RELATIONSHIP AMONG SERUM ZINC LEVELS AND SEVERITY AS WELL AS CONTROL OF CHILDHOOD ASTHMA

Yıl 2018, Cilt: 19 Sayı: 1, 17 - 23, 15.01.2018

Bahri Elmas , Öner Özdemır

https://doi.org/10.18229/kocatepetip.411179

Öz

OBJECTIVE: Childhood asthma is a multifactorial disease. It is known that anti-inflammatory and anti-oxidant agents play important roles in the pathogenesis of asthma. However, there are conflicting reports about the roles of antioxidant trace elements such as zinc in asthma. The aim of our study was to investigate the relationship between the serum zinc levels and the severity and control of asthma.

MATERIAL AND METHODS: This study enrolled 56 pediatric patients diagnosed with asthma between the ages of 3 to 17 between July 2014 and April 2015, and 26 healthy children. Control levels of asthma were determined based on the Global Initiative for Asthma Guidelines 2014 criteria. Serum zinc levels were studied using the atomic absorption spectroscopy method. Pulmonary function tests were performed on all patients who complied with the spirometry device.

RESULTS: Serum zinc levels were not statistically significant different between the asthma and control groups but significantly higher in the partially controlled asthmatic group compared with the full control asthmatic group (p=0.023). There was a statistically significant negative correlation between the control level of asthma and zinc levels (r: -0.437, p = 0.001). The zinc level in the group with FVC below 80% was significantly higher (p = 0.001). There was no significant difference in zinc levels according to asthma severity (p = 0.228). There was no significant correlation between asthma severity and serum zinc level (r = 0.168, p = 0.217).

CONCLUSIONS: Serum zinc levels were associated with the level of control of astma in children. Serum zinc levels might be considered as a useful biomarker that supports other parameters to determine the level of asthma control in children.

Anahtar Kelimeler

Asthma, childhood, control, severity

ÇOCUKLUK ÇAĞI ASTIMININ KONTROL VE ŞİDDET DÜZEYİ İLE SERUM ÇİNKO DÜZEYLERİ ARASINDAKİ İLİŞKİ

Öz

AMAÇ: Çocukluk çağı astımı multifaktöriyel bir hastalıktır. Patogenezinde anti-inflamatuvar ve anti-oksidan ajanların önemli rol oynadığı bilinir. Bununla birlikte anti oksidan çinko gibi eser elementlerin rolü ile ilgili farklı görüşler mevcuttur. Bizim çalışmamızın amacı astım kontrol ve şiddeti ile serum çinko düzyleri arasındaki ilişkiyi belirlemekti.

GEREÇ VE YÖNTEM: Çalışmaya Temmuz 2014 ile Nisan 2015 tarihleri arasında 3-17 yaş arası astım tanısı almış 56 hasta ve 26 sağlıklı çocuk alındı. Astım kontrol düzeyleri GINA 2014 kriterlerine göre belirlendi. Serum çinko düzeyleri atomic absorbsiyon spektroskopi metodu ile çalışıldı. Yapılabilen hastalara solunum fonksiyon testleri uygulandı.

BULGULAR: Astım ve kontrol grubu serum çinko düzeyleri arasında anlamlı fark bulunmadı. Serum çinko düzeyleri tam kontrollü astım grubuna göre kısmi kontrollü astım grubunda anlamlı şekilde yüksek bulundu (p=0.023). Astım kontrol düzeyi ile serum çinko düzeyleri arasında anlamlı negative korelasyon izlendi (r: -0.437, p=0.001). FVC %80 altında olan grupta serum çinko düzeyleri anlamlı şekilde yüksek bulundu (p=0.001). Astım şiddet düzeyine göre serum çinko düzeyleri arasında fark bulunmadı (p=0.228). Astım şiddeti ile serum çinko düzeyleri arasında anlamlı korelasyon saptanmadı (r=0.168, p=0.217).

SONUÇ: Serum çinko düzeyleri çocuklarda astım kontrolü ile ilişkili idi. Serum çinko düzeyleri astım kontrol düzeylerini belirlemede diğer parametrelere destekleyici olarak düşünülebilir.

