Serum concentration of C-reactive protein is not a good marker of bronchial hyperresponsiveness

Abstract

Introduction: Asthmatic inflammation is responsible for vital features of the disease, including bronchial hyperresponsiveness (BHR). At present we do not have precise markers for monitoring asthmatic inflammation. C-reactive protein (CRP), a marker of systemic inflammation, seemed to be a factor which could also reflect the level of asthmatic inflammation expressed by BHR. Therefore the relationship between CRP concentration and BHR was evaluated. Materials and Methods: One hundred and two patients entered the study. A skin prick test with a broad spectrum of common aeroallergens as well as baseline spirometry and a histamine bronchoprovocation test were performed in each subject. Blood samples for high-sensitivity CRP (hsCRP) measurement were taken before the bronchial challenge tests. Results: Serum hsCRP concentrations ranged from 0.20 to 14.5 mg/l (median: 1.2 mg/l, 25-75% quartiles: 0.6-2.4). Positive skin prick tests were found in 26 subjects. Bronchial hyperresponsiveness was confirmed in 42 patients (first subgroup), while 60 subjects did not demonstrate BHR (second subgroup). Among the patients with BHR, asthma was diagnosed in 33 cases and Corrao syndrome in 9. In both subgroups, serum hsCRP concentrations had similar levels (median: 1.4 mg/l, 25-75% quartiles: 0.8-2.4 and median: 0.9 mg/l, 25-75% quartiles: 0.5-2.8, respectively; p=0.297). There was no statistically significant correlation (r= -0.163, p=0.302) between serum hsCRP concentration and the level of BHR expressed as the 20% provocative concentration for histamine. In addition, hsCRP serum concentration, after adjustment for age, atopy, body mass index, and gender, was not a significant predictor of positive histamine bronchoprovocation test results (p=0.22, OR=0.86, 95% CI). Conclusions: Serum hsCRP concentration is not a good marker of BHR, which is mainly dependent on asthmatic inflammation and is measured during bronchial challenge with histamine. This finding is important for interpreting and discussing results obtained from epidemiological and population-based studies on relationships between either CRP concentration and BHR or local and systemic inflammation.

High Sensitivity C-Reactive Protein in Chronic Obstructive Pulmonary Disease and Asthma- A Prospective Study in North India

“…Above observations of our study are generally in confirmation of the results by studies conducted by Broekhuizen et al, 10 Olafsdottir et al, 9 Pinto-Plata et al, 4 Schneider et al, 14 Takemura et al, 6 Panaszek et al, 13 Qian et al 11 and Soferman et al 13 with the value of hs-CRP being directly proportional to the severity of disease both in asthma and COPD.…”

“…In another study by Panaszek et al, 13 the serum concentrations of hs-CRP ranged from 0.20 to 14.5 mg/L in both male and female asthmatic patients. The values of serum hs-CRP concentration ranged from 12.9 mg/L to 50.6 mg/L in male and female COPD patients (mild to very severe disease) in a study by Stolz et al 7 In a study by Pinto-Plata et al, 4 the serum concentrations of hs-CRP in both male as well as female patients was reported to be between 3.7 to 6.3 mg/L.…”

Allerjik Hastalıkları olan Hastaların Deri Prik Testi Sonuçlarının Obezite, C-Reaktif Protein (CRP) ve Serum Total IgE ile ilişkisi

“…CRP is increased in systemic inflammation associated with infection, cardiovascular diseases, autoimmune diseases. There are various studies showing either positive or negative association between CRP and asthma, atopy and bronchial hyperresponsiveness (5)(6)(7).…”

Effect of inhaled corticosteroids on systemic inflammation in asthma

“…[7] Several other studies have denied some of the above mentioned associations,[89] thereby emphasizing the need for further evaluation of the unique role of hs-CRP in asthma. Also, the effect of inhaled steroids needs to be studied.…”

“…Serum CRP levels were found to be correlating with asthma and its characteristics like bronchial hyperresponsiveness,[ 4 ] FEV1 level,[ 5 ] control of symptoms,[ 6 ] and sputum cytology. [ 7 ] Several other studies have denied some of the above mentioned associations,[ 8 9 ] thereby emphasizing the need for further evaluation of the unique role of hs-CRP in asthma. Also, the effect of inhaled steroids needs to be studied.…”