ROLE OF HIGH- SENSITIVITY C REACTIVE PROTEIN (hs-CRP) IN ASSESSMENT OF
ASTHMA CONTROL IN CHILDREN
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.