Zietkowski Ziemowit, Tomasiak-Lozowska Maria M, Skiepko Roman, Mroczko Barbara, Szmitkowski Maciej, Bodzenta-Lukaszyk Anna
Department of Allergology and Internal Medicine, Medical University of Bialystok, Poland.
Respir Med. 2009 Mar;103(3):379-85. doi: 10.1016/j.rmed.2008.10.003. Epub 2008 Nov 17.
Asthma is a chronic airway inflammatory disease. Measurement of serum high- sensitivity C-reactive protein (hs-CRP) levels has suggested the involvement of low-grade systemic inflammation in several disorders, such as cardiovascular disease and diabetes mellitus. In recent years, there have been some reports concerning hs-CRP assessment as a useful tool for detecting systemic inflammation in asthma. The study was undertaken to evaluate hs-CRP levels in the exhaled breath condensate (EBC) of asthmatics with different degrees of asthma severity and their relationship to hs-CRP levels in serum, clinical characteristics, and the intensification of airway inflammation.
The study group was 62 patients with allergic asthma (20 with steroid-naïve mild asthma, 19 with ICS-treated, stable mild-to-moderate asthma, 23 with ICS-treated unstable, severe asthma) and 15 healthy volunteers.
In the three groups of asthmatics hs-CRP concentrations in EBC and serum were significantly higher than in healthy volunteers. hs-CRP levels both in EBC and serum were significantly higher in patients with unstable asthma than in the two groups with stable disease. hs-CRP concentrations in EBC strongly correlated with those measured in serum. There was a significant correlation between hs-CRP levels both in EBC and serum and exhaled nitric oxide (F(ENO)) in the three groups of asthmatics or serum ECP in the group of patients with steroid-naïve mild asthma and unstable, severe asthma.
The levels of hs-CRP in EBC are correlated with those measured in serum and may provide another useful diagnostic tool for detecting and monitoring low-grade inflammation in patients with asthma.
哮喘是一种慢性气道炎症性疾病。血清高敏C反应蛋白（hs-CRP）水平的测定表明，低度全身性炎症参与了多种疾病，如心血管疾病和糖尿病。近年来，有一些关于将hs-CRP评估作为检测哮喘全身性炎症的有用工具的报道。本研究旨在评估不同哮喘严重程度的哮喘患者呼出气冷凝液（EBC）中的hs-CRP水平及其与血清hs-CRP水平、临床特征和气道炎症加剧之间的关系。
研究组包括62例过敏性哮喘患者（20例初治轻度哮喘患者、19例接受吸入性糖皮质激素（ICS）治疗的稳定轻度至中度哮喘患者、23例接受ICS治疗的不稳定重度哮喘患者）和15名健康志愿者。
三组哮喘患者EBC和血清中的hs-CRP浓度均显著高于健康志愿者。不稳定哮喘患者的EBC和血清中的hs-CRP水平均显著高于两组稳定疾病患者。EBC中的hs-CRP浓度与血清中测得的浓度密切相关。三组哮喘患者EBC和血清中的hs-CRP水平与呼出一氧化氮（F(ENO)）之间存在显著相关性，在初治轻度哮喘患者组以及不稳定重度哮喘患者组中，EBC和血清中的hs-CRP水平与血清嗜酸性粒细胞阳离子蛋白（ECP）之间也存在显著相关性。
EBC中的hs-CRP水平与血清中测得的水平相关，可能为检测和监测哮喘患者的低度炎症提供另一种有用的诊断工具。
