title: The FACT score in predicting pneumococcal antibody levels in asthmatics.
abstract: BACKGROUND
  There is no measure currently available to identify asthmatics with potential immune incompetence.
  
  
  OBJECTIVE
  We propose use of a novel scoring system called the FACT score, which is formulated based on four parameters: (1) Family history of asthma, (2) Atopic conditions, (3) Bacterial colonization and (4) Th1 versus Th2 immune profile.
  
  
  METHODS
  This was a cross-sectional study involving 16 asthmatics and 14 non-asthmatics. The first two parameters of the FACT score were obtained via a chart review and interview. For the third parameter, nasopharyngeal swab samples were cultured. The ratio of interleukin-5 to interferon-gamma for each patient was measured by peripheral blood mononuclear cells cultured with house dust mite. Antibodies to 23 pneumococcal antigens were used for humoral immunity.
  
  
  RESULTS
  The FACT scores for asthmatics (mean ± SD: 5.2 ± 1.87) were higher than those for non-asthmatics (mean ± SD: 3.3 ± 1.5) (p = 0.008). Of the 16 asthmatics, 7 (44%) had 12 or more positive serotype-specific polysaccharide antibodies, whereas 12 of 14 (86%) of non-asthmatics subjects had 12 or more positive serotype-specific polysaccharide antibodies (p = 0.014). Overall, the FACT score was inversely correlated with the number of positive serotype-specific antibody levels [rho (ρ) = -0.38, p = 0.04]. The proportions of subjects with 12 or more positive serotype-specific antibodies among non-asthmatics and asthmatics below and above the median of the FACT scores were 86, 50 and 38%, respectively (p = 0.052).
  
  
  CONCLUSIONS
  The FACT score may help us identify a subset of asthmatics with immune incompetence. Study findings need to be replicated in a larger study.
authors.affiliation: Division of Allergic Diseases, Mayo Clinic , Rochester, MN , USA .
authors.forename: Jenna C
authors.initials: JC
authors.lastname: Podjasek
authors.forename: Ji A
authors.initials: JA
authors.lastname: Jung
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kita
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Park
authors.forename: Young J
authors.initials: YJ
authors.lastname: Juhn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000235:genetics / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D020022:Genetic Predisposition to Disease; D006305:Health Status Indicators; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology*; D016867:Immunocompromised Host / Q000276:immunology*; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000276:immunology*; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology; D055815:Young Adult
keywords: Asthma; FACT score; epidemiology; immunity; immunodeficiency; infection; pneumococcal