696 Study of Some Inflammatory Markers in Children with Moderate Persistent Bronchial Asthma Before and After Therapy with Inhaled Corticosteroids

Abstract

Inhaled corticosteroids is the mainstay of bronchial asthma therapy (BA) because it targets the underlying airway inflammation. This study included 30 children aged 5-15 years with moderate persistent asthma. The aim was to study some inflammatory markers (sputum eosinophils SE, AEC, eosinophilic cationic protein ECP, and TNF- ∼) and measurement FEV1/FVC as an indicator of obstructive airway disease. The measurements were done 3 times for the patients and once for 20 age and sex matched healthy children (control group). The first sample was taken in both groups before start of therapy. The second was done for the patients after 3 months of ICS and the third was taken with reappearance of symptoms of BA during or after complete withdrawal of ICS over 4 months. Our patients in the pretreatment sample had significantly higher levels of sputum eosinophis, AEC, ECP, TNF- ∼, and FEV1/FVC compared to the control Compared to the pretreatment values these values except AEC decreased significantly after 3 months of ICS. Relapse occurred in 25 patients during withdrawal of the ICS therapy and only 5 patients remained asymptomatic after complete stoppage of the treatment. Relapse was associated with significant increase in the levels of TNF-∼ and SE in the third sample compared to the second sample. We conclude that non-invasive assessment of airway inflammation is enough to monitor children with BA. ICS is an effective tool against this inflammation. TNF-∼ followed by sputum eosinophils are sensitive predictors of relapse in the children withBA.