Background: The aim of this study was to explore whether serum baseline tryptase (sBT) levels might be a useful marker not only for the accurate diagnosis of childhood asthma, but also for the prediction of disease severity. Methods: A total of 114 asthmatic children were enrolled in this study, 36 of whom had mild intermittent asthma, 38 had mild persistent asthma, and 40 had moderate to severe persistent asthma. Additionally, 34 age-matched healthy children were enrolled as controls. The sBT levels of these populations were measured using a fluoroenzymeimmunoassay kit. The diagnostic performance of sBT levels and their correlation with asthma severity were systematically investigated using receiver operating characteristic (ROC) analysis and correlation analysis. Results: Children with mild and moderate to severe persistent asthma had significantly increased sBT levels as compared to those with mild intermittent asthma and healthy controls. ROC analysis further demonstrated that sBT levels not only appear to be highly sensitive and specific for distinguishing asthmatic children from healthy controls, but also show good accuracy for the differentiation of various asthmatic subgroups. Correlation analysis revealed that in all asthmatic subgroups sBT levels were significantly correlated with a variety of key markers that reflect the disease severity of asthma, including childhood asthma control test scores, serum IgE and interleukin-13 levels, blood eosinophil counts, and pulmonary test parameters. Conclusions: sBT levels may have a potential use in supporting a diagnosis of asthma in children and as a predictor of disease severity.

1.
Bush A, Fleming L: Diagnosis and management of asthma in children. BMJ 2015;350:h996.
2.
Barnes PJ: Immunology of asthma and chronic obstructive pulmonary disease. Nat Rev Immunol 2008;8:183-192.
3.
Puxeddu I, Levi-Schaffer F: Mast cells and eosinophils: the hallmark of asthma. Paediatr Respir Rev 2004;5(suppl A):S31-S34.
4.
Caughey GH: Of mites and men: trypsin-like proteases in the lungs. Am J Respir Cell Mol Biol 1997;16:621-628.
5.
Vitte J: Human mast cell tryptase in biology and medicine. Mol Immunol 2015;63:18-24.
6.
Yavuz ST, Sackesen C, Sahiner UM, Buyuktiryaki B, Arik Yilmaz E, Sekerel BE, Soyer OU, Tuncer A: Importance of serum basal tryptase levels in children with insect venom allergy. Allergy 2013;68:386-391.
7.
Sahiner UM, Yavuz ST, Buyuktiryaki B, Cavkaytar O, Yilmaz EA, Tuncer A, Sackesen C: Serum basal tryptase may be a good marker for predicting the risk of anaphylaxis in children with food allergy. Allergy 2014;69:265-268.
8.
Hart SP: Asthma severity and adequacy of management. Lancet 2002;359:75.
9.
Voorend-van Bergen S, Vaessen-Verberne AA, de Jongste JC, Pijnenburg MW: Asthma control questionnaires in the management of asthma in children: a review. Pediatr Pulmonol 2015;50:202-208.
10.
Joseph J, Benedict S, Safa W, Joseph M: Serum interleukin-5 levels are elevated in mild and moderate persistent asthma irrespective of regular inhaled glucocorticoid therapy. BMC Pulm Med 2004;4:2.
11.
Gaye B, Sikkema D, Lee TN: Development of an ultra-sensitive single molecule counting assay for the detection of interleukin-13 as a marker for asthmatic severity. J Immunol Methods 2015;426:82-85.
12.
Matsson P, Enander I, Andersson AS, Nystrand J, Schwartz L, Watkins J: Evaluation of mast cell activation (tryptase) in two patients suffering from drug-induced hypotensoid reactions. Agents Actions 1991;33:218-220.
13.
Amin K: The role of mast cells in allergic inflammation. Respir Med 2012;106:9-14.
14.
Frenzel L, Hermine O: Mast cells and inflammation. Joint Bone Spine 2013;80:141-145.
15.
Kucharewicz I, Bodzenta-Lukaszyk A, Szymanski W, Mroczko B, Szmitkowski M: Basal serum tryptase level correlates with severity of hymenoptera sting and age. J Investig Allergol Clin Immunol 2007;17:65-69.
16.
Pattemore PK, Holgate ST: Bronchial hyperresponsiveness and its relationship to asthma in childhood. Clin Exp Allergy 1993;23:886-900.
17.
Brannan JD: Bronchial hyperresponsiveness in the assessment of asthma control: airway hyperresponsiveness in asthma: its measurement and clinical significance. Chest 2010;138:11S-17S.
18.
Ediger D, Sin BA, Heper A, Anadolu Y, Misirligil Z: Airway inflammation in nasal polyposis: immunopathological aspects of relation to asthma. Clin Exp Allergy 2005;35:319-326.
19.
Ferguson AC, Whitelaw M, Brown H: Correlation of bronchial eosinophil and mast cell activation with bronchial hyperresponsiveness in children with asthma. J Allergy Clin Immunol 1992;90:609-613.
20.
Ngoc PL, Gold DR, Tzianabos AO, Weiss ST, Celedon JC: Cytokines, allergy, and asthma. Curr Opin Allergy Clin Immunol 2005;5:161-166.
21.
Holt PG, Sly PD: Th2 cytokines in the asthma late-phase response. Lancet 2007;370:1396-1398.
22.
Barnes PJ: Th2 cytokines and asthma: an introduction. Respir Res 2001;2:64-65.
23.
Prescott SL: New concepts of cytokines in asthma: is the Th2/Th1 paradigm out the window? J Paediatr Child Health 2003;39:575-579.
24.
Miraglia Del Giudice M, Pedullà M, Piacentini GL, Capristo C, Brunese FP, Decimo F, Maiello N, Capristo AF: Atopy and house dust mite sensitization as risk factors for asthma in children. Allergy 2002;57:169-172.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.