The role of serum nuclear factor erythroid 2-related factor 2 in childhood bronchial asthma.

Asthma is one of the most common chronic airway disease of childhood. Poor asthma control has been associated with antioxidant deficiencies. To assess the association of bronchial asthma in Egyptian children with serum nuclear factor erythroid 2-related factor2 (NRF2) and its relation to disease severity. The study included 60 asthmatic children with comparable 60 controls (age ranged from 6-16 years). Subjects were classified according to the severity of asthma into mild or moderate asthma in group I, and severe asthma in group II. Antioxidant markers including superoxide-dismutase (SOD), glutathione peroxidase (GPX) and NRF2 were assessed once in blood and serum of both subjects and controls. Mean serum NRF2 and GPX were significantly lower in asthmatic group than controls group (26.36 ± 4.18 pg/mL and 5.76 ± 0.81 mU/mL vs 29.05 ± 3.87 and 6.23 ± 0.97 respectively,  < 0.05). No significant difference was detected regarding SOD ( > 0.05). In severe bronchial asthma, mean serum NRF2 and GPX were significantly lower than in mild and moderate asthma (24.29 ± 1.86 pg/mL and 5.56 ± 0.67 mU/mL vs 27.95 ± 4.77 and 6.03 ± 0.90 respectively,  < 0.05). No significant difference was found in SOD regarding severity of bronchial asthma. Low NRF2 was the only predictor of the severity of bronchial asthma (OR = 0.749 and 95% CI 0.595 - 0.942). The pathogenesis of childhood bronchial asthma may be associated with low serum NRF2 which may be a strong predictor of the disease severity.