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Relationship between serum immunological biomarkers and small airway obstruction in patients with mild-to-moderate

Jing Xue¹, Xin Liu², Cairong Bai³

¹Department of Internal Medicine , Jingbian County Hospital of Traditional Chinese Medicine, Yulin ,China.

JPMA. the Journal of the Pakistan Medical Association

|May 20, 2026

Insights

Serum biomarkers total immunoglobulin E, C-reactive protein, and interleukin-6 correlate with small airway obstruction in children. Their combined use shows high diagnostic accuracy for identifying pediatric asthma and allergic rhinitis.

Area of Science:

Pediatric Pulmonology
Immunology
Biomarker Research

Background:

Small airway obstruction is a key feature of pediatric asthma.
Allergic rhinitis frequently coexists with asthma in children, potentially worsening outcomes.
Identifying reliable biomarkers for early detection and prognosis is crucial.

Purpose of the Study:

To investigate the relationship between serum immunological biomarkers and small airway obstruction in children.
To assess the prognostic value of these biomarkers in pediatric asthma.
To evaluate the diagnostic power of combined biomarkers for asthma with allergic rhinitis.

Main Methods:

Children aged 4-15 diagnosed with asthma were enrolled, divided into asthma alone and asthma with allergic rhinitis groups.
Serum levels of total immunoglobulin E, C-reactive protein, and interleukin-6 were measured.
Pulmonary function tests assessed small airway obstruction, including FEV1/FVC and FEF25-75%.

Main Results:

Serum interleukin-6 showed a significant negative correlation with small airway obstruction parameters (FEF25-75% and FEF50%) in children with asthma and allergic rhinitis.
Established cut-off values for total immunoglobulin E, C-reactive protein, and interleukin-6.
The combination of these three biomarkers achieved an AUC of 0.885, with 78.51% sensitivity and 89.26% specificity.

Conclusions:

Total immunoglobulin E, C-reactive protein, and interleukin-6 are associated with small airway obstruction in children.
The combination of these biomarkers offers significant diagnostic power for identifying pediatric patients with both asthma and allergic rhinitis.
These findings support the use of these biomarkers for improved diagnosis and management of pediatric respiratory conditions.

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Abstract

Objective:

To evaluate the correlation between various serum immunological biomarkers and small airway obstruction in children, and the prognostic value of the markers.

Methods:

This study was conducted at the First Affiliated Hospital of Xi'an Jiaotong University, Yulin, China, from February 2023 to March 2024, and comprised children aged 4-15 years diagnosed with asthma, who were divided into asthma group A and asthma with allergic rhinitis group B. Peripheral venous blood was collected from all the subjects to measure serum levels of total immunoglobulin E, C-reactive protein, eosinophil and interleukin-6 using enzyme-linked immunosorbent assay and standardised laboratory assays. Al participants underwent pulmonary function testing, including forced expiratory volume in 1 second, forced vital capacity, forced expiratory volume in 1 second/forced vital capacity ratio, and peak expiratory flow measurements. Data was analysed using SPSS 19 and GraphPad Prism 5.

Results:

Of the 295 patients, 178(60.3%) were in group A; 105(59%) girls and 73(41%) boys with mean age 8.5±1.8 years. The other 117(39.7%) patients were in group B; 72(61.5%) girls and 45(38.5%) boys with mean age 8.9±2.2 years (p>0.05). A significant negative correlation was found between serum interleukin-6 levels and the smal airway obstruction parameters mean mid-expiratory flow between 25-75% of forced vital capacity % predicted (r=-0.564, p<0.05) and forced expiratory flow % 50 predicted (r=-0.521, p<0.05) in group B. The cut-off values for total immunoglobulin E, C-reactive protein and interleukin-6 were 337.80IU/mL, 24.51mg/L and 38.75pg/mL, respectively. The area under the curve, sensitivity and specificity values of the combined diagnosis of total immunoglobulin E, C-reactive protein and interleukin-6 were 0.885, 78.51% and 89.26%, respectively.

Conclusions:

Biomarkers total immunoglobulin E, C-reactive protein and interleukin-6 were found to be associated with small airway obstruction, and their combination demonstrated high diagnostic power for identifying paediatric patients with both asthma and allergic rhinitis.

Keywords:

Asthma, Allergic rhinitis, Interleukin-6, Small airway obstruction.

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