الفهرس 
List of Contents
Chapter 2 : Airway Inflammatory BiomarkersOnly 14 pages are availabe for public view
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Abstract
Asthma is considered a series of complex, overlapping individual diseases or phenotypes, each defined by its unique interaction between genetic and environmental factors. These conditions include syndromes characterized by allergen-exacerbated, non allergic and aspirin-exacerbated factors along with syndromes best distinguished by their pathologic findings, response to therapy, and natural history. Identifying different asthma phenotypes and their underlying pathophysiologies can help in selecting the best treatment course for each patient. Our hypothesis depends on classification of asthmatic children according to their clinical phenotypes after validation of their symptoms. This approach to asthma phenotyping is a multidimensional approach based mainly on clinical symptomatology, airway inflammatory biomarkers, together with pulmonary functions. This classification of asthmatic patients that is based mainly on clinical symptoms could be a trial for using noninvasive techniques and in turn tailoring asthma treatment. The current study included the asthmatic children presented solely with cough without other symptoms (shortness of breath or wheezes), we tried to explore their clinical characteristics and laboratory airway biomarkers. Allergic rhinitis was present in 82% of asthmatic cases, meanwhile GERD represents 64% as a risk factor among cases, (52%) of cases were suffering from atopic dermatitis and 26% of cases were obese. Regarding pulmonary function tests, cough asthma phenotype cases showed statistically significant decrease in FEV 1%, FVC% and FEV1/FVC ratio. Regarding inflammatory profile, they showed significant increase in total serum IgE, peripheral eosinophilic percent and TGF-β1. Whereas, serum IL-10 showed significant decrease in asthmatic cases compared to controls. In conclusion, we tried to define one of symptom based asthma phenotypes, cough phenotype; in attempt to found asthma phenotype endotype link. In current study cough phenotype showed significant increase of total serum IgE in cases with AD compared to cases without, and also they showed significant increase of serum IL-10 in cases with GERD compared to cases without. Also, cough phenotype showed significant increase of serum TGF-β1 levels as a promoting effect of airway remodeling and significant increase of eosinophilic percentage as a mirror image of eosinophilic pattern of airway inflammation. This throws a light of importance of phenotyping of patients with asthma, as a trial helping for tailoring asthma medications. In all these settings, the evoked dilemma of asthma phenotyping could be only useful if they could have significant clinical implications.