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The Egyptian Journal of Bronchology
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  • Airways in health and disease
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Study of serum C-reactive protein level and sputum eosinophils in patients with bronchial asthma

Egyptian Journal of Bronchology volume 9, pages 43–47 (2015)Cite this article

Abstract

Background

Asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular mast cells, eosinophils, and lymphocytes. It is a major chronic airway disorder that poses a serious public health problem worldwide. C-reactive protein (CRP) is used mainly as a marker of inflammation.

Aim of the work

This study aims to clarify the relationship between serum CRP, sputum eosinophils, and the degree of airway inflammation in asthmatic patients (stable or in exacerbation) for use as a prognostic marker in detecting the severity of the disease.

Participants and methods

The study was carried out on 60 patients who were admitted to the chest department, Benha University Hospital. They were divided into two groups: 40 patients with bronchial asthma (20 patients with controlled asthma and 20 patients with exacerbated asthma) and 20 apparently healthy individuals. Patients and controls were subjected to a full assessment of history and clinical examination. Spirometry, serum CRP level, and sputum eosinophil count were measured in asthmatic patients and in healthy control individuals.

Results

Serum CRP was significantly increased in 85% of patients with acute exacerbation, whereas only 30% of patients with controlled asthma showed increased serum CRP. Its level was markedly increased during exacerbation. The sputum eosinophil count was highly increased in the exacerbated asthma group and 25% of patients in the controlled asthma group. There was a negative correlation between CRP, forced expiratory volume in the first second (FEV1), FVC, and FEV1/FVC and a highly significant positive correlation with sputum eosinophils.

Conclusion

There is an association between airway inflammation in bronchial asthma and elevated level of CRP and sputum eosinophils.

References

  1. Bousqeut J, Chanez P, Lacoste JY. Eosinophilic inflammation in asthma. N Engl J Med 2000; 323:1033–1039.

    Article  Google Scholar 

  2. Corry DB. Emerging immune targets for the therapy of allergic asthma. Nat Rev Drug Discov 2002; 1:55–64.

    Article  CAS  Google Scholar 

  3. Kay AB, Phipps S, Robinson DS. A role for eosinophils in airway remodelling in asthma. Trends Immunol 2004; 25:477–482.

    Article  CAS  Google Scholar 

  4. Kumari K, Rana AC. A review on epidemology, pathopysiology and management of asthma. J Appl Pharma Sci 2012; 02:55–64.

    Google Scholar 

  5. Louis R, Sele J, Henket M, Cataldo D, Bettiol J, Seiden L, Bartsch P. Sputum eosinophil count in a large population of patients with mild to moderate steroid-naive asthma: distribution and relationship with methacholine bronchial hyperresponsiveness. Allergy 2002; 57:907–912.

    Article  CAS  Google Scholar 

  6. Koh YI, Choi S. Blood eosinophil counts for the prediction of the severity of exercise-induced bronchospasm in asthma. Respir Med 2002; 96:120–125.

    Article  CAS  Google Scholar 

  7. Gillman B, Papachristodoulou DK, Thomas JH. Will’s biochemical basis of medicine. Oxford: Butterworth Heinemann; 2000.

    Google Scholar 

  8. Alobaidi AH, Alsamarai AM, Jawad AY, Alganabi JM. Association between C reactive protein and asthma. Tur Toraks Der 2010; 11:98–104.

    Article  Google Scholar 

  9. Pellizaro AM, Heuertz RM. C-reactive protein levels are elevated in asthma and asthma-like conditions. Clin Lab Sci 2010; 23:223–227.

    Article  Google Scholar 

  10. Adkinson NF, Yunginger JW, Busse WW, Bochner BS, Holgate ST, Simons FE. Middletons allergy: principles and practice. 6th ed. USA: Mosby; 2000; 2:1175–1208.

    Google Scholar 

  11. Al-Aarag AH, Ismaeel, YM, Mohammad AA. Study of serum C-reactive protein in patients with COPD. Med J Cairo Univ 2012; 80:163–168.

    Google Scholar 

  12. Wouters EFM. The systemic face of airway diseases: the role of C-reactive protein. Eur Respir J 2006; 27:877–879.

    Article  CAS  Google Scholar 

  13. Kony S, Zureik M, Driss F, Neukirch C, Leynaert B, Neukirch F. Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study. Thorax 2004; 59:892–896.

    Article  CAS  Google Scholar 

  14. Global Initiative for Asthma (GINA): Global Strategy for Asthma Management and Prevention. NHLBI/WHO workshop. Bethesda, MD: NIH; 2011. 95–3659.

  15. Busse WW, Holgate ST. Asthma and rhinitis. 2nd ed. Oxford: Blackwell Science; 2003. 1:245–841.

    Google Scholar 

  16. Anderson GP. COPD, asthma and C-reactive protein. Eur Respir J 2006; 27:874–876.

    Article  CAS  Google Scholar 

  17. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A. Standardisation of spirometry. Eur Respir J 2005; 26:319–338.

    Article  CAS  Google Scholar 

  18. Al Biltagi M, Abdul Baset A, Bassiouny M, Kasrawi MA, Attia M. Omega-3 fatty acids, vitamin C and Zn supplementation in asthmatic children: a randomized self-controlled study. Acta Paediatr 2009; 98:737–742.

