Показники цитокінового статусу дітей раннього віку з алергічним ураженням шлунково-кишкового тракту залежно від забезпеченості вітаміном D

Abstract

The rapid growth in the prevalence of allergic diseases among children in the modern world dictates the need for detailed study of pathogenetic mechanisms, the search for new methods of diagnosis, treatment and prevention of this pathology. Recent studies of the important immunological effects of vitamin D in allergic pathology make it important to study its effect on the course of gastrointestinal food allergy (GIFA) in young children. Purpose - to determine the serum concentrations of IL-10 and IL-17 in young children with GIFA, depending on the supply of vitamin D. Materials and methods. We examined 34 children aged from 2 months to 3 years with isolated gastrointestinal symptoms or a combination of gastrointestinal and skin symptoms associated with food. The comparison group consisted of 22 children of the same age with an unencumbered individual and family history of allergies. All examined children had quantified serum cytokine (IL-10, IL-17A) levels by enzyme-linked immunosorbent assays and serum hydroxycalciferol (25(OH)D) levels. Vitamin D deficiency in subjects was considered at a concentration of 25(OH)D in serum <20 ng/ml (or <50 nmol/l), a concentration of 21 ng/ml to 29 ng/ml (or from 50.1 nmol/l up to 74.9 nmol/l) was assessed as vitamin D deficiency. A sufficient concentration of vitamin D was considered to be 25(OH)D serum level >30 ng/ml. Data of clinical and laboratory researches were processed by methods of mathematical statistics accepted in biology and medicine. Results. There was a significantly increase in the average concentrations of IL-17A (180.4±23.0 pg/ml) and IL-10 (113.8±15.0 pg/ml) in children with gastrointestinal food allergy and in the comparison group - 45.7±18.1 pg/ml and 32.1±11.4 pg/ml, respectively, (p<0.05), which reflects the intensity of the allergic inflammatory process in the gastrointestinal tract. In children with allergic gastrointestinal inflammation who were deficient in vitamin D, the mean concentrations of proinflammatory cytokine IL-17A and regulatory cytokine IL-10 were significantly higher than in children with GIFA and optimal supply of vitamin D 244.9±19.7 ng/ml and 49.45±2.14 ng/ml respectively against 135.2±33.3 ng/ml and 26.41±1.81 ng/ml respectively, (p<0,05), which indicates a more intense activity of the inflammatory process in the intestine of children with insufficient supply of vitamin D. Conclusions. Allergic gastrointestinal inflammation in young children is characterized by increased concentrations of serum proinflammatory and regulatory cytokines - IL-10 and IL-17A, that is a protective reaction of the immune system and can be used as a marker of allergic inflammation in GIFA. The study of the regulatory effect of vitamin D on the expression of cytokines (IL-10 and IL-17A) in allergic gastrointestinal inflammation in young children will optimize the pathogenetic treatment of gastrointestinal food allergies. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local ethics committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Key words: cytokine status, young children, allergic pathology of the gastrointestinal tract, vitamin D.