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Interrelationship of endothelial function parameters in children with bronchial asthma in exacerbation and remission
Dmytro Butov1, Nataliia Makieieva2, Yuliia Vasylchenko2
1Kharkiv National Medical University, 4 Nauky Avenue, 61022 Kharkiv, Ukraine. dddimad@gmail.com.
Insights
Endothelial dysfunction is present in children with asthma, even in remission. Markers like soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) and reduced flow-mediated dilation (FMD%) indicate impaired vascular health, worsening with asthma severity.
Area of Science:
- Pediatric Pulmonology
- Cardiovascular Research
- Inflammation Biology
Background:
- Asthma in children is linked to endothelial dysfunction, a condition affecting blood vessel health.
- Elevated soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) suggests inflammatory cell adhesion and direct endothelial involvement in chronic airway inflammation.
- Endothelial dysfunction is observed even when asthma symptoms are in remission.
Purpose of the Study:
- To evaluate the endothelial state in children with clinically stable and exacerbated asthma.
- To assess markers of endothelial function, including sVCAM-1 levels, flow-mediated dilation (FMD%), and intima-media (I-M) thickness.
- To determine the relationship between asthma severity and endothelial dysfunction.
Main Methods:
- Studied 91 children with persistent asthma (mild, moderate, severe) and 20 healthy controls.
- Measured serum sVCAM-1 using enzyme-linked immunosorbent assay (ELISA).
- Assessed endothelium-dependent flow-mediated dilation (FMD%) and intima-media (I-M) thickness via ultrasonography.
Main Results:
- Significantly increased sVCAM-1 levels in asthmatic children compared to controls (p < 0.001).
- Diminished FMD% and increased I-M thickness observed in all asthma severity groups (p < 0.001).
- Endothelial markers (sVCAM-1, FMD%, I-M thickness) correlated significantly with asthma severity (p < 0.0001).
Conclusions:
- Confirmed endothelial dysfunction in children with asthma.
- Demonstrated a clear dependence of endothelial functional state on asthma severity.
- Highlighted the role of endothelial dysfunction in the pathophysiology of pediatric asthma.
Introduction:
In children with asthma, endothelial dysfunction signs are observed, and their extent depends on the severity of the disease. These changes are also present in remission. High level of soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) expression causes active adhesion of inflammatory cells and can indicate direct endothelium participation in development and supporting of chronic inflammation. Bronchial asthma (BA) is characterised by airways chronic inflammation. A special role in this inflammatory process formation is played by development of endothelial dysfunction. The aim of the study was to evaluate endothelial state in children with clinically stable and exacerbated asthma.
Material And Methods:
91 children with persistent asthma were examined. Among them there were 40 patients with mild persistent (group I), 34 subjects with moderate persistent (group II) and 17 individuals with severe persistent (group III) asthma. 20 healthy children were selected as controls. The serum levels of sVCAM-1 were determined by enzyme-linked immunosorbent assay (ELISA). The ultrasound assessment of endothelium-dependent flow-mediated dilation of the brachial artery (FMD%) has been made. Ultrasonography has been used for investigation of the intima-media thickness (I-M) complex. Data analysis was performed with the Statsoft Statistica Version 8 (Tulsa, OK).
Results:
The serum levels of sVCAM-1 were significantly increased in the patients with asthma exacerbation (p < 0.001) and remission (p < 0.001), compared with the controls. The index of FMD% was significantly diminished in the patients of I, II, III group with exacerbation (p < 0.001) and stayed lower in the subjects with asthma in remission (p < 0.001), compared with the controls. The thickness of I-M complex was significantly increased in the patients of I, II, III group, compared with the controls (p < 0.001). The endothelium parameter levels: sVCAM-1 (H = 56.11, p = 0.0001), FMD% (H = 43.20, p = 0.0000), the thickness of I-M complex (H = 49.37, p = 0.0000) depend on the severity of the disease. Correlations between the endothelium and pulmonary function parameters were proved (p < 0.05).
Conclusions:
Endothelial dysfunction in children with asthma was determined. Dependence of severity of the disease on functional state of the vascular endothelium was proved.
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