Immunoglobulin Isotypes and Complement Components (C3, C4) as a Biomarkers Correlated to Wheezy Children: a Case-Control Study

El-jwhri, Mohamed Faiz Faraj (2019-09-09)

Wheeze chest is a common problem among preschool children, and represents a common disorder characterized by airways obstruction. Almost 30% of children manifest wheeze chest symptoms before the age of three and 50% before the age of six. Their parents report at least one attack within this period (El-Asheer et al. 2016).Wheeze chest is common throughout early life and childhood. However, it is very rare in neonatal period. (El-Gamaland El-Sayed,2011) ?? Recurrent attacks of wheeze chest have a significant morbidity and have been estimated that about one third of school-age children manifest the symptom during the first 5 years of life. In young children, wheezing is associated with a poor quality of life. (et al. Eur J Pediatr 2015) When wheezing occurs for the first time, it appears to be triggered by some sort of viral infection. In this condition, the patient will be diagnosed with bronchiolitis if a respiratory distress takes place. Evident of respiratory syncytial virus (RSV) infection will make the diagnosis firmer. Wheezing can be classified into two main categories: unremitting and episodic wheeze. Unremitting wheezing is defined as children with distinct episodes of wheezing with a wide range of intermittent symptoms including wheezing at night or in response to exercise, laughter and cold air. Atopy is hardly ever associated with episodic wheezing and it rarely progresses to asthma later on in life. However, in the very first years of life atopic sensitization is often associated with preschool children who are suffering from unremitting wheezing. Environmental air pollution and prenatal exposure to tobacco smoke are considered to be environmental exposures affecting the growth of the airways. They are also considered to be associated with decreased postnatal lung function and with unremitting preschool wheezing. (Frey and von Mutius 2009

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Wheeze chest is a common problem among preschool children, and represents a common disorder characterized by airways obstruction. Almost 30% of children manifest wheeze chest symptoms before the age of three and 50% before the age of six. Their parents report at least one attack within this period. The major aims were to assess the correlation between the immunoglobulin (IgA, IgM, IgG, and IgE), complement, and the level of eosinophils and development of wheeze chest. And also correlate the level of IgE with the numbers of the attacks per year, age, family history, and eosinophilic count. A total number of a randomized (n=72) cases were involved in this study, divided into 2 groups, (n=52) patients with recurrent wheezy chest attacks and (n=21) controls. Five milliliters of blood sample were equally collected from all participants. All patients’ patents/relatives were present while withdrawing the blood samples and all of them were informed that this study was for the purpose of a medical research and to fulfill a requirement of under-graduation project, and all signed for approval. Three out of twelve variables have been found to be significant according to the correlation part in this study. Number of attacks strongly correlated with IgE with a P-value of (P=0.001), as well as the manifestation with a P-value of (P=0.002), while age was weakly correlated with IgE with a P-value of (P=0.005). The other 9 variables in this study were found to be insignificant, correlating with IgE. The two groups this test was used to determine are the controls (n=21) and the effected individuals (e=52). All thirteen variables were included in the test showing that all are insignificant, except for IgE (p>0.001) highly significant, number of attacks (p>0.001) highly significant, manifestation (p>0.001) highly significant, family history (p>0.001) highly significant and IgM (p=0.059) significant. Measuring IgE, IgM, and IgA in both control and effected children, approved only for IgE only, while disapproved for IgM, IgA, IgG, C3, C4 and eosinophil since there was no significant differences between patients and controls groups.

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