title: Systemic inflammation and its response to treatment in patients with asthma.
abstract: BACKGROUND
  Asthma is an obstructive airway disease characterized by airway inflammation.
  
  
  OBJECTIVE
  To measure systemic inflammation in asthma patients, and to assess the effect of treatment on systemic inflammation.
  
  
  METHODS
  In 30 newly diagnosed non-randomized adult asthma patients we measured systemic inflammation markers (serum high-sensitivity C-reactive protein, total leukocyte count, and erythrocyte sedimentation rate) before and after a 6-week standard treatment with inhaled steroids and inhaled β(2) agonist. The comparison group comprised 20 healthy control subjects. All the subjects were non-smokers.
  
  
  RESULTS
  The measured systemic inflammation markers were higher in the asthma patients: high-sensitivity C-reactive protein 4.8 ± 6.0 mg/dL vs 1.5 ± 1.4 mg/dL, P < .001; total leukocyte count 8,936 ± 2,592 cells/μL versus 7,741 ± 1,924 cells/μL, P < .001; erythrocyte sedimentation rate 24.8 ± 12.3 mm/h versus 15.3 ± 6.5 mm/h, P < .001. In the asthma patients, high-sensitivity C-reactive protein negatively correlated with percent-of-predicted FEV(1) (r = -0.64, P = .001), percent-of-predicted forced vital capacity (FVC) (r = -0.39, P = .03), FEV(1)/FVC% (r = -0.71, P < .001), and percent-of-predicted forced expiratory flow during the middle half of the FVC maneuver (FEF(25-75)) (r = -0.51, P = .004). Total leukocyte count negatively correlated with percent-of-predicted FEV(1) (r = -0.64, P = .001), percent-of-predicted FEV(1)/FVC (r = -0.74, P < .001), and percent-of-predicted FEF(25-75) (r = -0.58, P = .001). Body mass index positively correlated with high-sensitivity C-reactive protein (r = 0.65, P < .001). Multiple linear regression showed significant correlation of high-sensitivity C-reactive protein (r(2) = 0.75) with age (β = 0.31, P = .008), body mass index (β = 0.99, P = .001), family size (β = 0.33, P = .008), and weight (β = -0.45, P = .01). The systemic inflammation markers decreased significantly (P < .001 for all comparisons) after 6 weeks of treatment: high-sensitivity C-reactive protein decreased from 4.8 ± 6.0 mg/dL to 2.4 ± 5.4 mg/dL, total leukocyte count decreased from 8,936 ± 2,592 cells/μL to 6,960 ± 1,785 cells/μL, and erythrocyte sedimentation rate decreased from 24.8 ± 12.3 mm/h to 15.8 ± 10.1 mm/h.
  
  
  CONCLUSIONS
  Inhaled steroids plus inhaled β(2) agonist significantly reduced systemic inflammation in asthma patients.
authors.affiliation: Department of Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida 32209, USA. ankurgirdhar@yahoo.com
authors.forename: Ankur
authors.initials: A
authors.lastname: Girdhar
authors.forename: Vivek
authors.initials: V
authors.lastname: Kumar
authors.forename: Amita
authors.initials: A
authors.lastname: Singh
authors.forename: Balakrishnan
authors.initials: B
authors.lastname: Menon
authors.forename: V K
authors.initials: VK
authors.lastname: Vijayan
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016014:Linear Models; D008297:Male; D012129:Respiratory Function Tests; D018709:Statistics, Nonparametric; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications* / Q000378:metabolism
chemical_list: D002097:C-Reactive Protein