Prognosing a severe course of asthma in children following the study of endothelial function

Abstract

Background Asthma is a common disease with increasing prevalence in children and adults. The WHO estimates that annually 15 million disability-adjusted life-years are lost, and 250,000 asthma deaths are reported worldwide. Approximately, 500,000 annual hospitalizations are due to asthma (1). Aim In our study, we aimed to evaluate the endothelial function in children with asthma in remission and the prognosis of severe asthma. Materials and methods The study involved examination of 91 children, aged 6–17 years, with persistent asthma in the remission period. Indices of endothelial function (soluble vascular molecule of intercellular adhesion-1 [sVCAM-1], concentration of stable metabolites of nitric oxide in blood serum [NO2 +NO3 ], thickness of the intima-media complex [IMC] of the common carotid artery (CCA), and endothelium-dependent dilatation of the brachial artery [FMD%]). Statistical analyses were performed with StatSoft STATISTICA Version 8 (Tulsa, OK). To determine the relation between qualitative characteristics, the criterion χ2 was used, and the procedure of multiple logistic regression analysis was performed. Results The endothelium parameter levels (FMD% [H = 46.02], IMC [H = 60.75], NO2 + NO3 [H = 40.82], and sVCAM-1 [H = 76.57, p = 0.0000]) depend on the severity of the disease. The study showed that the factors that should be taken into account in prognosis of the formation of the severe course of asthma include positive family allergic history, serum sVCAM-1 and NO2 + NO3 levels, and the thickness of IMC CCA. Conclusions All the children with asthma in the remission period were found to have endothelial dysfunction. The degree of disruption of the function of the endothelium depends on the severity of the course of asthma. An algorithm for predicting the severe course of asthma in children has been developed.