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EG |
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Egypt J Pediatr Allergy Immunol |
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2011 |
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9 |
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93-97 |
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ESP - 32 |
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Original articles |
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Serum YKL-40 and assessment of severity of bronchial asthma in
Egyptian children |
Tarek Abdel-Gawad |
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Mervat Gamal Eldin Mansour |
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Manal Abdel-Aziz |
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Bothina Elbialy |
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Background: Serum and lung tissue levels of a chitinase-like protein YKL-
40 have recently been found to be increased in patients with bronchial
asthma. Furthermore, serum YKL-40 levels correlated positively with
thickening of the lung sub-epithelial basement membrane, frequency of
rescue inhaler use, and deterioration in pulmonary function in European
asthmatic subjects. Objectives: to assess the role of YKL-40 measurement in
evaluating asthma severity, compared to clinical assessment and the related
pulmonary function tests. Methods: We quantified serum YKL-40 levels in
two groups of Egyptian asthmatics: One group with mild to moderate
asthma, and one with severe asthma. Serum YKL-40 was measured by
enzyme-linked immunosorbent assay (ELISA) kits (Quidel). Clinical scoring
of asthma severity by Pediatric Asthma Score (PAS) and pulmonary
functions were performed. Results: The serum levels of YKL-40 were
significantly elevated in severely asthmatic Egyptian children compared with
the other group (151ng/ml- 72ng/ml; p<.05). YKL-40 levels were correlated
positively to PAS (r=0.34, p<0.05), and inversely to FEV1 (r= -0.32, p<0.5).
Best cut off value of YKL-40 for asthma prognosis was 90 ng/ml, sensitivity
86.5%, specificity 81%, and diagnostic accuracy of 85%. Conclusions:
YKL-40 is found in increased quantities in the sera of severe asthmatics, and
correlated significantly to PAS and pulmonary function deterioration. YKL-
40 is considered a promising biomarker for asthma severity and pulmonary
remodeling warranting further study as a potential novel pathway to disease
management. |
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