High-Sensitivity C - reactive protein Assessment in Bronchial Asthma: Impact of Exhaled Nitric Oxide and Body Mass Index
Qasim Jawad AL-Daami, Hala Saad Bash, Ghada Hamid Naji, Hayder Abdul- Amir Makki AL-Hindy
Background: Bronchial asthma (BA), is a chronic airway inflammatory illness affecting over 315 million individuals globally, initiating a major cause for illness and significant burden on communities. C-reactive protein (CRP) is a finely delicate, nonspecific biomarker of acute phase inflammation and injured cells. This protein is raised up during early stages of inflammation in bronchial asthma. The fraction exhaled nitric oxide test is feasible and non-invasive test, also it delivers an immediate result, besides it is reproducible marker of airways inflammation This study designed to illuminate the relationship between Hs/CRP levels, and FeNo index in patients with asthma.
Patients and methods: the study was performed in Merjan Medical City and spiro private clinic, it included 80 asthmatic patients with 60 healthy subjects as control group. The age ranged from 10 to 66 years old, male was dominant. The asthma was assessed using fractional exhaled nitric oxide (FeNo) test (medisoft® company, Belgium)
Results: Mean age of all study participants was 33.3±13.0, the asthmatic patients were on treatment for mean duration of 8.02 years. The mean obesity indices being significantly higher in BA group (p-0.041). Both FeNo and Hs/CRP levels were expressively high in individuals with mean of 28.6±28.2 ppb (p-0.001) and (p-0.028) sequentially. Meanwhile, there was no significant correlation of Hs/CRP with W/H, BMI, and duration of the asthma in BA patients. There was no effect of history of asthma treatment on the blood levels of Hs/CRP (p-0.34). Nevertheless, those on regular asthma therapy correlated with decreased levels of FeNo test (p-0.001). More than 50% of obese patients had higher levels of Hs/CRP. This is not the case for relation of obesity with the two FeNo categories which was not significant. In the meantime, the FeNo levels were significantly increased with the increment of Hs/CRP classes. ROC curve analysis of FeNo test in BA patients, showed significant (p-0.000) high accuracy, AUC, sensitivity and specificity. However, ROC curve analysis of Hs/CRP in BA patients revealed significant (p-0.006), but, lower accuracy, AUC, sensitivity and specificity.
Conclusion: In this study, there was strong correlation between degree of systemic inflammation as assessed by hs-CRP and asthma inflammation as assessed by measuring exhaled nitric oxide (FeNo concentration). In addition, there was high correlation between increased body weight with asthmatic airways inflammation