High-sensitivity C-reactive protein in the exhaled breath condensate and serum in stable and unstable asthma

Ziętkowski, Ziemowit; Tomasiak-Lozowska, Maria M.; Skiepko, Roman; Mroczko, Barbara; Szmitkowski, Maciej; Bodzenta-Łukaszyk, Anna

doi:10.1016/j.rmed.2008.10.003

Cited by 46 publications

(45 citation statements)

References 33 publications

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“…These results were confirmed by our previous report, in which the increase in hs-CRP levels both in serum and EBC and the correlation of this parameter with F ENO and ECP in asthmatic patients were revealed [32]. However, Rosias et al [33] were not able to demonstrate the presence of CRP in the EBC of asthmatic children and healthy controls.…”

Section: Discussionsupporting

confidence: 86%

Changes in High-Sensitivity C-Reactive Protein in Serum and Exhaled Breath Condensate after Intensive Exercise in Patients with Allergic Asthma

Ziętkowski¹,

Skiepko²,

Tomasiak-Lozowska³

et al. 2010

Int Arch Allergy Immunol

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Background: Exercise-induced bronchoconstriction (EIB) in asthmatics depends on the presence of allergic inflammation. This study was performed to assess the possible association of EIB with low-grade systemic inflammation, whose presence was revealed in asthmatic patients. Methods: The study was conducted in a group of 24 asthmatics (14 with EIB, 10 without EIB) and 8 healthy volunteers. Changes in serum and exhaled breath condensate (EBC) high-sensitivity C-reactive protein (hs-CRP) levels induced by intensive exercise were determined. Moreover, the possible correlation of these measurements with the results of other tests used in the diagnosis of asthma as well as laboratory tests commonly associated with asthma were investigated. Results: In asthmatic patients with EIB, a statistically significant increase in hs-CRP levels both in serum and EBC after an exercise test was observed. Twenty-four hours after the exercise test in the group of asthmatics with EIB, a statistically significant increase in exhaled nitric oxide (F_ENO), serum eosinophil cationic protein (ECP) concentrations and bronchial hyperreactivity to histamine was revealed. A statistically significant correlation between the maximum increase in hs-CRP levels both in serum and EBC after exercise and either baseline F_ENO and an increase in serum ECP or F_ENO 24 h after exercise in the group of asthmatics with EIB was revealed. Conclusions: We show that, as a result of intensive exercise leading to bronchoconstriction, an increase in serum and EBC hs-CRP occurs. Our observations could suggest that in asthmatic patients, as a consequence of exercise-induced bronchoconstriction, an intensification of low-grade systemic inflammation can be observed.

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Section: Discussionsupporting

confidence: 86%

Changes in High-Sensitivity C-Reactive Protein in Serum and Exhaled Breath Condensate after Intensive Exercise in Patients with Allergic Asthma

Ziętkowski¹,

Skiepko²,

Tomasiak-Lozowska³

et al. 2010

Int Arch Allergy Immunol

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“…It is possible that the chronic airway inflammation can contribute to a systemic inflammatory response, leading to atherosclerosis. 25,26 In a cross sectional study, Vijayakumar et al 27 reported that patients with bronchial asthma are twice as likely to develop arterial inflammation than control subjects with low Framingham risk scores without asthma. Asthma may activate the expression of bronchoalveolar coagulation, and further impair the procoagulant activities and attenuate fibrinolysis.…”

