Биомаркеры воспаления и контроль бронхиальной астмы у детей

Abstract

Asthma is the heterogeneous lung disease, caused by a chronic inflammation, characterized by various phenotypes, for the identification of which biomarkers can be used. However, most biomarkers are still experimental and have limitations for clinical practice. Objective. To study the link between the values of T2-inflammatory biomarkers in children with poor asthma control and features of asthma treatment. Patients and methods. The study included 100 patients aged 5 to 17 years (average age 13 years) with an established diagnosis of asthma. The level of asthma control of patient was assessed using asthma control tests and asthma control tests in children (ACT and C-ACT). The following markers were studied: the level of total immunoglobulin E (total IgE), peripheral blood eosinophils, fractional exhaled nitric oxide (FeNO), the number of eosinophils in nasal smears. The significance of the marker was determined by statistical data analysis methods used in medicine. Results. Despite the prescribed basic therapy, most children do not achieve normal asthma control. It was revealed that 43% of patients had one or more elevated markers of T2 inflammation. Children with partially controlled and uncontrolled asthma had high levels of total IgE (≥100 IU/ml), elevated levels of eosinophils in the blood (≥400 cells/ml) and high FeNO values (≥20 parts per billion). The most significant biomarker of poor asthma control in children is the level of total serum IgE ≥100 IU/ml. It has been established that allergic asthma in children is usually combined with the predominance of Th2 lymphocytes and eosinophilic inflammation of the respiratory tract. Conclusion. T2-inflammation biomarkers can be used as indicators of respiratory tract inflammation activity and to assess asthma control in children. Key words: biomarkers, asthma, children, asthma control, T2-inflammation