Hs-CRP may be potent biomarker of uncontrolled asthma among children

INDIA: A recent research article published in the Journal of Asthma has concluded that high-sensitivity C reactive protein (hs-CRP) is an important biomarker in asthmatic control. The study reported a higher serum hs-CRP level in children with uncontrolled asthma.

Asthma is a condition of chronic airway inflammation, and hs-CRP is a sensitive biomarker in low-grade chronic inflammation. Its role in asthma has not been studied thoroughly.

Previous studies have concluded that "hs-CRP could be a surrogate marker which indirectly reflects the degree of inflammation of the airway.

There needs to be more data on a hs-CRP biomarker in paediatric asthmatic patients for airway inflammation.

Adding more relevant data, a study was conducted by a team of researchers led by Dr Arwind Kumar from the Pediatric Pulmonology and Intensive Care Division of the Department of Pediatrics and Department of Cardiac Biochemistry at CN Center of All India Institute of Medical Sciences to examine,

What is the correlation between hs-CRP and asthma control levels?

The critical points of the study are:

• The study enrolled 150 children with a history of asthma (physician-diagnosed).

• The children enrolled in the study were aged 6 to 15 years.

• GINA-2016 criteria assessed the level of control of asthma.

• Assessment of the relationships between serum hs-CRP and asthma control measures (Asthma control criteria, impulse oscillometry, eosinophil counts, spirometry and Fractional exhaled nitric oxide (FeNO) were done.

• Fifty-two children constituting 35%, had well-controlled asthma.

• Seventy-six children constituting 51%, had a history of partly controlled asthma.

• Twenty-two children constituting 14%, had uncontrolled asthma.

• In well-controlled, partly-controlled, and uncontrolled asthma, median values as 0.47 mg/L, 0.30 mg/L and 2.74 mg/L for Hs – CRP. The p-value was 0.029.

• The area under the curve (ROC curve analysis) had a hs-CRP of 0.67 (for discriminating between uncontrolled and controlled asthma).

• The cutoff 1.1 mg/L of hs-CRP level in serum had a sensitivity and specificity of 68.1% and 67.97%, respectively.

• In two groups with hs-CRP of < 3 mg/L and ≥ 3 mg/L, there was a higher proportion of uncontrolled asthmatic children in the high hs-CRP group with a p-value of 0.03.

The researchers said, "We observed higher serum hs-CRP values in children with uncontrolled asthma. The findings of our study suggest that hs-CRP is a potential biomarker of asthma control."

Further reading:

Arvind Kumar, Kana Ram Jat, Jhuma Sankar, R Lakshmy, Rakesh Lodha & SK Kabra (2022) ROLE OF HIGH- SENSITIVITY C REACTIVE PROTEIN (hs-CRP) IN ASSESSMENT OF ASTHMA CONTROL IN CHILDREN, Journal of Asthma, DOI: 10.1080/02770903.2022.2155187