Serum eosinophilic cationic protein and high sensitive C-reactive protein as alternative parameters for differentiation of severity stages and monitoring control in bronchial asthma patients

Abstract

Background: High sensitive C-reactive protein (hs-CRP) and eosinophilic cationic protein (ECP) have been shown to be associated with asthma in recent studies. However, the relationship between hs-CRP and the control of asthma has not been clearly identified yet.Patients and methods: Thirty patients with newly-diagnosed bronchial asthma and 20 healthy individuals were enrolled in this study. In addition to medical history and physical examination, asthma was assessed according to the Global Initiative for Asthma (GINA) guidelines. Respiratory function tests (RFT), serum hs-CRP and ECP levels, serum total IgE levels, circulating eosinophil count (CE) and asthma control test (ACT) were performed for all subjects.Results: Serum ECP, serum hs-CRP, serum total IgE and CE were significantly higher (p < 0.01, 0.01, 0.05 and 0.05, respectively), while forced expiratory volume in 1 s (FEV 1 %) and ACT were significantly lower (p < 0.05) in asthmatic patients compared to the control group. In all patients with bronchial asthma, serum levels of hs-CRP and ECP showed significant positive correlations with asthma severity (hs-CRP, r s = 0.59, p < 0.01; ECP, r s = 0.63, p < 0.01, respectively) but, significant negative correlations with ACT (hs-CRP, r s = À0.53, p < 0.05; ECP, r s = À0.62, p < 0.01, respectively) and FEV 1 % (hs-CRP, r s = À0.46, p < 0.05; ECP, r s = À0.57, p < 0.01, respectively). Serum ECP and hs-CRP levels showed significant fall (p < 0.01and p < 0.05, respectively), while, FEV 1 % and ACT showed significant increase (p < 0.05) in asthmatic patients who were followed up after 2 months of therapy.

Comparing the Asthma Control and Anti-inflammatory Effects of Different Fixed Combinations of Inhaled Corticosteroids Plus Long-acting Beta 2 Agonist; A Randomized Clinical Trial

“…ICS including fluticasone and budesonide have been shown to be effective in reducing serum levels of hs-CRP [19] and ECP [20] asthma. In line with our findings, previously serum hs-CRP and ECP were reduced in asthmatic patients who were followed up after 2 months of therapy [16]. To our knowledge, our study is the first to compare the effectiveness of different ICS/LABA combinations on serum levels of hs-CRP and ECP and thus further studies are needed.…”

“…Inflammatory markers as hs-CRP and ECP are increased in asthmatics compared to healthy individuals [14], [15], [16]. hs-CRP is an indicator of chronic, low grade inflammation in many conditions including asthma [17].…”

“…Another, large real-life study that included 1563 asthmatic patients receiving fluticasone/formoterol treatment and were observed over 1 year, showed a comparable increase in their increase in the number of patients with asthma control from 30.9% at baseline to 62.4% at the end of the study versus 16.7% to 69% in our fluticasone/formoterol group. Moreover, the percentage of patients whose disease was 'somewhat controlled' (total score [16][17][18][19] decreased slightly from baseline to end of study (25.9-21.0%) versus (54.8-31%) in our study; the percentage of patients whose disease was poorly controlled (total score <15) decreased substantially (43.1-16.7%) versus (28.5-0%) in our study [23].…”

Enhanced apoptotic activity in allergic diseases and its relationship with eosinophil cationic protein, systemic inflammation, and severity of atopic sensitisation

“…A study revealed that hsCRP level was significantly elevated in patients with asthma attacks and was related to the state of asthma exacerbation [17]. Sileem et al [18] demonstrated that serum concentrations of hsCRP and tIgE significantly increased in asthmatic patients compared with those in healthy individuals. In our study, 72.8% of allergic patients showed an increase in hsCRP concentration.…”

Impact of obesity on airway remodeling in asthma: pathophysiological insights and clinical implications

“…The development of airway remodeling may not be solely due to local airway inflammation. Systemic inflammation may be associated with the development of airway remodeling, although the data supporting this connection is still limited (142,143), and there is no clinical study yet in the population with asthma and obesity. Individuals with severe asthma exhibited significantly greater WT% and a higher WA% compared to those with mild-to-moderate asthma and healthy individuals (134).…”