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Plasma asymmetric dimethylarginine in childhood asthma exacerbation

Background Asymmetric dimethylarginine (ADMA) is a new marker of inflammation in different inflammatory disorders. Bronchial asthma as a chronic disease of inflammatory nature is related to an expanded levels of numerous markers of inflammation which are used to assess the degree of severity of childhood asthma and might be the object of new therapeutic alternatives aiming at enhancing the management of such diseases. Aim The aim of this study was to evaluate the plasma levels of ADMA in asthmatic children during asthma exacerbation and to assess the relationship between these levels and the degree of asthma control during the past 6 months. Patients and methods A total of 250 asthmatic children, aged 6–12 years, with acute exacerbation were evaluated during their visit to emergency room unit for serum ADMA (measured by high-performance liquid chromatography) and peak expiratory flow rate before receiving any treatment. They were 125 males and 125 females. Moreover, 100 participants were taken as controls. Results Plasma ADMA was significantly higher in asthmatic children compared with the control group. It was higher in asthmatic children who had poorer response to initial therapy at emergency room. Plasma ADMA showed significant negative correlation with peak expiratory flow rate and significant positive correlation with a number of asthma exacerbations during the past 6 months Conclusion Plasma ADMA is elevated during exacerbation of childhood asthma. High levels above 2.83 μmol/l can predict poor response to initial therapy at emergency room and the need for hospitalization with sensitivity and specificity of 91.5 and 84.25%, respectively.