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ROLE OF HIGH- SENSITIVITY C REACTIVE PROTEIN (hs-CRP) IN ASSESSMENT OF ASTHMA CONTROL IN CHILDREN
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  • ARVIND KUMAR,
  • Kana Jat,
  • Jhuma Sankar,
  • Ram Lakshmy,
  • RAKESH LODHA,
  • Sushil Kabra
ARVIND KUMAR
All India Institute of Medical Sciences
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Kana Jat
All India Institute of Medical Sciences
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Jhuma Sankar
PGIMER, Dr RML Hospital
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Ram Lakshmy
All India Institute of Medical Sciences
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RAKESH LODHA
AIIMS
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Sushil Kabra
All India Institute of Medical Sciences
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Abstract

Introduction: Data are scarce on hs-CRP as a biomarker for airway inflammation in pediatric asthma. We aimed to examine correlation between hs-CRP and asthma control levels. Methods: Children with physician-diagnosed asthma, ages 6 to 15 years, were enrolled. Asthma control criteria of GINA-2016 were used to assess the level of asthma control. The relationships between serum hs-CRP and each of asthma control measures (Asthma control criteria, spirometry, impulse oscillometry, eosinophil counts and Fractional exhaled nitric oxide (FeNO) were assessed. Results: Out of total 150 asthmatic children; 52 (35%) had well controlled asthma, 76 (51%), and 22 (14%) children had partly controlled and uncontrolled asthma, respectively. Median (IQR) values of hs-CRP were 0.47 (0.1, 1.67) mg/L in well controlled, 0.30 (0.1, 1.83) mg/L in partly controlled, and 2.74 (0.55, 3.74) mg/L in uncontrolled asthma (p=0.029). Correlation between hs-CRP and FEV1% was significant (p=0.019). Using Receiver Operator Characteristic (ROC) analysis, area under curve for hs-CRP mg/L to discriminate between uncontrolled and (controlled + partly controlled) asthma was 0.67 (95% CI 0.55, 0.80) and a cutoff 1.1 mg/L of serum hs-CRP level had a sensitivity of 68.1% with specificity of 67.97%. In two groups of hs-CRP (< 3 mg/L) and hs-CRP (≥ 3 mg/L), high hs-CRP group had higher proportion of uncontrolled asthmatic children (p=0.03). Conclusion: Our study demonstrated higher serum hs-CRP values in uncontrolled asthma that supports the use of hs-CRP as surrogate marker of small airway inflammation. hs-CRP may be considered as a tool to predict asthma status.

Peer review status:IN REVISION

12 Mar 2021Submitted to Pediatric Pulmonology
15 Mar 2021Assigned to Editor
15 Mar 2021Submission Checks Completed
17 Mar 2021Reviewer(s) Assigned
04 Apr 2021Review(s) Completed, Editorial Evaluation Pending
04 Apr 2021Editorial Decision: Revise Major