الفهرس 
Childhood Bronchial AsthmaOnly 14 pages are availabe for public view
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Abstract
A
sthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role. Generally, most asthma starts from childhood in relation to sensitization to common inhaled allergens, these inhaled allergens stimulate T helper type 2 (Th2) cell proliferations.
Th2 cells activation and recruitment requires antigen-presentation by DCs. DCs play a role both in the initiation and maintenance of allergic airway inflammation and asthma, and control many aspects of the disease, including bronchial hyperresponsiveness and goblet cell metaplasia.
DCs are also known to display marked heterogeneity, and a commonly employed sub-classification is into conventional (also known as myeloid) and plasmacytoid cells. Conventional DCs (cDCs) have a crucial role in the development of Th2 responses and allergic airways inflammation, while plasmacytoid DCs (pDCs) have a role in response to viral infections, development of tolerance and control of allergic airways inflammation.
The aim of this study was to measure serum level of DCs in asthmatic children and its correlation with clinical and functional severity. The current study was conducted on 60 asthmatic children who attended The Pediatric Chest Clinic, Children’s Hospital, Ain Shams University and 12 healthy age and sex matched children as control group. The age of the children included in the study ranged between 6-16 years with mean age 9±2.6 years. Asthmatic children were 23 females and 37 males with a female to male ratio 1:1.2. Their ages ranged from 6-16 years with mean age 9.1±2.6 years. While the control group was 11 females and 9 males with a female to male ratio was 1:3, their ages ranged from 6-15years with mean age 9.1±2.8years.
The asthmatic patients were further subdivided into:
According to asthma control during the past three months into controlled (n=25), partially-controlled (n=14) and uncontrolled (n=21) based on (GINA, 2008).
According to asthma severity into, mild Persistent (n=25), moderate persistent (n=17) and severe persistent (n=18) (GINA, 2008).
According to intake of inhaled corticosteroid (ICS) therapy in to ICS group (n=46) and non-ICS group (n=14).
For all studied patients and control group, complete history and clinical examination were done. FEV1 was measured by spirometry. Venous blood sample was taken for detection of CD83-FITC and CD304-PE (Beckman Coulter, Miami, USA) by flow cytometry.
This study revealed statistically significant reduced FEV1% of predicted in all asthmatic children which decreased more with increased severity of the disease.
In the current study, absolute eosinophilic counts in the blood of asthmatic patients (423± 173) were higher than that of control group (101.1± 37.9) with p value (0.000).
This study showed a statistically sighnificant higher absolute counts of total DCs (172.7 ± 148.5) and plasmacytoid DCs (80.7 ± 73.3) in the peripheral blood of asthmatic patient compared to control group (6.3 ± 2.5, 2.4 ± 1.3 respectively) P value (0.000), and higher in sever (371.6 ± 88.6, 150.1± 42.6) and uncontrolled (328.8 ± 135, 132.9 ± 43.4) than mild (42.9 ± 18.4, 21.9± 8.5) and controlled (72.600 ± 58.73, 40.5 ± 33.14) respectively p value (0.000).
This study showed a statistically sighnificant higher absolute counts of total DCs and plasmacytoid DCs in the peripheral blood of asthmatic patients not on ICS (374 ± 85.5, 157.7 ± 25.7) respectively compared to asthmatic patients on ICS (111.4 ± 102, 57.9 ± 47.4) respectively with p value (0.000)
In this study there was no statistical significant difference between asthmatic patients according to passive smoking.
In this study there was a highly significant positive correlations between total DCs counts (mm³) and Eosinophilic counts (mm³) and plasmacytoid DCs counts (mm³) (P<0.001).
There was a highly significant negative correlations between total DCs counts (mm³) and FEV1% of predicted (P<0.001).
In this study there was a significant positive correlation between plasmacytoid counts (mm³) and Eosinophilic counts (mm³)
There was a highly significant negative correlations between plasmacytoid DCs counts (mm³) and FEV1% (P<0.001).
In conclusion: in this study, multiple aspects of DC biology and development of asthma have been reviewed and showed that Absolute counts of DCs may correlate with severity of bronchial asthma clinically and functionally and it may be a target of future therapeutic interventions.