Determination of platelet activation in children with asthma

Asthma is a chronic inflammatory disease which mast cells, eosinophils, T lymphocytes, dendritic cells, macrophages and neutrophils are the cells that play a role in inflammation. Coughing, wheezing, shortness of breath is caused by attacks. In literature, mean platelet volume (MPV) and platelet distribution range (PDW) values change in periods of inflammatory diseases such as rheumatoid arthritis and familial mediterranean fever flare-ups. The purpose of this study, is to examine whether changes in MPV, PDW, plateletcrit (PCT) and P selectin levels of children with asthma during an attack and asymptomatic period which is at least 1 month after the attack, can be used as a marker. 40 patients aged between 6 to 16 were included in the study, who were enrolled to the Faculty of Medicine, Baskent University Ankara Hospital Pediatric Allergy Clinic between April 2011- July 2011. 22 children had mild and 18 children had moderate-to-severe asthma attack. Blood samples were taken for MPV, PDW, PCT, P selectin, eosinophils and platelets levels at the attack. Pulmonary function tests were performed with spirometry. In acute therapy, inhaled steroids, inhaled short-acting β2-agonist and oral steroid were given to the patients. At least 1 month after the attack patients were seen again during their symptom-free period. Blood was taken again from patients for MPV, PDW, PCT, P selectin, eosinophil and platelet counts and pulmonary function tests were repeated. While there was not any significant difference in platelet counts and the PDW levels between attack and for at least 1 month after the attack, MPV, PCT and P selectin levels were significantly lower at the time of attack. While significant decrease was observed in MPV and PCT levels in mild and moderate-severe asthma attack group during attack compared to immediately after the attack, no significant change was observed in platelet count, PDW and P selectin levels. When mild and moderate-to-severe asthma attack groups during attack were compared, no statistically significant difference was found between platelet activation markers. However, the number of white blood cells and fragmented after the attack, was found to be significantly higher. As a result, according to our opinion complete blood count parameters Which is include MPV, PDW and PCT that are commonly used in routine practice can be used to determine the attack and the severity. The most important problem of our study was the limited number of patients, but in future we suggest that more extensive studies, can find out clinical significance of platelet activation markers in asthma attack more clearly.