Archive for March, 2019


Sunday, March 24th, 2019

Asthma is the most common chronic disorder in children all over the world.

Its incidence and prevalence has increased in last decades even in the presence of more advance diagnostic modalities and more sophisticated treatments available now a days.

The cornerstone of controller medication for asthma is inhalational steroid.

Injectable and or oral steroid  is the principal agent for the treatment,and becomes life saving, when a child lends up in emergency department with acute severe exacerbation of asthma.

Few children with asthma do not respond to steroid therapy and the physicians lend up in problem when they give steroid, spend time and then do not see any improvement in the child.

In such situations,if we know which child will not respond to steroids,will be very helpful.

In a research study,192 asthmatic children who were on inhalation steroid treatment and 130 healthy were included.

Serum level of OX40L was estimated in all children.Its level was correlated with clinical characteristics of asthma and the response of steroid treatment.Serum levels of eosinophils,Nutrophils,IgE,Interleukin 6 and TSLP(Thymic stromal lymphopoietin) were estimated in all children.

There was a positive correlation between serum levels OX40L and serum levels of Eosinophils,Nutrophils,IgE,Interleukin 6 and TSLP which are known serum markers of asthma and its severity.

There was a significant high level of  serum OX40L  in asthmatic children in comparision to healthy children and the level of serum 0X40L was much higher in steroid resistant asthma(SRA) in comparision to Steroid sensitive asthma(SSA)

There was a negative correlation between serum level of 0X40L and Asthma score test(AST) and FEV1 which are measured to assess the severity of asthma at regular intervals.

So,the high level of serum 0X40L has 2 meanings,firstly, it indicates more severe asthma and secondly very high level may suggest the asthma is unresponsive to steroid treatment.

In future , the agent targetting this 0XL40 is required to customise the treatment of asthma.


REFERENCES:Elevated serum OX40L is a biomarker for identifying corticosteroid resistance in pediatric asthmatic patients
BMC Pulmonary Medicine — Ma SL, et al. | March 21, 2019