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

Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.
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.