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Biomarkers Reflecting the Severity of Bronchial Asthma in Children
Peter Kunc1,2, Michal Pokusa2,3, Dominika Hajduchova2
1Clinic of Pediatric Respiratory Diseases and Tuberculosis/ National Institute of Pediatric Tuberculosis and Respiratory Diseases, Dolny Smokovec/ Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin, Martin, Slovak Republic.
Insights
Pediatric asthma biomarkers like IL-13 and FeNO show complex correlations, with FeNO linked to eosinophil counts. Further research is needed to improve their clinical use in managing childhood asthma and predicting exacerbations.
Area of Science:
- Pediatric Pulmonology
- Biomarker Research
- Inflammatory Airway Diseases
Background:
- Childhood asthma incidence and prevalence are rising globally.
- Asthma biomarkers are crucial for identifying phenotypes and personalizing treatment.
- Understanding biomarker associations can improve clinical management strategies.
Purpose of the Study:
- To investigate associations between novel and established inflammatory biomarkers in pediatric asthma.
- To compare these biomarkers in children with mild versus moderate persistent asthma, stratified by inhaled corticosteroid (ICS) use.
- To evaluate the relationship between circulating and exhaled biomarkers.
Main Methods:
- Serum levels of IL-13, IL-1β, EDN, and SPD were measured using ELISA in 44 children (8-12 years).
- Exhaled nitric oxide (FeNO) and blood eosinophil counts were also assessed.
- Participants were divided into mild (non-ICS) and moderate (ICS-treated) persistent asthma groups.
Main Results:
- No significant differences in baseline IL-13, IL-1β, SPD, EDN, or FeNO were found between ICS-treated and non-treated groups.
- Positive correlations were observed between IL-13, SPD, and IL-1β across both groups.
- FeNO correlated positively with EDN and eosinophil counts, and negatively with IL-1β in ICS-treated patients.
Conclusions:
- The role of asthma biomarkers in routine pediatric clinical practice remains complex, especially for predicting exacerbations.
- Investigating relationships between carefully selected biomarkers may enhance their clinical predictive value.
- Further research is warranted to optimize the use of biomarkers for personalized asthma management.
Background:
Bronchial asthma, the most prevalent chronic inflammatory airway disease in children, exhibits a concerning rise in both incidence and prevalence. Asthma biomarkers hold promise for stratifying patients into distinct clinical phenotypes, paving the way for targeted and personalized treatment approaches.
Aim Of Study:
This study aimed to evaluate the association between novel and non-established semi-invasive circulating and well-known exhaled inflammatory biomarkers in two distinct pediatric asthma populations stratified by disease severity.
Materials And Methods:
Forty-four asthmatic children aged 8-12 years meeting inclusion criteria were recruited from hospitalized patients. The first group (n=15, mean age 9.8 years) consisted of patients with mild persistent asthma who did not require regular inhaled corticosteroids (ICS). The second group (n=29, mean age 9.8 years) consisted of children with moderate to persistent asthma who received regular ICS treatment. Serum levels of interleukins (IL-13, IL-1β), eosinophil-derived neurotoxin (EDN), and surfactant protein D (SPD) were measured by ELISA in all participants. In addition, exhaled nitric oxide (FeNO) and blood eosinophil counts were evaluated.
Results:
No significant differences were observed in the baseline plasma concentrations of inflammatory markers (IL-13, IL-1β, SPD, and EDN) or exhaled FeNO between the ICS-treated and non-ICS-treated groups. Further inter-individual analysis confirmed significant positive correlations between IL-13, SPD, and IL-1β (Pearson's r = 0.591-0.781) in both groups of patients. Interestingly, the ICS-treated group compared to the nontreated group showed an exclusive moderate negative correlation between FeNO and IL-1β. In contrast, FeNO exhibited a positive correlation with EDN and a strong association with eosinophil count in all the study groups.
Conclusion:
Our findings highlight the complex and unresolved role of asthma biomarkers in routine clinical practice for the management of childhood asthma, particularly in predicting exacerbations. By comparing the relationships of carefully selected biomarkers, we can achieve a greater clinical predictive value.
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