Serum osteoprotegerin levels in school-aged children with asthma

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Hikmet Tekin Nacaroglu
Övgü Büke
Özlem Bostan Gayret
Meltem Erol
Oguzhan Zengi


Asthma, Childhood, Osteoprotegerin


Background: Various inflammatory biomarkers have been used in asthma cases for evaluating inflammation, however it has been determined that the majority of these biomarkers are insufficient for putting forth the course and severity of the disease. Osteoprotegerin is a glycoprotein mediator in the lung and macrophages. As far as we know, there are no studies about the role played by osteoprotegerin in child patients with asthma.

Objective: It was planned to examine the relationship between osteoprotegerin levels in childhood asthma and respiratory functions and airway inflammation and to assess its use as a biomarker.

Methods: The study included patients aged 6---16 years who were diagnosed with asthma at the pediatric allergy outpatient clinic of Bagcilar Training and Research Hospital in Turkey. The correlation analyses for the osteoprotegerin levels of asthma patients and their respiratory functions were examined.

Results: The age average of asthma cases was 10.61 ± 3.04 years and 51.2 % were female. No statistically significant difference was observed between the osteoprotegerin levels of the groups (p > 0.05). A negative and statistically significant correlation was observed between the FEV1 and FVC values and osteoprotegerin levels (p = 0.015, p = 0.003).

Conclusions: This was the first study to examine the relationship between osteoprotegerin levels and airway inflammation in children with asthma. We believe that there is a need for wider scale studies in which clinical symptoms and more parameters are evaluated for defining the role played by osteoprotegerin level in children with asthma and for determining its usability as a biomarker.

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1. Asthma Management and Prevention [accessed 27.8.19]

2. Akelma AZ, Kanburoglu MK, Cizmeci MN, Mete E, Catal F, Tufan N. Level of serum neutrophil gelatinase-associated lipocalin in childhood asthma. Allergol Immunopathol. 2015;43:142-6.

3. Bloemen K, Van Den Heuvel R, Govarts E, Hooyberghs J, Nelen V, Witters E, et al. A new approach to study exhaled proteins as potential biomarkers for asthma. Clin Exp Allergy. 2011;41:346-56.

4. van de Kant KD, Jansen MA, Klaassen EM, van der Grinten CP, Rijkers GT, Muris JW, et al. Elevated inflammatory markers at preschool age precede persistent wheezing at school age. Pediatr Allergy Immunol. 2012;23:259-64.

5. Akelma AZ, Cizmeci MN, Kanburoglu MK, Bozkaya D, Catal F, Mete E, et al. Elevated level of serum osteopontin in schoolage children with asthma. Allergol Immunopathol. 2014;42:275-81.

6. Simonet WS, Lacey DL, Dunstan CR, Kelley M, Chang MS, Luthy R, et al. Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell. 1997;89:309-19.

7. Tsuda E, Goto M, Mochizuki SI, Yano K, Kobayashi F, Morinaga T, et al. Isolation of a novel cytokine from human fibroblasts that specifically inhibits osteoclastogenesis. Biochem Biophys Res Commun. 1997;234:137-42.

8. Schoppet M, Preissner KT, Hofbauer LC. RANK ligand and osteoprotegerin: paracrine regulators of bone metabolism and vascular function. Arterioscler Thromb Vasc Biol. 2002;22:549-53.

9. Stejskal D, Bartek J, Pastorkova R, Ruzicka V, Oral I, Horalik D. Osteoprotegerin, RANK, RANKL. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2001;145:61-4.

10. Hofbauer LC, Shui C, Riggs BL, Dunstan CR, Spelsberg TC, O’Brien T, et al. Effects of immunosuppressants on receptor activator of NF-B ligand and osteoprotegerin production by human osteoblastic and coronary smooth muscle cells. Biochem Biophys Res Commun. 2001;280:334-9.

11. Boyce BF, Xing L. Functions of RANKL/RANK/OPG in bone modeling and remodeling. Arch Biochem Biophys. 2008;473:139-46.

12. Dovio A, Data V, Angeli A. Circulating osteoprotegerin and soluble RANKL: do they have a future in clinical practice? J Endocrinol Invest. 2005;28:14-22.

13. Chang YH, Lin KD, He SR, Hsieh MC, Hsiao JY, Shin SJ. Serum osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) are elevated in type 2 diabetic patients with albuminuria and serum osteoprotegerin is independently associated with the severity of diabetic nephropathy. Metabolism. 2011;60:1064-9.

14. Plantinga M, Guilliams M, Vanheerswynghels M, Deswarte K, Branco-Madeira F, Toussaint W, et al. Conventional and monocyte-derived CD11b(+) dendritic cells initiate and maintain T helper 2 cell-mediated immunity to house dust mite allergen. Immunity. 2013;38:322-57.

15. Schmudde I, Laumonnier Y, Kohl J. Anaphylatoxins coordinate innate and adaptive immune responses in allergic asthma. Semin Immunol. 2013;25:2-11.

16. Shi JH, Lin YG, Li TS. The roles of dendritic cells in antigen presentation and the pathogenesis of asthma. Zhonghua Jie HeHe Hu Xi Za Zhi. 2005;28:22-7.

17. Yang X, Wang X, Chi M, Zhang M, Shan H, Zhang QH, et al. Osteoprotegerin mediate RANK/RANKL signaling inhibition eases asthma inflammatory reaction by affecting the survival and function of dendritic cells. Allergol Immunopathol. 2019;47:179-84.

18. Anand DV, Lahiri A, Lim E, Hopkins D, Corder R. The relationship between plasma osteoprotegerin levels and coronary artery calcification in uncomplicated type 2 diabetic subjects. J Am Coll Cardiol. 2006;47:1850-7.

19. Maruyama K, Takada Y, Ray N, Kishimoto Y, Penninger JM, Yasuda H, et al. Receptor activator of NF-kappa B ligand and osteoprotegerin regulate proinflammatory cytokine production in mice. J Immunol. 2006;177:3799-805.

20. Rhee EJ, Lee WY, Kim SY, Kim BJ, Sung KC, Kim BS, et al. Relationship of serum osteoprotegerin levels with coronary artery disease severity, left ventricular hypertrophy and C-reactive protein. Clin Sci (Lond). 2005;108:237-43.

21. Buzi F, Maccarinelli G, Guaragni B, Ruggeri F, Radetti G, Meini A, et al. Serum osteoprotegerin and receptor activator of nuclear factors kB (RANKL) concentrations in normal children and in children with pubertal precocity, Turner’s syndrome and rheumatoid arthritis. Clin Endocrinol (Oxf). 2004;60:87-91.

22. To M, Ito K, Ausin PM, Kharitonov SA, Barnes PJ. Osteoprotegerin in sputum is a potential biomarker in COPD. Chest. 2011;140:76-83.

23. Kumar RM, Pajanivel R, Koteeswaran G, Menon SK, Charles PM. Correlation of total serum immunoglobulin E level, sputum, and peripheral eosinophil count in assessing the clinical severity in bronchial asthma. Lung India. 2017;34:256-61.

24. Di Lorenzo G, Mansueto P, Melluso M, Morici G, Norrito F, Esposito Pellitteri M, et al. Non-specific airway hyperresponsiveness in mono sensitive Sicilian patients with allergic rhinitis. Its relationship to total serum IgE levels and blood eosinophils during and out of the pollen season. Clin Exp Allergy. 1997;27:1052-9.