Naslov
Biomarkeri lokalne i sistemske upale u astmi u djece
(Markers of lung and systemic inflammation in childhood asthma)

Autori
Navratil, Marta ; Plavec, Davor ; Dodig, Slavica ; Jelčić, Žaneta ; Nogalo, Boro ; Erceg, Damir ; Turkalj, Mirjana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Prvi kongres hrvatskih alergologa i kliničkih imunologa s međunarodnim sudjelovanjem : zbornik radova = First Croatian Congress of Allergology and Clinical Immunology : abstracts book / Stipić Marković, Asja ; Čvorišćec, Branimir - Zagreb : Hrvatsko društvo za alergologiju i kliničku imunologiju ; Hrvatski liječnički zbor, 2009, 133-134

ISBN
978-953-6201-15-0

Skup
Kongres hrvatskih alergologa i kliničkih imunologa s međunarodnim sudjelovanjem (1 ; 2009)

Mjesto i datum
Zagreb, Hrvatska, 21.05.2009. - 23.05.2009

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
astma; epala; dijete; CRP; FENO
(asthma; inflammation; child; CRP; FENO)

Sažetak
Cil rada je bio sporediti različite upalne biomarkere u djece s kontroliranom i nekontroliranom astmom i istražiti njihovu ulogu u procjeni kontrole bolesti. Ispitanici i metode: Studijsku populaciju čini 44 bolesnika (starost 10, 7± 2, 9 godina, 23 dječaka) s blagom do srednje teškom astmom (30 kontroliranih, 14 nekontroliranih astmatičara) na svojoj redovitoj terapiji astme. Mjerili smo plućnu funkciju (spirometrija) i upalne biomarkere (eozinofilni kationski protein [ECP], izdahnuti NO [FENO], C-reaktivni protein visoke osjetljivosti (hs-CRP), broj leukocita (L) te diferencijalnu krvnu sliku periferne krvi. Rezultati: Forsirani ekspiratorni volumen u 1. sekundi (FEV1) i limfociti bili su signifikantno viši u bolesnika s kontroliranom astmom (FEV1, 96, 5± 9, 5% prema 86, 6± 13, 3%, P=0, 019 ; limfociti Z-skor, 0, 22 ± 0, 4 prema -0, 06± 0, 4, P=0, 035). FENO, serumska koncentracija hs-CRP-a i ECP-a su bili viši u bolesnika s nekontroliranom astmom, ali razlika nije dosegla značajnost (FENO, 52± 39 ppb prema 38± 33 ppb ; hs-CRP, 0, 65± 0, 73 mg/L prema 0, 29± 0, 15 mg/L ; ECP 31, 4± 19, 9 mcg/L prema 24, 5± 19, 8 mcg/L). FENO je pokazao bolju korelaciju s perifernim biomarkerima eozinofilne upale nego ECP uz blagu povezanost ova 2 markera (r2=0.168). Oba markera (samostalno ili u kombinaciji) su pokazala slabu prediktivnu vrijednost za kontrolu astme u usporedbi s kombinacijom drugih upalnih biomarkera (FENO, hs-CRP, ECP, IgE, Z-skor za postotak eozinofilnih granulocita i apsolutni broj bazofilnih granulocita) koji su pokazali bolju, ali još uvijek nedovoljnu prediktivnost za kontrolu astme (P=0, 02 ; PPV 89, 3%, NPV 50, 0%). U djece asmatičara FEV1 je pokazao umjerenu prediktivnost za kontrolu astme. Sistemski i lokalni biomarkeri upale odražavaju umjerenu prediktivnost za kontrolu astme u djece, ali samo kad su razmatrani u kombinaciji. To compare different biomarkers of inflammation in children with controlled and uncontrolled asthma and to investigate their relationship with other clinical indices of asthma activity. The study group comprised 44 patients (age 10.7± 2.9, 23 boys) with mild-to-moderate asthma (30 uncontrolled, 14 controlled asthma) all on their regular asthma therapy. We measured lung function and inflammatory biomarkers: spirometry, eosinophilic cationic protein (ECP), exhaled NO (FENO), high-sensitivity C-reactive protein (hs-CRP), white blood cell (WBC) counts and differentials from peripheral blood. Forced expiratory volume in 1 second (FEV1) and lymphocytes were significantly higher in controlled than in uncontrolled asthma (FEV1, 96.5± 9.5% vs. 86.6± 13.3%, P=0.019 ; and lymphocyte Z-score, 0.22± 0.4 vs. -0.06± 0.4, P=0.035). FENO, serum hs-CRP and ECP were however higher in uncontrolled asthma but the difference didn’ t reach significance (FENO, 52± 39 ppb vs. 38± 33 ppb ; hs-CRP, 0.65± 0.73 mg/L vs. 0.29± 0.15 mg/L ; ECP 31.4± 19.9 mcg/L vs. 24.5± 19.8 mcg/L). FENO was more closely correlated with peripheral blood markers of eosinophilic inflammation than ECP with the correlation of these 2 markers being mild (r2=0.168). Both of this markers (alone or combined) showed poor predictability of asthma control, compared to the combination of several inflammatory markers (FENO, hs-CRP, ECP, IgE, Z-scores for % of eosinophils and absolute number of basophils) that showed better but still only fair predictability of asthma control (P=0.02 ; PPV 89.3%, NPV 50.0%). In asthmatic children FEV1 showed moderate predictability of control. Markers of both lung and systemic inflammation showed only fair predictability of asthma control in children but only when used in combination.

Izvorni jezik
Hrvatski, engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

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