アレルギーと治療のジャーナル

概要

Urinary Glycosaminoglycans in Asthmatic Children in Relation to Disease Control by Inhaled Corticosteroids

Deraz TE, Terez B Kamel, Enas S Nabih and Walaa A Abdelazem

Background: Chronic inflammation and airway remodeling are important characteristics of human asthma. Increased deposition of extracellular matrix in the airway wall contributes to airway remodeling in asthmatics. Glycosaminoglycans (GAGs) are polysaccharides attached to a protein core to form proteoglycans, a component of the ECM. Objective and method: In this study, urinary GAGs levels of asthmatic children were investigated in relation to disease control and medication. Sixty asthmatic children (48 boys, 12 girls), aged 4-14 years, were recruited in the study; twenty were controlled asthma on inhaled fluticasone, twenty were uncontrolled asthma due to incompliance on inhaled fluticasone and twenty uncontrolled who were only on relief medications. Age and gender matched 20 healthy controls were also included. GAGs were precipitated from collected early morning urine samples, isolated and quantified then expressed in μg GAGs/mg creatinine/m2. Urinary GAGs levels were significantly lower among healthy controls than asthmatics (58.0 ± 31.0 and 98.1 ± 41.0 μg/mg creatinine/m2 respectively) with significant higher values in children on inhaled corticosteroids (ICS) whether controlled or uncontrolled (113.3 ± 56.8 and 88.9 ± 49.7 μg/mg creatinine/m2 respectively) than asthmatics on relief medications (32.2 ± 23.5 μg/mg creatinine/m2). Furthermore, we found a positive correlation between daily doses of inhaled fluticasone and urinary GAGs values. Conclusion: Urinary GAGs secretion is reduced in asthmatic children using only relief medication but it is increased in those on long-term treatment with ICS which plays an important role in preventing remodeling.