Клиническое значение оксида азота выдыхаемого воздуха, назального оксида азота, эозинофилов периферической крови как маркеров воспаления дыхательных путей при бронхиальной астме и аллергическом рините

Abstract

Chronic airway inflammation plays an important role in the development and progression of bronchial asthma (BA) and allergic rhinitis (AR). The lack of correlation between the severity of clinical symptoms and the activity of inflammation determines the need to develop and introduce various biomarkers into clinical practice. Allergic ВА and AR are predominantly based on eosinophilic inflammation. Sufficiently studied markers of eosinophilic inflammation of the respiratory tract are peripheral blood eosinophils, exhaled nitric oxide (FeNO), nasal nitric oxide (nNO). FeNO increases in BA and AR, decreases with the use of glucocorticoids, and can be used to monitor the course of these diseases as well as in the diagnosis of BA. nNO can also be used as a surrogate marker for eosinophilic inflammation of the upper airways, but research results are conflicting, and further research is required on the clinical significance of this marker. A significant limitation of the use of nitric oxide levels in real clinical practice is the high cost of analyzers and their components. The search for cheaper markers that can be used in practical work to assess eosinophilic inflammation of the upper and lower respiratory tract, in particular, peripheral blood eosinophils, is relevant. A large number of studies have proven the possibility of using peripheral blood eosinophils as markers of eosinophilic inflammation of the lower respiratory tract. They are comparable to induced sputum eosinophils and can be useful in assessing the severity and control of asthma as well as in prescribing biological therapy. In the available literature, it was not possible to find data on the use of peripheral blood eosinophils to assess inflammation of the upper respiratory tract. Airway inflammation markers are an important tool for clarifying the phenotype/endotype of respiratory diseases and for an individual approach to the treatment of patients with BA and AR.