High-Sensitivity C Reactive Protein as a Biomarker for Grading of Childhood Asthma in Relation to Clinical Classification, Induced Sputum Cellularity, and Spirometry

Background: Asthma is the most common chronic inflammatory disease in childhood and some reports have demonstrated systemic inflammation. The relevance of high-sensitivity assays for C-reactive protein (hs-CRP), which are known to be a sensitive marker of low-grade systemic inflammation, has not been fully studied in childhood asthma. Aim of study: This cross sectional case-control study aimed at evaluating serum hs-CRP in asthmatic children with different grades of severity and control. Methods: Serum hs-CRP, sputum cytology study, and forced expiratory volume in 1 sec (FEV1) % of predicted for age and sex were estimated in 60 asthmatic children (30 uncontrolled steroid-naive, and 30 controlled on inhaled steroid). They were recruited from Pediatric Chest Clinic, Children's Hospital, Ain Shams University. Sixty healthy children-age and sex-matched were included as a control group. Results: Serum hs-CRP concentrations were significantly higher in asthmatics than in controls with a median of 1.93 mg/L and 0.24 mg/L, respectively. Serum hs-CRP levels were significantly higher in uncontrolled steroid-naive asthmatics than those controlled on inhaled steroid with a median of 3.15 mg/L and 1.55 mg/L, respectively. Serum hs-CRP showed a sensitivity of 72% and a specificity of 93%. Conclusions: Despite that pulmonary function tests and clinical classification are the gold standard for grading of asthma, hs-CRP can be considered as a new marker for assessment of different grades of asthma severity and control. It can be used for indirect detection and monitoring of airway inflammation, disease severity, and response to steroid treatment in asthmatic children. Pediatr Pulmonol. 2012; 47:220-225. (C) 2011 Wiley Periodicals, Inc.