title: Blood Coagulation and Asthma Exacerbation in Children.
abstract: BACKGROUND
  Recent studies have demonstrated the activation of coagulation pathways in asthmatic airways. This study aimed to determine systemic blood coagulation during asthma exacerbation compared with the stable state in children.
  
  
  METHODS
  Pediatric patients (aged between 5 and 15 years) suffering from asthma exacerbation were enrolled. von Willebrand factor (vWF), plasminogen activator inhibitor type-1 (PAI-1), protein C, D-dimer, prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), and C-reactive protein (CRP) levels were measured during asthma exacerbation and stable state.
  
  
  RESULTS
  A total of 22 patients were enrolled. The median vWF, PAI-1, and CRP during asthma exacerbation were significantly higher than those of the stable state: 147.5% (interquartile range, IQR: 111.05-196.57) versus 94% (IQR: 69.72-109.62, p < 0.001), 41.9 ng/ml (IQR: 21.91-48.61) versus 26.17 ng/ml (IQR: 15.89-34.44, p < 0.03), and 4.46 mg/l (IQR: 2.15-16.23) versus 0.87 mg/l (IQR: 0.20-3.89, p < 0.015), respectively. However, the median protein C during asthma exacerbation was significantly lower than that of the stable state: 99.5% (IQR: 86.75-117) versus 113% (IQR: 94-115.25), p = 0.01. No significant difference was found between the levels of D-dimer, F1 + 2, and TAT during asthma exacerbation and stable state. Ultimately, D-dimer was positively correlated with asthma exacerbation score (R = 0.466, p = 0.027). A significant correlation was observed between vWF and CRP (R = 0.527, p = 0.012).
  
  
  CONCLUSIONS
  Evidence was found of increased endothelial activation and increased PAI-1 during asthma exacerbation. This may emphasize the potential role of blood coagulation in asthma exacerbation.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Wiparat
authors.initials: W
authors.lastname: Manuyakorn
authors.forename: Dara
authors.initials: D
authors.lastname: Mairiang
authors.forename: Nongnuch
authors.initials: N
authors.lastname: Sirachainan
authors.forename: Praguywan
authors.initials: P
authors.lastname: Kadegasem
authors.forename: Wasu
authors.initials: W
authors.lastname: Kamchaisatian
authors.forename: Suwat
authors.initials: S
authors.lastname: Benjaponpitak
authors.forename: Ampaiwan
authors.initials: A
authors.lastname: Chuansumrit
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D002097:C-Reactive Protein; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012720:Severity of Illness Index; D014841:von Willebrand Factor
chemical_list: D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D014841:von Willebrand Factor; D002097:C-Reactive Protein