Abstract
Introduction: High-sensitivity C -reactive protein (hs-CRP) is a biomarker reflecting low-grade systemic inflammation, but its role among wheezing infants is still unknown.
Objective: To demonstrate, whether hs-CRP has any association with recurrent wheezing, atopic markers, baseline lung function, or airway responsiveness in infants with persistent or recurrent lower airway symptoms.
Methods: 62 consecutive steroid-free infants aged 6-27 months (median 15, interquartile range 14;17 months) with persistent or recurrent lower airway symptoms underwent whole body plethysmography, rapid thoracoabdominal compression, methacholine challenge, and skin-prick tests (SPT). Total immunoglobulin E (IgE), blood eosinophils, and hs-CRP were determined.
Results: Recurrent physician-diagnosed wheezing (≥3 wheezing episodes) and blood eosinophilia (eosinophils ≥0.4 x 109/l and ≥4%) were associated with undetectable hs-CRP (n=9/52, p=0.044; n=13/49, p=0.013). Hs-CRP was not associated with atopic eczema, IgE, SPT positivity, or baseline lung function. The infants with blood eosinophilia and increased airway responsiveness to methacholine (PD40V'maxFRC <0.9 mg) also had significantly lower hs-CRP values than those without (n=8/54, p=0.019).
Conclusions: There was no evidence of low-grade systemic inflammation in symptomatic children with recurrent wheezing, blood eosinophilia, or eosinophilia and increased airway responsiveness. Neither was hs-CRP associated with other atopic markers or baseline lung function. In this age group, inflammation of the airways may not be reflected as low-grade systemic inflammation, thus explaining nearly undetectable hs-CRP.
- Copyright ©the authors 2016
