Abstract
Background and PurposeBronchial asthma (BA) is a chronic airway disease characterized by airway hyperresponsiveness and remodeling, which are intimately linked to chronic airway inflammation. Reactive oxygen species (ROS) such as hydrogen peroxide are generated by inflammatory cells that are involved in the pathogenesis of BA. However, the role of ROS in the management of BA patients is not yet clear. We attempted to determine the role of ROS as a biomarker in the clinical setting of BA.Subjects and MethodsWe enrolled patients with BA from 2013 through 2015 and studied the degrees of asthma control, anti-asthma treatment, pulmonary function test results, fractional exhaled nitric oxide (FeNO), serum reactive oxygen metabolite (ROM) levels, and serum levels of interleukin (IL)-6 and IL-8.ResultsWe recruited 110 patients with BA. Serum ROM levels correlated with white blood cell (WBC) count (rs = 0.273, p = 0.004), neutrophil count (rs = 0.235, p = 0.014), CRP (rs = 0.403, p < 0.001), and IL-6 (rs = 0.339, p < 0.001). Serum ROM levels and IL-8 and CRP levels negatively correlated with %FEV1 (rs = -0.240, p = 0.012, rs = -0.362, p < 0.001, rs = -0.197, p = 0.039, respectively). Serum ROM levels were significantly higher in patients who experienced severe exacerbation within 3 months than in patients who did not (339 [302–381] vs. 376 [352–414] CARR U, p < 0.025). Receiver-operating characteristics analysis showed that ROM levels correlated significantly with the occurrence of severe exacerbation (area under the curve: 0.699, 95% CI: 0.597–0.801, p = 0.025).ConclusionsSerum levels of ROM were significantly associated with the degrees of airway obstruction, WBC counts, neutrophil counts, IL-6, and severe exacerbations. This biomarker may be useful in predicting severe exacerbations of BA.
Highlights
The use of inhaled corticosteroids and long-acting β2-agonists has reduced asthma-related exacerbations [1]
Serum reactive oxygen metabolite (ROM) levels correlated with white blood cell (WBC) count, neutrophil count, C-reactive protein (CRP), and IL-6
Serum ROM levels and IL-8 and CRP levels negatively correlated with %FEV1
Summary
The use of inhaled corticosteroids and long-acting β2-agonists has reduced asthma-related exacerbations [1]. Some patients with bronchial asthma (BA) still suffer from symptoms in spite of the standard treatment. They are diagnosed as having severe asthma or refractory asthma [2,3], and their medical expenses are high. Their quality of life is reduced by the persistence of chronic airway obstruction and frequent exacerbations. The relationship between the degree of BA exacerbation in clinical settings and the degree of oxidative stress is not yet clear. Reactive oxygen species (ROS) such as hydrogen peroxide are generated by inflammatory cells that are involved in the pathogenesis of BA. We attempted to determine the role of ROS as a biomarker in the clinical setting of BA.
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