Simge Atar Bese, Gülten Tuncerler, Cihangir Sahin, Nur Torer, Ozge Çevik, Pinar Uysal, Duygu Erge
These findings suggest that serum endocan is associated with airway dysfunctioning and may reflect disease activity during pediatric AE, while IOS may provide additional information regarding persistent small-airway involvement after recovery.
BACKGROUND: Asthma exacerbations (AE) impose a significant burden on children and the healthcare systems, highlighting the need for objective biomarkers and functional assessment tools.
OBJECTIVE: This study aimed to evaluate serum endocan levels and respiratory function parameters during AE and the post-recovery (PR) period, and to compare the results with healthy controls.
MATERIALS AND METHODS: In this prospective longitudinal observational study, children aged 6-18 years were evaluated during AE (n = 66), 1 month after recovery (PR group, n = 54), and as age- and gender-matched healthy controls (HC, n = 50). All participants underwent spirometry, impulse oscillometry (IOS), and serum endocan measurement.
RESULTS: Serum endocan levels were significantly higher in the AE group than in the PR and HC groups [267.33 (186.68-370.20) vs. 133.07 (38.26-226.78) and 118.11 (42.93-180.20) pg/mL, respectively; P < 0.001]. Spirometric indices, including zFEV1, zFVC, zFEV1/FVC, and zFEF25-75, were significantly lower in the AE group than in both comparison groups (all P < 0.05). Compared to healthy controls, children in the AE group exhibited higher R5-20, Fres, and AX values and lower zX20 values (all P ≤ 0.002). R5-20 remained significantly higher during AE than in the PR period (P = 0.038), while spirometric indices showed significant improvement after recovery (all P < 0.05). Notably, despite normalization of spirometric parameters and serum endocan levels, the PR group continued to exhibit higher R5-20 and AX values and lower zX20 values than healthy controls (all P < 0.05), suggesting persistent small-airway dysfunctioning. Serum endocan levels showed weak-to-moderate negative correlations with zFEF25-75, zFEV1, and zFEV1/FVC (Spearman's rho = -0.306, -0.291, and -0.223, respectively; all P ≤ 0.013).
CONCLUSION: These findings suggest that serum endocan is associated with airway dysfunctioning and may reflect disease activity during pediatric AE, while IOS may provide additional information regarding persistent small-airway involvement after recovery.