study of some oxidants/antioxidants and trace elements in children with bronchial asthma

ABSTRACT

Asthma is a chronic inflammatory disorder of the airways involving variable airflow obstruction and increased airway responsiveness to a variety of stimuli. The rise in prevalence of asthma and allergic diseases among children is a matter of worldwide concern. Epidemiological evidence suggests that changes in diet, in particular reduced antioxidant intake have contributed to the increased asthma prevalence and severity and raises the possibility that dietary interventions may improve asthma. To evaluate the oxidants/antioxidants, and trace elements status in children with bronchial asthma this study was conducted on 39 asthmatic patients [mean age of 8.5 +/- 2.1 years] as well as 20 apparently healthy controls of matched age and sex recruited from Assiut Pediatric University hospital. Beside thorough history-taking, and meticulous clinical examination for all cases and controls, lung function tests and a chest x-ray were done for each asthmatic child. Fifteen patients had mild bronchial asthma, twelve had moderate, and twelve had severe asthma according to the National Asthma Education and Prevention program. The following investigations were done to all studied children plasma lipid peroxide level expressed in terms of malondialdhyde [MDA]; red blood cell enzyme activity of each of glutathione peroxidase [GSH-Px], and superoxide dismutase [SOD]; plasma levels of vitamins [A, E, and C], zinc [Zn], copper [Cu], selenium [Se] and magnesium [Mg]. Asthmatic children showed significantly higher plasma level of MDA than controls. Red blood cell enzyme activity of each of GSH-Px, and SOD, also, plasma levels of vitamins A, and C, Zn, Se, and Mg showed significantly lower values in asthmatic children than controls. The changes observed in the studied parameters were more apparent in patients with severe asthma than those with mild degree. Significant positive correlations were observed between the values of forced expiratory volume 1 [FEV 1], and each of GSH-Px, SOD, and vitamin A, Zn, and Se, while significant negative correlation was found between FEV 1 and MDA. Also, significant negative correlations were detected between MDA, and each of GSH-Px, SOD, vitamin C and Zn. Oxidative stress and disturbed antioxidants and trace elements status are present in asthmatic children, and may have important consequences for the pathogenesis, and severity of asthma. Special attention must be given to the assessment of dietary intake of vitamins and trace elements. So, good dietetic intakes of high biological value protein, and supplements of vitamins, and trace elements are recommended as an adjuvant therapy. Long term prospective trials are recommended to determine whether modification of dietary intake will be beneficial in prevention, or reduction of the severity and or morbidity of the disease