Study subject
A total of 393 bronchial asthmatic children aged between 5 and 12 years,
consisting of 318 stable asthmatics (205 males and 113 females) and 75
acute asthma attack sufferers (47 males and 28 females), were recruited
from the pediatric clinics of the Chang Gung Memorial Hospital, Taiwan,
as a part of the ongoing PATCH study (Prediction of Allergies in
Taiwanese Children). A total of 97 (59 males and 38 females) age-matched
healthy subjects with no history of bronchial asthma, allergic, or
immunological diseases) were enrolled from an elementary school in
Taoyuan City, Taiwan. The diagnosis and classification of the clinical
severity of asthma followed the published
guidelines12. Asthma severity was categorized as mild
(intermittent), moderate and severe. The mild-asthma group exhibited a
symptom frequency of less than once a day and nocturnal symptoms of less
than once a week, with an FEV1 > 80% of
predict as well as those experiencing minor limitations in their daily
activities. The inclusion criteria for the children with severe asthma
consisted of frequent daytime symptoms and night waking maybe every
night, an FEV1 <60% of predicted and
experienced major limitations in their daily activities. Patients with
moderate asthma had features between these two extremes. An acute asthma
attack was defined as a patient with dyspnea symptoms and audible
expiratory wheeze accompanied by a 20% reduction in
FEV1. Levels of EBC eicosanoids, FEV1,
and FeNO were measured during acute asthma attack episodes and at two
weeks after the acute asthma attacks. For the management of acute asthma
exacerbation, all of the asthmatic children received terbutaline
inhalation and oral prednisolone 1 mg/kg/day for 3 days. In the two
weeks prior to EBC collection, none of the patients took medication
containing antipyretics or anti-platelet agents that would have
suppressed platelet function. The healthy, non-asthmatic, and
non-allergic subjects served as normal controls. This study was approved
by the Humane Research Committee and informed consents were obtained
from patients’ parents or guardians prior to the start of the study.
Additional phenotypic characterization for participants with asthma
included assessment for BMI and measurement of serum IgE levels (UniCap
100, Pharmacia, Uppsala, Sweden), FEV1, and fraction of
exhaled nitric oxide (FeNO) levels.