الفهرس 
BRONCHIAL ASTHMAOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Asthma is a chronic inflammatory disorder of the airways characterized by an obstruction of airflow, which may be completely or partially reversed with or without specific therapy. Airway inflammation is associated with airway hyperreactivity or bronchial hyperresponsiveness MCP-1 might play a significant role in allergic responses by inducing mast cell activation and leukotriene C4 release into the airway .
Hs-CRP could be theoretically useful tool for detecting systemic inflammation in asthma.
This comparative cross sectional study aimed at determining the serum levels of Monocyte chemotactic protein-1 (MCP-1) and high sensitivity C reactive protein in asthmatic children with different grades of severity.
The study was designed to investigate their levels during asymptomatic state and acute attack of asthma so as to evaluate their relation to airway inflammation and severity of asthma. This study was conducted on 30 asthmatic children aged from 5-16 years old as well as 30 age matched healthy control children .
Patients were recruited from outpatient clinic or in patient pediatric Department of Faculty of Medicine, Benha University hospital in the period from August , 2012 to August , 2013 .
All the included children were subjected to:
i-Detailed medical history .
ii- Thorough clinical examination laying stress on anthropometric measures and chest examination .
iii-Peak expiratory flow rate recording by peak flow meter.
iv- Laboratory investigations including measurement of :
- CBC for HB , WBC, eosinophil count and neutrophil count.
- Serum Hs-CRP (mg/L) by (ELISA) technique.
- Serum MCP-1 (pg/ml). by (ELISA ) technique .
Patients were investigated twice , one during acute attack and the second one during asymptomatic phase of asthma .
In the current work we found that :
Significant statistical differences between asthma group and control as regard personal history of atopy and degree of mother education.
Significant statistical decreases in asthma than control as regard body mass index and hemoglobin concentration(P<0.05).
Highly significant increases in absolute neutrophil counts in asthma group during attack than in between attacks and than control group (P<0.001) and show significant increase in absolute neutrophil counts in asthma group during attack than control group (P=0.035) .
Highly significant increase in absolute blood eosinophil counts in asthma group during the attack than control and in asthmatic during exacerbation than in between attacks (P<0.001).But no significant increase in absolute eosinophil counts in asthma group in between attacks than control group (p>0.05).
Highly significant statistical difference in serum level of Hs-CRP between asthma group during the attack and control group, between asthma group in between attacks and control group and between asthma group during and in between attacks(P<0.001).
Highly significant increases in serum level of MCP-1 between asthma group during the attack than control, between asthma group during the attack and in between attacks (P<0.001).While the differerence between asthmatic in between attacks and control was non significant(P>0.05).
Regarding serum level of Hs-CRP and MCP-1 in relation to asthma severity:
• Significant higher in serum level of Hs-CRP in moderate than mild exacerbation and in severe than mild exacerbation .
• Mean serum MCP-1 was highest in severe asthma exacerbation followed by moderate exacerbation than in mild exacerbation .
• Significant increases in serum Hs-CRP and MCP-1 levels with increase of the grade of asthma among asthma patients.
The current correlation studies showed:
• Significant positive correlation between serum Hs-CRP level and absolute eosinophilic count, asthma attack severity and asthma grade in between attacks.
• Significant positive correlation between serum MCP- 1 and absolute eosinophilic,neutrophilic counts,asthma attack severity ,grade of asthma in between attacks and Hs-CRP level.
ROC curve analysis revealed that the cut off value of Hs-CRP and MCP-1(2.37 and 266.9 respectively ) could differentiate severe persistent asthma from non severe asthma with sensitivity 80% for both and specificity 68%, 88% respectively .
We concluded that .
Hs-CRP can be used as marker for asthma inflammation .
Elevated MCP-1 in asthmatic patients during asymptomatic and stable phase suggest its role in the pathogenesis of asthma inflammatory process.
Lastly we recommended the use of the cut off values of both Hs-CRP and MCP-1 for prediction of severe asthma grade for the early and proper management of asthma .