PURPOSE: The aim of the study was to evaluate the presence of systemic inflammation in bronchial asthma patients and to assess the effect of treatment on levels of systemic inflammation.
METHODS: Serum high sensitivity C-reactive Protein (hs-CRP), total leucocyte count (TLC) and erythrocyte sedimentation rate (ESR) were cross sectionally examined in adult patients with asthma (n=30), and healthy controls (n=20). All were non smokers. The diagnosis of bronchial asthma was based on the history (episodic breathlessness, recurrent episodes of wheezing, chest tightness and nocturnal cough) and improvement in FVC or FEV1 of at least 12% and 200 ml after inhalation of β2 agonists. Control subjects were asymptomatic and had normal chest skiagrams and pulmonary function. Serum hs-CRP was estimated using microplate immunoenzymometric assay (Monobind Inc. Costa Meca, CA) and was done on automated enzyme linked immunosorbant assay (ELISA) reader. Levels of these inflammatory markers were reassessed after treatment with inhaled steroids and inhaled β2-agonists for six weeks.
RESULTS: Levels of these systemic inflammatory markers were increased in asthma patients as compared with controls [hs-CRP 4.77±6.03 mg/L vs 1.46±1.40 mg/L, p=0.007; TLC 8935.6±2591.5 cells/cu.mm vs 7741±1924.2 cells/cu.mm, p=0.085; ESR 24.8±12.3 mm in first hour vs 15.4±6.5 mm in first hour, p=0.001]. The levels of hs-CRP was correlated negatively with FEV1% predicted (r=−0.638, p=0.000), FVC% predicted (r=−0.386, p=0.034), FEV1/FVC% (r=−0.714, p<0.000) and FEF25–75% predicted (r=−0.507, p=0.004) and TLC was negatively correlated with FEV1% predicted (r=−0.644, p=0.000), FEV1/FVC% (r=−0.743, p<0.000)and FEF25–75% predicted (r=−0.580, p=0.000). The levels of inflammatory markers decreased significantly after a six weeks of treatment [hs-CRP 4.77±6.03 mg/L vs 2.37±5.42 mg/L, TLC 8935.6±2591.5 cells/cu.mm vs 6960.1±1784.5± cells/Cu.mm, ESR 24.8±12.3 mm in first hour vs 15.8±10.1 mm in first hour,(p<0.001 for all comparisons)].
CONCLUSION: Bronchial asthma is associated with systemic inflammation as shown by the increase in levels of systemic markers of inflammation and there is a significant reduction in the level of systemic inflammation after treatment.
CLINICAL IMPLICATIONS: This observation holds a potential to better understand the extrapulmonary effects of bronchial asthma.
DISCLOSURE: Ankur Girdhar, No Financial Disclosure Information; No Product/Research Disclosure Information