Anahtar Kelimeler

Astım, çocukluk çağı, kontrol, şiddet, çinko

Kaynakça

• Gelfand EW. Pediatric asthma: a different disease. Proc Am Thorac Soc. 2009;6:278-82. Zalewski PD, Truong-Tran AQ, Grosser D, Jayaram L, Murgia C, Ruffin RE: Zinc metabolism in airway epithelium and airway inflammation: basic mechanisms and clinical targets. A review. Pharmacol Ther 2005;105:127-149.
• Alavinezhad A, Boskabady MH. The prevalence of asthma and related symptoms in Middle East countries. Clin Respir J. 2017 May 24. doi: 10.1111/crj.12655.
• Qu J, Li Y, Zhong W, Gao P, Hu C. Recent developments in the role of reactive oxygen species in allergic asthma. J Thorac Dis. 2017;9:E32-E43.
• Holgate ST, Lackie PM, Davies DE, Roche WR, Walls AF. The bronchial epithelium as a key regulator of airway inflammation and remodelling in asthma. Clin. Exp. Allergy 1999; 29: 90–5.
• Topic A, Francuski D, Nikolic A, et al. The Role of Oxidative Stress in the Clinical Manifestations of Childhood Asthma. Fetal Pediatr Pathol. 2017:1-10. doi: 10.1080/15513815.2017.1315199.
• Jayaram L, Chunilal S, Pickering S, Ruffin RE, Zalewski PD. Sputum zinc concentration and clinical outcome in older asthmatics. Respirology. 2011;16:459-66.
• Arik Yilmaz E, Ozmen S, Bostanci I, Misirlioglu ED, Ertan U. Erythrocyte zinc levels in children with bronchial asthma. Pediatr Pulmonol. 2011;46:1189-93.
• Romieu I, Sienra Monge JJ, Ramı´rez Aguilar M, et al. Antioxidant supplementation and lung functions among children with asthma. exposed to high levels of air pollutants. Am J Respir Crit Care Med. 2002;166:703-9.
• Truong-Tran AQ, Ruffin RE, Zalewski PD. Visualization of labile zinc and its role in apoptosis of primary airway epithelial cells and cell lines. Am J Physiol Lung Cell Mol Physiol 2000;279:1172–1183.
• Rerksuppaphol S, Rerksuppaphol L. Zinc Supplementation in Children with Asthma Exacerbation. Pediatr Rep. 2016;8:6685.
• El-Alameey IR, Fathy GA, Shady MMA, et al. Relationship of Oxidant and Antioxidant Markers to Asthma Severity in Egyptian Asthmatic Children. Open Access Maced J Med Sci. 2017;5:645-650.
• Ozdemir O. Zinc and Allergy Relation. MOJ Immunol 2014;1:00005. DOI: 10.15406/moji.2014.01.00005.
• Sagdic A, Sener O, Bulucu F, et al. Oxidative stress status and plasma trace elements in patients with asthma or allergic rhinitis. Allergol Immunopathol (Madr). 2011; 39:200-5.
• Di Toro R, Galdo Capotorti G, Gialanella G, Miraglia del Giudice M, Moro R, Perrone L. Zinc and copper status of allergic children. Acta Pediatr Scand 1987;76: 612-7.
• Kocyigit A, Armutcu F, Gurel A, Ermis B. Alterations in plasma essential trace elements selenium, manganese, zinc, copper, and iron concentrations and the possible role of these elements on oxidative status in patients with childhood asthma. Biol Trace Elem Res. 2004;97:31-41.
• Razi CH, Akelma AZ, Akin O, et al. Hair zinc and selenium levels in children with recurrent wheezing. Pediatr Pulmonol. 2012;47:1185-91.
• Lytvynets' LIa. (Macro-and microelements imbalance in etiology and progression of bronchial asthma in children]. Lik Sprava. 2013;4:33-8.
• Khanbabaee G, Omidian A, Imanzadeh F, Adibeshgh F, Ashayeripanah M, Rezaei N. Serum level of zinc in asthmatic patients: a case-control study. Allergol Immunopathol (Madr). 2014;42:19-21.
• Ghaffari J, Khalilian A, Salehifar E, Khorasani E, Rezaii MS. Effect of zinc supplementation in children with asthma: a randomized, placebo-controlled trial in northern Islamic Republic of Iran. East Mediterr Health J. 2014;20:391-6.
• Tahan F, Karakukcu C. Zinc status in infantile wheezing. Pediatr Pulmonol. 2006;41:630-4.
• Picado C, Deulofeu R, Lleonart R, et al. Dietary micronutrients/antioxidants and their relationship with bronchial asthma severity. Allergy. 2001;56:43-9.
• Nurmatov U, Devereux G, Sheikh A. Nutrients and foods for the primary prevention of asthma and allergy: systematic review and meta-analysis. J Allergy Clin Immunol. 2011;127:724-33.
• Iurina TM, Kupriianova TA, Chereĭskaia NK, Liamina OI, Stotskaia TV. [Macro- and trace elements of blood in elderly patients with bronchial asthma]. Klin Med (Mosk). 2002;80:30-4.