O Emin1, A Hasan2, D M Rusen3. 1. Department of Pediatrics, Division of Pediatric Allergy, Bezmialem Vakif University, Istanbul, Turkey. Electronic address: minozkaya@yahoo.com. 2. Department of Pediatrics, Kurtalan National Government Hospital, Kurtalan-Siirt, Turkey. 3. Department of Pediatrics, Bezmialem Vakif University, Istanbul, Turkey.
Abstract
BACKGROUND: Assessment of asthma with a control test has been suggested as a relevant approach in recent years. However, no biomarker of systemic inflammation has been included in the assessment of asthma control. OBJECTIVE: To evaluate plasma paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) levels in children with asthma according to the disease control, and the performance in the identification of uncontrolled patients. METHODS: Stable asthmatic children (n=85) and healthy controls (n=55) were recruited for this study. Blood samples were collected for plasma PON1, TOS, and TAS measurements. Any contributing factors that may affect plasma PON1, TAS, and TOS levels were excluded from both groups. The diagnostic potential of these measures was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: Comparing the asthmatic children with the control group, plasma TAS and TOS levels were significantly higher (TAS; 6.9 ± 2.1, 1.05 ± 0.32, P<0.001, and TOS; 12.5 ± 3.4, 5.5 ± 3.8, P<0.001, respectively) and PON1 level was significantly lower (156.5 ± 55, 298.6 ± 87.6, respectively, P<0.001) in the asthmatic group than controls. In ROC analysis, PON1 presented an AUC 0.679 and TOS presented an AUC 0.645 for the identification of uncontrolled asthma, respectively. Asthma Control Test (ACT) presented an AUC of 0.972 for the identification of uncontrolled asthma. CONCLUSION: PON1 and TOS levels may be systemic markers of uncontrolled asthma in children. Combined use of these two biomarkers with asthma control test may identify patients with uncontrolled asthma in children.
BACKGROUND: Assessment of asthma with a control test has been suggested as a relevant approach in recent years. However, no biomarker of systemic inflammation has been included in the assessment of asthma control. OBJECTIVE: To evaluate plasma paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) levels in children with asthma according to the disease control, and the performance in the identification of uncontrolled patients. METHODS: Stable asthmatic children (n=85) and healthy controls (n=55) were recruited for this study. Blood samples were collected for plasma PON1, TOS, and TAS measurements. Any contributing factors that may affect plasma PON1, TAS, and TOS levels were excluded from both groups. The diagnostic potential of these measures was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: Comparing the asthmatic children with the control group, plasma TAS and TOS levels were significantly higher (TAS; 6.9 ± 2.1, 1.05 ± 0.32, P<0.001, and TOS; 12.5 ± 3.4, 5.5 ± 3.8, P<0.001, respectively) and PON1 level was significantly lower (156.5 ± 55, 298.6 ± 87.6, respectively, P<0.001) in the asthmatic group than controls. In ROC analysis, PON1 presented an AUC 0.679 and TOS presented an AUC 0.645 for the identification of uncontrolled asthma, respectively. Asthma Control Test (ACT) presented an AUC of 0.972 for the identification of uncontrolled asthma. CONCLUSION:PON1 and TOS levels may be systemic markers of uncontrolled asthma in children. Combined use of these two biomarkers with asthma control test may identify patients with uncontrolled asthma in children.