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High-Sensitivity C-Reactive Protein Can Reflect Small Airway Obstruction in Childhood Asthma.

 A Ra Ko  ;  Yoon Hee Kim  ;  In Suk Sol  ;  Min Jung Kim  ;  Seo Hee Yoon  ;  Kyung Won Kim  ;  Kyu-Earn Kim 
 Yonsei Medical Journal, Vol.57(3) : 690-697, 2016 
Journal Title
 Yonsei Medical Journal 
Issue Date
Airway Obstruction/diagnosis* ; Airway Obstruction/etiology ; Asthma/diagnosis* ; Asthma/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*
High-sensitivity C-reactive protein ; asthma ; childhood
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.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
고아라(Ko, A Ra)
김경원(Kim, Kyung Won) ORCID logo https://orcid.org/0000-0003-4529-6135
김규언(Kim, Kyu Earn)
김윤희(Kim, Yoon Hee) ORCID logo https://orcid.org/0000-0002-2149-8501
설인숙(Sol, In Suk) ORCID logo https://orcid.org/0000-0003-2470-9682
윤서희(Yoon, Seo Hee) ORCID logo https://orcid.org/0000-0002-8361-9815
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