ORIGINAL ARTICLE
Year : 2018  |  Volume : 12  |  Issue : 2  |  Page : 154-159

Bronchial asthma: clinical phenotypes and endotypes and their relation with glucocorticoids circadian rhythm and parasympathetic activity


1 Professor of Allergy, Respiratory and Clinical Immunology Department, Mansoura University, Faculty of Medicine, Mansoura, Egypt
2 Professor of Pediatrics, Mansoura University, Faculty of Medicine, Mansoura, Egypt
3 Professor of Clinical Pathology, Mansoura University, Faculty of Medicine, Mansoura, Egypt
4 Lecturer of Pediatrics, Mansoura University, Faculty of Medicine, Mansoura, Egypt

Correspondence Address:
Wafaa Nabil Laimon
MD degree in Pediatrics, Lecturer of Pediatrics, Mansoura University Children’s Hospital, Al-Gomhoria Street, Mansoura, 35516
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejb.ejb_8_17

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Introduction Asthma is a heterogeneous disease and presents in different clinical patterns ‘phenotypes’ as a result of diverse pathobiological background ‘endotypes’. Objectives The aim of this study was to study serum interleukin-13 (IL-13) levels and the frequency of (IL-13) +1923C/T gene polymorphism in Egyptian children with asthma and to study glucocorticoids circadian rhythm in nocturnal asthma. Patients and methods The frequency of (IL-13) +1923C/T gene polymorphism genotypes was determined in 114 asthmatic Egyptian children and compared with a matched group of 152 healthy controls using PCR. Serum IL-13 and cortisol a.m. and p.m. concentrations in serum were assessed using enzyme linked immunosorbent assay. Results Serum IL-13 was found to be significantly higher in asthmatic patients when compared with the control group (P<0.0001). In the asthmatic group, forced expiratory volume in 1 s showed a significant negative correlation with serum IL-13 (ρ=−0.2, P=0.03), whereas peripheral blood eosinophilic % showed a significant positive correlation with serum IL-13 (ρ=0.18, P=0.05). No statistically significant differences were found between asthmatic patients and controls in IL-13 C1923T genotype frequency. A significantly lower serum cortisol pm was found in asthmatic patients with nocturnal symptoms when compared with those without nocturnal symptoms (P<0.0001). Conclusion Serum IL-13 is significantly higher in asthmatic patients when compared with controls. (IL-13) +1923C/T gene polymorphism is not a risk factor for development of asthma in Egyptian children. Nocturnal symptoms in some asthmatic patients can be partly attributed to lower serum cortisol level at night.


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