RT Journal Article
SR Electronic
T1 Systemic Inflammation and Its Response to Treatment in Patients With Asthma
JF Respiratory Care
FD American Association for Respiratory Care
SP 800
OP 805
DO 10.4187/respcare.00601
VO 56
IS 6
A1 Ankur Girdhar
A1 Vivek Kumar
A1 Amita Singh
A1 Balakrishnan Menon
A1 VK Vijayan
YR 2011
UL http://rc.rcjournal.com/content/56/6/800.abstract
AB BACKGROUND: Asthma is an obstructive airway disease characterized by airway inflammation. OBJECTIVE: To measure systemic inflammation in asthma patients, and to assess the effect of treatment on systemic inflammation. METHODS: In 30 newly diagnosed non-randomized adult asthma patients we measured systemic inflammation markers (serum high-sensitivity C-reactive protein, total leukocyte count, and erythrocyte sedimentation rate) before and after a 6-week standard treatment with inhaled steroids and inhaled β2 agonist. The comparison group comprised 20 healthy control subjects. All the subjects were non-smokers. RESULTS: The measured systemic inflammation markers were higher in the asthma patients: high-sensitivity C-reactive protein 4.8 ± 6.0 mg/dL vs 1.5 ± 1.4 mg/dL, P < .001; total leukocyte count 8,936 ± 2,592 cells/μL versus 7,741 ± 1,924 cells/μL, P < .001; erythrocyte sedimentation rate 24.8 ± 12.3 mm/h versus 15.3 ± 6.5 mm/h, P < .001. In the asthma patients, high-sensitivity C-reactive protein negatively correlated with percent-of-predicted FEV1 (r = −0.64, P = .001), percent-of-predicted forced vital capacity (FVC) (r = −0.39, P = .03), FEV1/FVC% (r = −0.71, P < .001), and percent-of-predicted forced expiratory flow during the middle half of the FVC maneuver (FEF25-75) (r = −0.51, P = .004). Total leukocyte count negatively correlated with percent-of-predicted FEV1 (r = −0.64, P = .001), percent-of-predicted FEV1/FVC (r = −0.74, P < .001), and percent-of-predicted FEF25-75 (r = −0.58, P = .001). Body mass index positively correlated with high-sensitivity C-reactive protein (r = 0.65, P < .001). Multiple linear regression showed significant correlation of high-sensitivity C-reactive protein (r2 = 0.75) with age (β = 0.31, P = .008), body mass index (β = 0.99, P = .001), family size (β = 0.33, P = .008), and weight (β = –0.45, P = .01). The systemic inflammation markers decreased significantly (P < .001 for all comparisons) after 6 weeks of treatment: high-sensitivity C-reactive protein decreased from 4.8 ± 6.0 mg/dL to 2.4 ± 5.4 mg/dL, total leukocyte count decreased from 8,936 ± 2,592 cells/μL to 6,960 ± 1,785 cells/μL, and erythrocyte sedimentation rate decreased from 24.8 ± 12.3 mm/h to 15.8 ± 10.1 mm/h. CONCLUSIONS: Inhaled steroids plus inhaled β2 agonist significantly reduced systemic inflammation in asthma patients.