الفهرس 
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Abstract
Allergic asthma is an inflammatory disease of the airways driven by an overactive immune response against allergens (Sheih et al., 2016).Exposure to aeroallergens is an important factor in the pathogenesis and control of allergic diseases, including asthma. Indoor allergens are of particular importance and principally include house dust mites, pets such as dogs and cats, pests such as cockroach and rodents, and Molds (Sheehan and Phipatanakul, 2016). Moderate and severe asthma are associated with increased neutrophils and Th17 cytokines such as IL-17A, IL-17F and IL-23, in the bronchoalveolar lavage fluid of patients (Newcomb and Peebles Jr, 2013) The aim of the work: is to assess the relation between serum level of IL -23 and severity of bronchial asthma in atopic asthmatic children. Type of study: This study is case control study.
Materials and Methods:. The study was carried out from December 2017 to December 2019. This study included 50 atopic asthmatic children were following up at Pulmonology, Asthma and Clinical Immunology Unit Mansoura University Children Hospital and 50 children are age and sex matched as control group. inclusion criteria:-Asthmatic children above 7 years (the suitable age required for spirometry).Diagnosis of bronchial asthma was done according to the Global Initiative for Asthma (GINA) recommendations, based on clinical asthma symptoms and spirometry a ≥12% increase in forced expiratory flow in one second (FEV1).Clinical diagnosis of atopy depends on current or past symptoms of atopic dermatitis, allergic rhino- conjunctivitis (seasonal or perennial) or food allergy. Atopy is confirmed when children fulfilled one of the following criteria: total IgE level higher than the upper normal limits for age (32 IU/ml); blood eosinophilia (more than 5%) in differential count or absolute count (more than 450/μl); or skin prick testing that is 3 mm greater than control. Results: All the studied groups were comparable for age and sex. We found that the most common allergens among our studied children with atopic asthma were, pigeon representing 30%.Clinical presentation of the included cases had been classified according to severity into severe (24%), moderate (36%) and mild (40%).Our study showed that there was statistically significant difference between cases and control group as regard serum level of IL23. Median IL23 was higher in cases group it was 840pg/ml (300-1460) while median IL23 in control group was 116.50 (65.4-400), P value was <0.001 In the current work, there was statistically significant relation between severity of asthma and pulmonary function test, as regard FVC%, FEV1% , FEV1/FVC%, P value was <0.001.in our study there was no statistically significant relation between severity of asthma in children and serum IL-23 level. Conclusion: We conclude that there was no statistically significant relation between severity of asthma in children and serum IL-23 level. Recommendations: The dynamics of concentration of IL-23 in severe asthma evolution has not been evaluated properly yet. More studies concerned about evaluating IL-23 level in severe asthma are essential.