Nasal lavage fluid nuclear factor kappa B and cytology in asthmatic children and their correlation with severity and control

BackgroundAsthma is the most common chronic inflammatory disease in childhood. The relevance of NFκB which is known to be an inflammatory marker in upper airway epithelium and its relation to lower airway inflammation has not been fully studied in childhood asthma.Aim of studyThe study aimed at evaluating the diagnostic value of nasal lavage nuclear factor kappa B and cells as a less-invasive bench-side maneuver and inflammatory biomarkers in asthmatic children and correlating with asthma severity.MethodsThis case-control study recruited 60 asthmatic children from Pediatric Chest Clinic, Children’s Hospital; Ain Shams University. Thirty healthy non-asthmatic children-age and sex-matched were included as a control group. Nasal lavage cytology, nasal lavage NFκB and forced expiratory volume in 1s (FEV1) % of predicted for age and sex were estimated.ResultsNasal lavage NFκB levels were significantly higher in asthmatics than in controls with a mean of 0.129±0.113μg/μg nuclear proteins and 0.0176±0.013μg/μg nuclear proteins, respectively. Nasal lavage NFκB and eosinophil levels were significantly higher with increasing asthma severity and with worsening levels of asthma control. Nasal lavage NFκB showed a sensitivity of 87% and a specificity of 87% in predicting asthma severity.ConclusionsDespite that spirometry and clinical classification are the gold standards for grading of asthma, Nasal lavage NFκB and cells can be considered as a new less-invasive non-subjective inflammatory marker for assessment of different grades of asthma severity and control