Serum intercellular adhesion molecule-1 and leukotreine B4 in children with bronchial asthma: correlation with bronchial hyperreactivity

ABSTRACT

The objective of the present study was to investigate circulating intercellular adhesion molecule-1 [cICAM-1] and serum Leukotreine B[4] [LTB[4]] in asthmatic children. Twenty five asthmatic children and similar number controls were enrolled. Using enzyme immunoassay techniques, serum ICAM-1 and LTB[4] levels were determined on admission in acute attacks, 24 hrs and 2 weeks after remission. Bronchial hyperreactivity was tested in 10 patients with forced expiratory volume in one second [FEV[1]]> 80% using Methacholine inhalation provocation test. The results of the present study showed that cICAM-1 and LTB[4] increased significantly in patients with acute attacks Vs controls [P<0.05]. Both cICAM-1 and LTB[4] levels correlated significantly with severity as well as frequency of acute attacks [P<0.05], but correlated insignificantly with the atopic status of the patients as well as bronchial hyperreactivity represented by the peak concentration of methacholine at which FEV[1] dropped by 20% of post-saline inhalation value[PC20FEV1] [P>0.05]. Serum ICAM-1 and LTB[4] showed insignificant drop 24 hr after remission [P>0.05]. But significantly dropped two weeks later on [P < 0.05]. Those patients with chronic asthma sustained significantly higher levels of cICAM-1 and LTB[4] two weeks after remission [P<0.05 Vs controls]. There was significant drop in LTB[4] 24hr after remission in dexamethazone-treated patients Vs non-dexamethazone treated patients [P<0.05]. cICAM-1 levels showed no such significant drop [P>0.05]. However, dexamethazone administered during acute paroxysm showed insignificant effect on cICAM-1 and LTB[4] levels obtained two weeks after remission [P>0.05]. In conclusions i]. The present data suggested that ICAM-1 and LTB[4] may play a remarkable pathophysiologic role in acute and chronic asthma in children. ii] ICAM-1 and LTB[4] are suggested to have no influence on bronchial hyperreactivity in asthmatic children and both are not influenced by the atopic status of the child, but closely linked to the severity and frequency of acute asthmatic attacks and chronicity of asthma iii] cICAM-1 is under limited steroid control, while LTB[4] levels is suggested to be steroid-sensitive iv] The present data, opens the door in the near future, for possible therapuetic interventions using novel anti-inflammatory agents acting by blocking ICAM-1 molecules and LTB[4] receptors, in acute and chronic asthma in children