Asthma in children: can serum tryptase levels predict disease severity?

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Takeaway
  • Serum baseline tryptase (sBT) distinguished children with asthma from healthy controls, except in cases of mild intermittent asthma.

Why this matters

  • sBT level may have potential as a predictor of disease severity.

Key results

  • Median sBT levels in mild and moderate-severe persistent asthma were 4.2 μg/L and 4.7 μg/L, respectively.
  • Levels were similar in mild intermittent asthma vs healthy controls ( 3.1 vs 2.5 μg/L; P=.335).
  • To distinguish children with asthma vs healthy controls, a cut-off of 3.2 μg/L showed sensitivity of 75.4%, specificity of 88.2%, and AUC of 0.844. 
  • To distinguish persistent vs intermittent asthma, a cut-off value of 3.6 μg/L had 85.9% sensitivity, 88.9% specificity, and AUC of 0.906. 
  • sBT showed weak performance in distinguishing patients with mild intermittent asthma vs healthy controls (sensitivity 41.7%, specificity 88.2%, AUC 0.646). 
  • sBT strongly correlated with childhood asthma control test (C-ACT) scores, serum IgE, and eosinophil counts. 
  • sBT did not significantly corelate with C-ACT scores in mild intermittent asthma. 
  • sBT was closely associated with FEV1 predicted, FEV1:FVC, serum interleukin-13 (IL-13) levels, and interferon-gamma (IFN-γ):IL-13, but not serum IFN-γ levels.

Study design

  • Observational study of 114 children with asthma and 34 age-matched controls. 
  • Funding: None.

Limitations

  • Small, monocentric, monoethnic study.