Section: Discussionmentioning

confidence: 99%

Asthma Is Associated With a Subsequent Risk of Peripheral Artery Disease

Yao

Shen

et al. 2016

Medicine

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Asthma has been associated with the atherosclerosis risk, but not clear of peripheral artery disease (PAD). We attempted to examine the risk of PAD in patients with asthma.From the insurance claims data of Taiwan, we identified 28,158 newly diagnosed asthma patients in 2000 to 2005 and 56,316 persons without asthma randomly selected into the comparison cohort, frequency matched by sex, age, and the date of diagnosis. Both cohorts were followed up until the end of 2011 to estimate the incident PAD. Adjusted hazard ratios (aHRs) of PAD were estimated using the Cox proportional hazards model after controlling for sex, age, and comorbidities.The incidence of PAD was 1.46 times higher in the asthma cohort than in the comparison cohort, with an aHR of 1.34 [95% confidence interval (CI) = 1.24–1.45]. Incidence of PAD was higher in men, the aged, and those with comorbidities in both cohorts. The aHRs of PAD remained significant for the asthma cohort in all subgroups of sex, age, and the presence of comorbidity. The aHRs of PAD were 14.1 (95% CI = 8.18–24.5) in asthma patients with multiple emergency visits and 22.3 (95% CI = 15.6–31.9) for those with multiple hospitalizations.Although smoking is a potential confounding factor, this study suggests patients with asthma have a significantly higher risk of developing PAD than the general population. The results also support the notion that poor control of asthma status is a key factor in subsequent PAD development.

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“…High sensitivity CRP, a systemic marker of low-grade inflammation has been negatively correlated with pulmonary function tests (FEV1) ( r = −0.49, p = 0.01) and positively associated with percent eosinophils (r = 0.44, p=0.03) in induced sputum from asthmatics (Allam et al, 2009) as well as an increased frequency of airway hyperresponsiveness (Ridker et al, 1997). While some studies in adult asthmatics demonstrate that hs-CRP in serum is correlated with hs-CRP in EBC (r = 0.74 in stable asthma treated with inhaled corticosteroids, p=0.0003) as well as exhaled nitric oxide (r = 0.62, p = 0.004) (Zietkowski et al, 2009), other studies do not find this relationship (Sutherland et al, 2007). Overlapping lines of evidence in asthmatics (Navratil et al, 2009; Takemura et al, 2006) and those with chronic obstructive pulmonary disease (Sin and Man, 2006; Dahl et al, 2001) suggest that while systemic and airway inflammation may be correlates of one another, they may also operate independently in influencing lung structure and function.…”

Section: Linking Stress Immunomodulation Respiratory Function and mentioning

confidence: 99%

Perinatal stress and early life programming of lung structure and function

Wright

2010

Biological Psychology

104

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Exposure to environmental toxins during critical periods of prenatal and/or postnatal development may alter the normal course of lung morphogenesis and maturation, potentially resulting in changes that affect both structure and function of the respiratory system. Moreover, these early effects may persist into adult life magnifying the potential public health impact. Aberrant or excessive pro-inflammatory immune responses, occurring both locally and systemically, that result in inflammatory damage to the airway are a central determinant of lung structure-function changes throughout life. Disruption of neuroendocrine function in early development, specifically the hypothalamic-pituitary-adrenal (HPA) axis, may alter functional status of the immune system. Autonomic nervous system (ANS) function (sympathovagal imbalance) is another integral component of airway function and immunity in childhood. This overview discusses the evidence linking psychological factors to alterations in these interrelated physiological processes that may, in turn, influence childhood lung function and identifies gaps in our understanding.

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High-sensitivity C-reactive protein in the exhaled breath condensate and serum in stable and unstable asthma

Abstract: The levels of hs-CRP in EBC are correlated with those measured in serum and may provide another useful diagnostic tool for detecting and monitoring low-grade inflammation in patients with asthma.

Cited by 46 publications

References 33 publications

Changes in High-Sensitivity C-Reactive Protein in Serum and Exhaled Breath Condensate after Intensive Exercise in Patients with Allergic Asthma

Changes in High-Sensitivity C-Reactive Protein in Serum and Exhaled Breath Condensate after Intensive Exercise in Patients with Allergic Asthma

Asthma Is Associated With a Subsequent Risk of Peripheral Artery Disease

Perinatal stress and early life programming of lung structure and function

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