Role of Inflammatory Mediators—Absolute Eosinophil Count, C-Reactive Protein, and Total Immunoglobulin E—in Pediatric Asthma: A Clinicopathological Correlation with Disease Severity at a Tertiary Care Hospital in Eastern Uttar Pradesh

Background: Bronchial asthma is a common long-term (chronic) lung disease that is associated with episodes of variable airflow blockage and persistent inflammation of the airways. Measurement of some inflammatory markers like absolute eosinophil count (AEC), C-reactive protein (CRP) and total immunoglobulin E (IgE) is based on the idea that they may indicate disease activity and severity helping with disease risk stratification and management. The objective is to assess the contribution of AEC, CRP and total IgE in children with asthma and to draw a clinicopathology correlation with the severity of the disease. Material and Methods: A cross sectional analytical study was carried out in the Department of Department of Paediatric, Maa Vindhyavasini Autonomous State Medical College, Mirzapur, Uttar Pradesh for 18 months in a hospital setting. A total of 120 children aged from 5 to 18 years had a clinically diagnosed bronchial asthma were enrolled. Demographic and clinical information was collected and then the severity of asthma was determined based on the Global Initiative for Asthma (GINA) guidelines. The serum levels of AEC, total IgE and serum CRP were measured. Data was analysed with SPSS version 26.0 and p<0.05 was regarded as statistically significant. Results: Of the 120 participants 58.3% were males, with a mean age of 9.8 ± 3.4 years. The most common presentation was moderate persistent asthma (40.0%). There was a significant increase in mean AEC, CRP, and total IgE with increasing disease severity (p<0.001). High AEC (or more specifically >700 cells/µL), high CRP (or more specifically >10mg/L) and high IgE (or more specifically >800IU/mL) were highly associated with severe persistent asthma. The total IgE, AEC and CRP had positive correlations with asthma severity (r=0.74, 0.71 and 0.65 respectively) and in addition the levels of these inflammatory markers had significant negative correlation with the pulmonary function (p<0.001). Conclusion: There is a significant association between the severity of asthma in children and AEC, CRP and total IgE. Such easy-to-measure markers could be useful as ancillary tools to guide clinical practice in the management of the disease, in characterizing high risk children and in determining individual management in everyday clinical practice.

Keywords: Pediatric asthma; Absolute eosinophil count (AEC); C-reactive protein (CRP); Immunoglobulin E (IgE); Inflammatory biomarkers; Disease severity; Bronchial asthma; Clinicopathological correlation; Children; Airway inflammation.