revealed similar results when outliers were excluded.


CONCLUSIONS
The results suggest that atopy related indices and airway inflammation are separate dimensions in the assessment of childhood asthma, and inflammatory markers in peripheral blood and EBC are non-overlapping factors of asthma.
Leung
T F
TF
Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong SAR, China. tfleung@cuhk.edu.hk
Wong
G W K
GW
Ko
F W S
FW
Lam
C W K
CW
Fok
T F
TF
D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001991:Bronchitis / Q000175:diagnosis* / Q000503:physiopathology; D018925:Chemokines / Q000378:metabolism; D002648:Child; D002908:Chronic Disease; D005163:Factor Analysis, Statistical; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000175:diagnosis* / Q000503:physiopathology; D007975:Leukotriene B4 / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D014797:Vital Capacity / Q000502:physiology
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D018925:Chemokines; D007975:Leukotriene B4; D009569:Nitric Oxide