Increased C-reactive protein is associated with airway wall thickness in steroid-naive asthma.
BACKGROUND
Asthma is characterized by chronic airway inflammation and remodeling. Levels of serum high-sensitivity C-reactive protein (hs-CRP) reflect airway eosinophilic inflammation. However, the relation between hs-CRP and the development of airway wall thickening remains unknown.


OBJECTIVE
To evaluate whether serum hs-CRP is associated with airway geometry in asthma.


METHODS
Forty-eight steroid-naive patients with asthma, 51 patients with asthma treated with inhaled corticosteroids, and 38 aged-matched healthy controls were studied cross-sectionally. Serum hs-CRP levels, lung function, and inflammatory cell counts in sputum were measured. Quantitative computed tomographic analysis of the apical segment of the right upper lobe was performed.


RESULTS
Serum hs-CRP levels were significantly elevated in steroid-naive patients with asthma compared with controls and steroid-treated patients with asthma and were associated with airflow limitation. In steroid-naive patients, serum hs-CRP levels were correlated with airway wall thickness (r = 0.88, P < .001) and sputum eosinophil percentage (r = 0.75, P < .001). Multivariate analysis showed a significant association between hs-cRP levels and forced expiratory volume in 1 second (percentage predicted; R(2) = 0.65, P = .001).


CONCLUSIONS
Serum hs-CRP may be a useful systemic biomarker of airway eosinophilia in steroid-naive asthma and has potential utility as a marker for the development of airway wall thickening.


BACKGROUND
University Hospital Medical Information Network (www.umin.ac.jp/ctr/index/htm); identifier, UMIN000006724.
Department of Respiratory Medicine, Atami Hospital, International University of Health and Welfare, Atami, Japan. Electronic address: hoshino@iuhw.ac.jp.
Makoto
M
Hoshino
Department of Radiology, Atami Hospital, International University of Health and Welfare, Atami, Japan.
Junichi
J
Ohtawa
Department of Radiology, Atami Hospital, International University of Health and Welfare, Atami, Japan.
Kenta
K
Akitsu
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D001249:Asthma / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D015415:Biomarkers / Q000097:blood; D001980:Bronchi / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004802:Eosinophilia / Q000097:blood* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D004804:Eosinophils / Q000276:immunology / Q000473:pathology*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013183:Sputum / Q000737:chemistry
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D002097:C-Reactive Protein