title: Relationship between exhaled leukotriene and 8-isoprostane levels and asthma severity, asthma control level, and asthma control test score.
abstract: OBJECTIVE
  Exhaled breath condensate (EBC) is a completely non-invasive method for the collection of airway secretions to measure intense inflammation in the airways of asthmatics. It has been shown that the childhood asthma control test (c-ACT) is a good tool for use in the evaluation of asthmatics. Whether the c-ACT score and asthma control level correlate with the airway inflammation is not well known. We aimed to evaluate the relationship between exhaled cysteinyl leukotrienes (Cys-LTs) and 8-isoprostane levels and asthma severity, asthma control level and c-ACT score in asthmatic children.
  
  
  METHODS
  Thirty asthmatic children were evaluated with c-ACT score and pulmonary function tests. Asthma severity and asthma control level were assessed according to GINA. EBC was collected and Cys-LTs and 8-isoprostane concentrations were determined using a specific immunoassay kit.
  
  
  RESULTS
  Exhaled 8-isoprostane level in patients with moderate persistent asthma [114 (55-146)pg/ml] was higher than in the mild persistent group [52 (21-91)pg/ml] (p=0.05, Mann-Whitney U [MWU]). EBC 8-isoprostane in children with 1-4 asthma exacerbations/year [52 (16-80)pg/ml] was significantly lower than in children with >4 asthma exacerbations/year [114 (57-129)pg/ml] (p<0.05, MWU). No significant relation was determined between exhaled 8-isoprostane and Cys-LTs levels and c-ACT score and asthma control level. Exhaled 8-isoprostane correlated negatively with bronchodilator response (p=0.015, r=-0.45).
  
  
  CONCLUSIONS
  Exhaled 8-isoprostane, as an oxidative stress specifier, was found to be increased in relation with asthma exacerbation frequency and oxidative stress increases with the severity of asthma. In contrast to asthma severity level, c-ACT score and asthma control level may not reflect airway inflammation.
authors.affiliation: Department of Pediatric Allergy and Immunology, Medical Faculty, Gaziantep University, Gaziantep, Turkey. Electronic address: okeskin@gantep.edu.tr.
authors.forename: O
authors.initials: O
authors.lastname: Keskin
authors.affiliation: Department of Pediatrics, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Balaban
authors.affiliation: Department of Pediatrics, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Keskin
authors.affiliation: Department of Pediatric Allergy and Immunology, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Kucukosmanoglu
authors.affiliation: Department of Pulmonology, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Gogebakan
authors.affiliation: Department of Pediatric Allergy and Immunology, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: M Y
authors.initials: MY
authors.lastname: Ozkars
authors.affiliation: Department of Biostatistics, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kul
authors.affiliation: Department of Pulmonology, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Bayram
authors.affiliation: Department of Pediatrics, Medical Faculty, Gaziantep University, Gaziantep, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Coskun
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D001944:Breath Tests; D002648:Child; D003545:Cysteine / Q000378:metabolism*; D015237:Dinoprost / Q000031:analogs & derivatives* / Q000378:metabolism; D018450:Disease Progression; D045853:Exhalation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007249:Inflammation / Q000276:immunology; D015289:Leukotrienes / Q000378:metabolism*; D008297:Male; D018384:Oxidative Stress / Q000276:immunology; D012720:Severity of Illness Index
chemical_list: D015289:Leukotrienes; C112381:cysteinyl-leukotriene; C075750:8-epi-prostaglandin F2alpha; D015237:Dinoprost; D003545:Cysteine