    Article  CAS  Google Scholar 

  19. Rosner B, Milton RC. Significance testing for correlated binary outcome data. Biometrics 1988; 44:505–512.

    Article  CAS  Google Scholar 

  20. Szalai AJ. C-reactive protein (CRP) and autoimmune disease: facts and conjectures. Clin Dev Immunol 2004; 11:221–226.

    Article  CAS  Google Scholar 

  21. Jousilahti P, Salomaa V, Hakala K, Rasi V, Vahtera E, Palosuo T. The association of sensitive systemic inflammation markers with bronchial asthma. Ann Allergy Asthma Immunol 2002; 89:381–385.

    Article  Google Scholar 

  22. Ford ES. Asthma, body mass index, and C-reactive protein among US adults. J Asthma 2003; 40:733–739.

    Article  Google Scholar 

  23. Gan WQ, Man SF, Senthilselvan A, Sin DD. Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax 2004; 59:574–580.

    Article  CAS  Google Scholar 

  24. Kony S, Zureik M, Driss F. Association of BHR and lung function with CRP: a population based study. Thorax 2004; 59:1–5.

    Article  Google Scholar 

  25. Takemura M, Matsumoto H, Niimi A, Ueda T, Matsuoka H, Yamaguchi M. High sensitivity C-reactive protein in asthma. Eur Respir J 2006; 27:908–912.

    Article  CAS  Google Scholar 

  26. Fujita M, Ueki S, Ito W, Chiba T, Takeda M, Saito N. C-reactive protein levels in the serum of asthmatic patients. Ann Allergy Asthma Immunol 2007; 99:48–53.

    Article  CAS  Google Scholar 

  27. Sahoo RC, Acharya PR, Noushad TH, Anand R, Acharya VK, Sahu KR. A study of high-sensitivity C-reactive protein in bronchial asthma. Indian J Chest Dis Appl Sci 2009; 51:213–216.

    Google Scholar 

  28. Rosenberg, HF; Phipps, S, Foster PS. Esinophil trafficking in allergy and asthma. J Allergy Clin Immunol 2007; 119:1303–1310.

    Article  CAS  Google Scholar 

  29. Guill, MF. Asthma update: clinical aspects and management. Pediatr Rev 2004; 25:335–399.

    Article  Google Scholar 

  30. Mojtaba E, Somayeh B, Cayman A, Davood K. A study of high-sensitivity C-reactive protein in relation to respiratory symptoms in mild to moderate asthma. Int J Biosci 2011; 1:83–88.

    Google Scholar 

  31. Razi E, Ehteram H, Akbari H, Chavoshi V, Razi A. Evaluation of high-sensitivity c-reactive protein in acute asthma. Tanaffos 2012; 11:32–37.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Louis R, Lau LC, Bron AO, Roldaan AC, Radermecker M, Djukanovic R. The relationship between airways inflammation and asthma severity. Am Respir Crit Care Med 2000; 161:9–16.

    Article  CAS  Google Scholar 

  33. Ronchi MC, Piragino C, Rosi E. Do sputum eosinophils and ECP relate to the severity of asthma? Eur Respir J 1997; 10:1809–1813.

    Article  CAS  Google Scholar 

  34. Azzawi M, Johnston PW, Majumdar S, Kay AB, Jeffery PK. lymphocytes and activated eosinophils in airway mucosa in fatal asthma and cystic fibrosis. Am Rev Respir Dis 1992; 145:1477–1482.

    Article  CAS  Google Scholar 

  35. Shaaban R, Kony S, Driss F, Leynaert B, Soussan D, Pin I. Change in C-reactive protein levels and FEV1 decline: a longitudinal population-based study. Respir Med 2006; 100:2112–2120.

    Article  Google Scholar 

  36. Aronson D, Roterman I, Yigla M, Kerner A, Avizohar O, Sella R. Inverse association between pulmonary function and C-reactive protein in apparently healthy subjects. Am J Respir Crit Care Med 2006; 174:626–632.

    Article  CAS  Google Scholar 

  37. Wu SH, Yin PL, Zhang YM, Tao HX. Reversed changes of lipoxin A4 and leukotrienes in children with asthma in different severity degree. Pediatr Pulmonol 2010; 45:333–340.

    Article  Google Scholar 

  38. Filley WV, Holley KE, Kephart GM, Gleich GJ. Identification by immunofluorescence of eosinophil granule major basic protein in lung tissues of patients with bronchial asthma. Lancet 1982; 2:11–16.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Chest, Faculty of Medicine, Benha University, Banha, Egypt

    Abdelsadek H. Al-Aarag, Abeer M. Rawy MD & Marwa M. Abdelraheem

  2. Department of Clinicl and Chemical Pathology, Faculty of Medicine, Benha University, Banha, Egypt

    Mona M. EL-Behissy

Authors
  1. Abdelsadek H. Al-Aarag
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  2. Abeer M. Rawy MD
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  3. Mona M. EL-Behissy
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  4. Marwa M. Abdelraheem
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Corresponding author

Correspondence to Abeer M. Rawy MD.

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Al-Aarag, A.H., Rawy, A.M., EL-Behissy, M.M. et al. Study of serum C-reactive protein level and sputum eosinophils in patients with bronchial asthma. Egypt J Bronchol 9, 43–47 (2015). https://doi.org/10.4103/1687-8426.153597

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  • DOI: https://doi.org/10.4103/1687-8426.153597

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