Abstract
The aim of this work was to look for non-invasive biomarkers that may enable us to assess asthma severity, as a surrogate for the invasive bronchial mucosa biopsy, by studying TGF-β1 and YKL-40. TGF-β1 is used as biomarkers in the pathogenesis, prediction and follow up of asthma severity. YKL-40 has a role in airway inflammation; this relation suggests that YKL-40 and TGF-β1 can be used as biomarkers in the pathogenesis, prediction and follow-up of asthma severity. Defective extracellular matrix (ECM) turnover characterizes airway remodeling. Transforming Growth Factor Beta-1 (TGF-β1) stimulate airway remodeling through activation of gene transcription via binding to specific subfamilies of cell transmembrane receptors. The work was done on a 60 subject aged between 20–40 years with equal sex. Classified into three groups; 20 patients with mild asthma, 20 patients with severe asthma and 20 normal subjects were taken as controls. For all subjects chest X-ray, pulmonary functions tests, allergy skin prick test, eosinophilic count, total IgE, YKL-40 and TGF-β1 in serum were performed. The results showed that serum TGF-β1 and serum YKL-40 between the three groups were highly significantly different (P<0.01) between the three groups in asthmatic patients compared with control group. These variations were correlated positively with the severity of the disease indicating that their increased serum levels may be a biological characteristic of the disease exacerbation with a sentinel role in asthma.
Highlights
Transforming growth factor β1 (TGF-β1) is thought to play a role in airway remodeling in asthmatic patients; controversy remains whether the concentration of TGF-β1 is correlated with the disease severity [1]
There were highly significant differences in eosinophil count, forced vital capacity (FVC)%, FEV1, FEV1/FVC%, peak expiratory flow (PEF)%, serum total IgE, serum YKL-40, and serum TGF-β1 between the three studied groups, with exception of FEV%, as a nonsignificant difference was observed between mild group and control group only (Table 1)
The cutoff point of TGF-β1 level between the patients and controls was more than 126.9 pg/ml, with sensitivity of 100%, specificity of 100%, and accuracy of 100%, as done by Receiver operator characteristic (ROC) curve and is shown in Table 3 and Fig. 2
Summary
Transforming growth factor β1 (TGF-β1) is thought to play a role in airway remodeling in asthmatic patients; controversy remains whether the concentration of TGF-β1 is correlated with the disease severity [1]. YKL-40 is a measurable serum chitinase-like macromolecule and is synthesized in white cell precursors at the myelocyte-metamyelocyte stages. It is localized inside the specific granules of neutrophils and discharged from totally activated cells as from neutrophils and macrophages that regulates the innate immune responses in inflammatory and tissue-transforming states [3]. Defective extracellular matrix (ECM) turnover characterizes airway remodeling. Transforming Growth Factor Beta-1 (TGF-β1) stimulate airway remodeling through activation of gene transcription via binding to specific subfamilies of cell transmembrane receptors
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