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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Inflammatory markers in childhood asthma

1 / Darko Richter2 / Renata Zrinski-Topić1

1Department of Clinical Laboratory Diagnosis, Srebrnjak Children’s Hospital, Zagreb, Croatia

2Department of Pediatrics, University Hospital Center, Zagreb, Croatia

Corresponding author: Slavica Dodig, Department of Clinical Laboratory Diagnosis, Srebrnjak Children’s Hospital, Srebrnjak 100, 10000 Zagreb, Croatia Phone: +385-1-6391-126, Fax: +385-1-6391-188

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 49, Issue 4, Pages 587–599, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2011.094, February 2011

Publication History

Received:
2010-08-23
Accepted:
2010-10-18
Published Online:
2011-02-09

Abstract

The major characteristic of asthma is persistent airway inflammation that fails to resolve spontaneously. Dysregulation of pro- and anti-inflammatory mechanisms is responsible for the development of chronic inflammation. The inflammatory reaction is mediated by numerous cells and their mediators. Detection and quantification of airway inflammation in children are subject to many requirements, e.g., use of biologic samples obtained in a non-invasive way; use of standardized analytical methods to determine biomarkers that can identify inflammation processes (inflammation itself, oxidative stress, apoptosis and remodelling); determining the role of systemic inflammation; assessment of correlation of various biomarkers of inflammation with clinical parameters and their diagnostic efficacy; providing a tool(s) to monitor diseases, and to evaluate adequacy of therapy; and predicting the clinical course of inflammation and prognosis of asthma. Using standardized analyses, it is now possible to determine direct markers of local inflammation, i.e., fractional nitric oxide (marker of oxidative stress) in exhaled breath, pH (marker of acid stress) in breath condensate, and indirect markers in blood/serum, i.e., eosinophil granulocytes (indicating migration), eosinophil cationic protein (marker of activated eosinophil granulocytes) and C-reactive protein (marker of systemic inflammation). However, none of these biomarkers are specific for asthma. Further standardization of the known pulmonary biomarkers of local inflammation and identification of new ones will allow for longitudinal follow-up of inflammation in children with asthma.

Keywords: airway inflammation; asthma; child; exhaled breath; exhaled breath condensate

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