Nasal lavage fluid nuclear factor kappa B and cytology in asthmatic children and their correlation with severity and control

Background: Asthma is the most common chronic inflammatory disease in childhood. The relevance of NFκB which is known to be an inflammatory marker in upper airway epithelium and its relation to lower airway inflammation has not been fully studied in childhood asthma. Aim of study: The study aimed at evaluating the diagnostic value of nasal lavage nuclear factor kappa B and cells as a less-invasive bench-side maneuver and inflammatory biomarkers in asthmatic children and correlating with asthma severity. Methods: This case-control study recruited 60 asthmatic children from Pediatric Chest Clinic, Children’s Hospital; Ain Shams University. Thirty healthy non-asthmatic children-age and sex-matched were included as a control group. Nasal lavage cytology, nasal lavage NFκB and forced expiratory volume in 1 s (FEV1) % of predicted for age and sex were estimated. Results: Nasal lavage NFκB levels were significantly higher in asthmatics than in controls with a mean of 0.129 ± 0.113 μg/μg nuclear proteins and 0.0176 ± 0.013 μg/μg nuclear proteins, respectively. Nasal lavage NFκB and eosinophil levels were significantly higher with increasing asthma severity and with worsening levels of asthma control. Nasal lavage NFκB showed a sensitivity of 87% and a specificity of 87% in predicting asthma severity. Conclusions: Despite that spirometry and clinical classification are the gold standards for grading of asthma, Nasal lavage NFκB and cells can be considered as a new less-invasive non-subjective inflammatory marker for assessment of different grades of asthma severity and control

Is Serum Tryptase a Valuable Marker for Obesity-Bronchial Asthma Interrelationship in Children?

Background: Asthma among obese represents a unique phenotype. Mast cells are more abundant inobese. Serum tryptase (ST) is a marker of mast cell numbers or activity. Since obesity and asthma have been linked in epidemiological studies, a possible higher mast cell activity in obesity could be a factor between the two conditions. This study was to investigate ST and its potential association between obesity and childhood asthma.Methods: Study recruited 60 asthmatic children, their age ranged from 5-16 years. They were divided according to BMI centile to 30 obese and 30 non-obese asthmatics. Thirty healthy non-asthmatic,&nbsp; nonatopic and non-obese children; were included as a healthy control. Serum tryptase, atopy (skin prick test reactivity) and spirometry were assessed.Results: Frequency of atopy and positive skin prick test significantly increased among obese more than non-obese asthmatics (P&lt;0.05, OR = 1.96, 95% CI = 1.27-3.24). FEV1% of predicted mean levels were lower among obese than non-obese asthmatics (p&lt;0.05). ST was significantly higher in asthmatics than in controls with a mean ±SD of 53.3±13.78 ng/ml and 10.06±4.39 ng/ml respectively. ST was higher in obese than non-obese asthmatics with a mean ±SD of 71.73±19.17 ng/ml and 34.5±8.68 ng/ml&nbsp; respectively (P&lt;0.05). There was a negative correlation between ST and FEV1 % of predicted and&nbsp; positive correlations between ST and age, BMI, and waist circumference among asthmatics. Conclusion: Mast cells play a role in both obesity and asthma, serum tryptase, being a marker of mast cell activation, could represent a link between them.</p