SERUM SOLUBLE
ICAM-1 AND E-SELECTIN IN ASTHMATIC CHILDREN: CORRELATION WITH SEVERITY AND
TREATMENT
AbdelFattah M, Assem
H, Sharaki O, Meles F
Department of
Pediatrics, Faculty of Medicine, Alexandria University, Alexandria, Egypt
Objective: to
study serum soluble intercellular adhesion molecule 1 (sICAM-1) and
E-selectin in children with bronchial asthma in relation to severity of the
attack, and the response to therapy.
Methods: The
study included 40 children with bronchial asthma (10 with stable asthma and
30 with acute exacerbation). Full history taking and clinical examination
were done with measurement of PaO2, PEFR, serum sICAM-1 and E-selectin.
Results:
Children with acute asthma exacerbation before and after therapy had
relatively higher mean sICAM-1 and E-selectin than children with stable
asthma. The level of sICAM-1 on presentation was highest in children with
severe exacerbation (459.5?24.8 ng/mL) than all other groups. Children with
mild exacerbation had a mean sICAM of 298.8 ? 62.7 ng/mL that is
significantly lower than children with moderate or severe exacerbation but
still significantly higher than controls. Therapy of moderate and severe
acute exacerbation was accompanied by a significant reduction of sICAM-1.
On presentation, E-selectin was highest in children with severe acute
exacerbation (97.8 ? 18.3 ng/mL). Children with stable asthma had
significantly higher E-selectin than controls. Therapy of severe acute
exacerbation resulted in significant reduction of E-selectin but still higher
than controls. sICAM-1 had
significant positive correlation with respiratory rate and E-selectin and
significant n!
egative correlation with PaO2 and PEFR.
Conclusion: Increased
levels of sICAM-1 and E-selectin in children with asthma may reflect the extensive
inflammatory response occurring in the airways especially during acute
exacerbation. They could be valuable diagnostic markers for assessment of
severity of the disease.