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. 2013 Aug;132(2):328-35.e5.
doi: 10.1016/j.jaci.2013.03.003. Epub 2013 Apr 26.

The chitinase-like protein YKL-40: a possible biomarker of inflammation and airway remodeling in severe pediatric asthma

Jon R Konradsen  1 , Anna James, Björn Nordlund, Lovisa E Reinius, Cilla Söderhäll, Erik Melén, Asa M Wheelock, Karin C Lödrup Carlsen, Marika Lidegran, Marri Verhoek, Rolf G Boot, Barbro Dahlén, Sven Erik Dahlén, Gunilla Hedlin
Affiliations

The chitinase-like protein YKL-40: a possible biomarker of inflammation and airway remodeling in severe pediatric asthma

Jon R Konradsen et al. J Allergy Clin Immunol. 2013 Aug.

Erratum in

  • J Allergy Clin Immunol. 2013 Nov;132(5):1259. Wheelock, Asa [corrected to Wheelock, Asa M]

Abstract

Background: Problematic severe childhood asthma includes a subgroup of patients who are resistant to therapy. The specific mechanisms involved are unknown, and novel biomarkers are required to facilitate treatment and diagnosis of therapy-resistant asthma. The chitinase-like protein YKL-40 has been related to asthma and airway remodeling.

Objectives: To compare serum YKL-40 levels in children with severe, therapy-resistant asthma (n = 34), children with controlled persistent asthma (n = 39), and healthy controls (n = 27), and to investigate correlations with biomarkers of inflammation and airway remodeling.

Methods: The study protocol included questionnaires, measurement of exhaled nitric oxide in exhaled air, blood sampling for inflammatory biomarkers, and high-resolution computed tomography of the lungs to identify bronchial wall thickening (therapy-resistant only). Serum YKL-40 levels were measured by ELISA, and all asthmatic children were genotyped for a CHI3L1 promoter single nucleotide polymorphism (rs4950928).

Results: Serum YKL-40 levels were significantly higher in children with therapy-resistant asthma than in healthy children (19.2 ng/mL vs 13.8 ng/mL, P = .03). Among children with severe, therapy-resistant asthma, YKL-40 levels correlated with fraction of exhaled nitric oxide in exhaled air (r = 0.48, P = .004), blood neutrophils (r = 0.63, P < .001), and bronchial wall thickening on high-resolution computed tomography (r = 0.45, P = .01). Following adjustment for CHI3L1 genotype, significantly greater levels of YKL-40 were found in children with therapy-resistant asthma than in children with controlled asthma.

Conclusions: YKL-40 levels are increased in children with severe, therapy-resistant asthma compared to healthy children, and also compared to children with controlled asthma following correction for genotype.

Keywords: Asthma; Feno; Fraction of exhaled nitric oxide in exhaled air; HRCT; High-resolution computerized tomography; airway remodeling; children; chitinases; genes; imaging; inflammation.

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