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ROLE OF HIGH- SENSITIVITY C REACTIVE PROTEIN (hs-CRP) IN ASSESSMENT OF ASTHMA CONTROL IN CHILDREN
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  • ARVIND KUMAR,
  • Kana Jat,
  • Jhuma Sankar,
  • Ram Lakshmy,
  • RAKESH LODHA,
  • Sushil Kabra
ARVIND KUMAR
All India Institute of Medical Sciences

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Kana Jat
All India Institute of Medical Sciences
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Jhuma Sankar
PGIMER, Dr RML Hospital
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Ram Lakshmy
All India Institute of Medical Sciences
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RAKESH LODHA
AIIMS
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Sushil Kabra
All India Institute of Medical Sciences
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Abstract

Introduction: Data are scarce on hs-CRP as a biomarker for airway inflammation in pediatric asthma. We aimed to examine correlation between hs-CRP and asthma control levels. Methods: Children with physician-diagnosed asthma, ages 6 to 15 years, were enrolled. Asthma control criteria of GINA-2016 were used to assess the level of asthma control. The relationships between serum hs-CRP and each of asthma control measures (Asthma control criteria, spirometry, impulse oscillometry, eosinophil counts and Fractional exhaled nitric oxide (FeNO) were assessed. Results: Out of total 150 asthmatic children; 52 (35%) had well controlled asthma, 76 (51%), and 22 (14%) children had partly controlled and uncontrolled asthma, respectively. Median (IQR) values of hs-CRP were 0.47 (0.1, 1.67) mg/L in well controlled, 0.30 (0.1, 1.83) mg/L in partly controlled, and 2.74 (0.55, 3.74) mg/L in uncontrolled asthma (p=0.029). Correlation between hs-CRP and FEV1% was significant (p=0.019). Using Receiver Operator Characteristic (ROC) analysis, area under curve for hs-CRP mg/L to discriminate between uncontrolled and (controlled + partly controlled) asthma was 0.67 (95% CI 0.55, 0.80) and a cutoff 1.1 mg/L of serum hs-CRP level had a sensitivity of 68.1% with specificity of 67.97%. In two groups of hs-CRP (< 3 mg/L) and hs-CRP (≥ 3 mg/L), high hs-CRP group had higher proportion of uncontrolled asthmatic children (p=0.03). Conclusion: Our study demonstrated higher serum hs-CRP values in uncontrolled asthma that supports the use of hs-CRP as surrogate marker of small airway inflammation. hs-CRP may be considered as a tool to predict asthma status.
03 Jul 2023Published in Journal of Asthma volume 60 issue 7 on pages 1466-1473. 10.1080/02770903.2022.2155187