title: Serum Reactive Oxygen Metabolite Levels Predict Severe Exacerbations of Asthma.
abstract: OBJECTIVE
  Bronchial asthma (BA) is a chronic airway disease characterized by airway hyperresponsiveness and remodeling, which are intimately linked to chronic airway inflammation. Reactive oxygen species (ROS) such as hydrogen peroxide are generated by inflammatory cells that are involved in the pathogenesis of BA. However, the role of ROS in the management of BA patients is not yet clear. We attempted to determine the role of ROS as a biomarker in the clinical setting of BA.
  
  
  METHODS
  We enrolled patients with BA from 2013 through 2015 and studied the degrees of asthma control, anti-asthma treatment, pulmonary function test results, fractional exhaled nitric oxide (FeNO), serum reactive oxygen metabolite (ROM) levels, and serum levels of interleukin (IL)-6 and IL-8.
  
  
  RESULTS
  We recruited 110 patients with BA. Serum ROM levels correlated with white blood cell (WBC) count (rs = 0.273, p = 0.004), neutrophil count (rs = 0.235, p = 0.014), CRP (rs = 0.403, p < 0.001), and IL-6 (rs = 0.339, p < 0.001). Serum ROM levels and IL-8 and CRP levels negatively correlated with %FEV1 (rs = -0.240, p = 0.012, rs = -0.362, p < 0.001, rs = -0.197, p = 0.039, respectively). Serum ROM levels were significantly higher in patients who experienced severe exacerbation within 3 months than in patients who did not (339 [302-381] vs. 376 [352-414] CARR U, p < 0.025). Receiver-operating characteristics analysis showed that ROM levels correlated significantly with the occurrence of severe exacerbation (area under the curve: 0.699, 95% CI: 0.597-0.801, p = 0.025).
  
  
  CONCLUSIONS
  Serum levels of ROM were significantly associated with the degrees of airway obstruction, WBC counts, neutrophil counts, IL-6, and severe exacerbations. This biomarker may be useful in predicting severe exacerbations of BA.
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Keitaro
authors: K
authors: Nakamoto
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Masato
authors: M
authors: Watanabe
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Mitsuru
authors: M
authors: Sada
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Toshiya
authors: T
authors: Inui
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Masuo
authors: M
authors: Nakamura
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Kojiro
authors: K
authors: Honda
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Hiroo
authors: H
authors: Wada
authors: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Yu
authors: Y
authors: Mikami
authors: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Hirotaka
authors: H
authors: Matsuzaki
authors: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Masafumi
authors: M
authors: Horie
authors: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Satoshi
authors: S
authors: Noguchi
authors: Department of Respiratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Yasuhiro
authors: Y
authors: Yamauchi
authors: Department of Internal medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
authors: Hikari
authors: H
authors: Koyama
authors: Department of Internal medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
authors: Toshiyuki
authors: T
authors: Kogane
authors: Department of Internal medicine, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
authors: Tadashi
authors: T
authors: Kohyama
authors: Department of Respiratory Medicine, Kyorin University School of Medicine, Tokyo, Japan.
authors: Hajime
authors: H
authors: Takizawa
mesh_terms: D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000097:blood* / Q000276:immunology / Q000503:physiopathology*; D015415:Biomarkers / Q000097:blood*; D001944:Breath Tests; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D017382:Reactive Oxygen Species / Q000097:blood*; D012129:Respiratory Function Tests
chemical_list: D018927:Anti-Asthmatic Agents; D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D015850:Interleukin-6; D016209:Interleukin-8; D017382:Reactive Oxygen Species