High-Sensitivity C-Reactive Protein Can Reflect Small Airway Obstruction in Childhood Asthma.
10.3349/ymj.2016.57.3.690
- Author:
A Ra KO
1
;
Yoon Hee KIM
;
In Suk SOL
;
Min Jung KIM
;
Seo Hee YOON
;
Kyung Won KIM
;
Kyu Earn KIM
Author Information
1. Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea. yhkim@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
High-sensitivity C-reactive protein;
asthma;
childhood
- MeSH:
Airway Obstruction/*diagnosis/etiology;
Asthma/*diagnosis/physiopathology;
C-Reactive Protein/*analysis;
Child;
Child, Preschool;
Female;
Forced Expiratory Volume;
Humans;
Inflammation/*etiology;
Male;
Neutrophils/metabolism;
Oscillometry/*methods;
Respiratory Function Tests/*methods;
Respiratory System;
Sensitivity and Specificity;
*Spirometry
- From:Yonsei Medical Journal
2016;57(3):690-697
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: High-sensitivity assays enabled the identification of C-reactive protein (hs-CRP) at levels that were previously undetectable. We aimed to determine if hs-CRP could reflect airway inflammation in children, by comparing hs-CRP with spirometry and impulse oscillometry (IOS) parameters and symptomatic severities. MATERIALS AND METHODS: A total of 276 asthmatic children who visited Severance Children's Hospital from 2012-2014 were enrolled. Serum hs-CRP and pulmonary function tests were performed on the same day. Patients were divided into hs-CRP positive and negative groups (cut-off value, 3.0 mg/L). RESULTS: Of the 276 asthmatic children [median age 7.5 (5.9/10.1) years, 171 boys (62%)], 39 were hs-CRP positive and 237 were negative. Regarding spirometry parameters, we observed significant differences in maximum mid-expiratory flow, % predicted (FEF25-75) (p=0.010) between hs-CRP positive and negative groups, and a negative correlation between FEF25-75 and hs-CRP. There were significant differences in the reactance area (AX) (p=0.046), difference between resistance at 5 Hz and 20 Hz (R5-R20) (p=0.027), resistance at 5 Hz, % predicted (R5) (p=0.027), and reactance at 5 Hz, % predicted (X5) (p=0.041) between hs-CRP positive and negative groups. There were significant positive correlations between hs-CRP and R5 (r=0.163, p=0.008), and X5 (r=0.164, p=0.007). Spirometry and IOS parameters had more relevance in patients with higher blood neutrophil levels in comparison to hs-CRP. CONCLUSION: Hs-CRP showed significant correlation with FEF25-75, R5, and X5. It can reflect small airway obstruction in childhood asthma, and it is more prominent in neutrophil dominant inflammation.
