Investigation of the relationship between asthma control test and mediators of exhaled breath condansate with asthma control scale and severity of astma in childhood asthma

Objective: Cysteinyl leukotrienes which have affect on contraction of airwaysmooth muscle, increase of vascular permeability, increase of mucus secretion, decreaseof mucociliary clearence, and 8-isoprostane are well known the oxidative stressmediators, and it has been shown that they are increased in exhaled breathcondansate(EBC). In this study, investigation of the relation between asthma control test(ACT) and mediators of EBC with asthma control scale (ACS) and severity of asthma(SA) was aimed.Patients and Methods: One hundred seventy three included to asthmatic children(56 female, 117 male) were this study. Information about age, sex, history of atopy,number of attack, presence of nocturnal and exercise dyspnea, medication status,presences of humidity, animal and cockroach at home, history of parental smoking wereobtained. Scores of ACT, ACS and SA were determined. Complete blood count, levelof Ig E, skin prick test and pulmonary function test results were obtained. Cysteinylleukotrien and 8-isoprostane levels in EBC were studied with ELISA method.Results: Asthma control test can define controlled astma with 80 % sensitivityand 77 % specifity if ACT score was higher than 23 (p=0.0001). When the score ofACT ? 20, it defines uncontrolled asthma whith 79 % sensitivity and 78 % specifity(p=0.0001). There is a positive correlation between ACT score with forced expiratoryvolume in one second (FEV1)/forced vital capacity(FVC) (p=0.032) and with forcedexpiratory flow at 25-75 % (FEF % 25-75)(p=0.029). Patients without a prophylacticmedication have increased level of cysteinyl leukotrienes in EBC than the patients withprophylactic medication. Patients with moderate persistant asthma have increased levelof 8-isoprostane in EBC than the patients with mild persistant asthma (p=0.052).Patients who have 1-4 asthma attacks per year have lower level of 8-isoprostane in EBCthan the patients who have ?5 asthma attacks per year(p=0.048).Conclusion: Asthma Control Test (ACT) is an important test that can be used todetermine Asthma Control Scale (ACS). There was a positive correlation between theseverity of asthma and number of asthma attacks and the level of 8-isoprostan in EBC.Prophylactic medication decreases the level of cysteinyl leukotrienes in EBC.Key Words: Asthma Control Scale, Astma Control Test, Children, Cysteinyl leukotriene,Exhaled breath condansate, Severity of asthma, 8-Isoprostane