Cytokine plasma levels in moderate-to-severe asthmatic children with different asthma control

Abstract

Background: Th2 cells and cytokines play a critical role in the formation and activation of inflammation. It is important to study of asthma pathogenesis to identify markers of an uncontrolled disease. Aims and Objectives: To study the role of the IL-4, IL-5, IL-13, and TNF-α plasma levels to the pathogenesis of asthma. Methods: Children were divided into controlled (CA, n=40) and uncontrolled asthma (UA, n=54). The diagnosis, severity and level of control over the course of the disease were established in accordance with GINA. All children were on basic therapy with equivalent doses of inhaled corticosteroids (ICS). The plasma levels of cytokines was measured by using the Milliplex Map Cytokine Panel (Millipore, USA). The calculation of the median (Me) and percentiles (25%; 75%) was carried out using Statistica 6.0. Results: A statistically significant high level of IL-5 in the plasma of CA patients was revealed in comparison with UA (0.54 pg/ml (0.32-1.02)/0.38 pg/ml (0.32-0.58); p=0.05). No statistically significant differences in levels of IL-4, IL-13 and TNF-α in patients was shown. Conclusions: Higher levels of IL-5 in children with moderate-to-severe CA may indicate a greater contribution of eosinophilic inflammation to the pathogenesis of asthma and, therefore, potentially greater susceptibility to a successful response to corticosteroid therapy. We suppose that the level of plasma IL-5 may be used to predict the success of patient’s response to doses of ICS: in children with asthma and low plasma levels of IL-5, higher starting doses of ICS may be required to control the disease.