Abstract
Bronchial asthma is a prevalent chronic allergic disease of lungs at early ages. A priority task in allergology is to search biological markers related to uncontrolled atopic bronchial asthma. Cytokines fulfill their distinct function in pathogenesis of atopic bronchial asthma, participating at the initiation, development and persistence of allergic inflammation in airways, causing different variations of clinical course of the disease (with respect to its acuteness, severity, frequency of exacerbations). The present work has studied indices of cellular and humoral links of immunity, as well as levels of some pro and anti-inflammatory cytokines in peripheral blood serum (IL-4, IL-10, IL-2 and TNFα), aiming to determine potential markers of uncontrolled atopic bronchial asthma in children. A group of Caucasian (European) children was involved into the research: Cohort 1, moderate atopic bronchial asthma with controlled course during the last 3 months (n = 59); Cohort 2, severe/moderate-severe atopic bronchial asthma with uncontrolled course of the disease within last 3 months (n = 51), Cohort 3 – control, practically healthy children without signs of atopy (n = 33). All the children included in the group with atopic bronchial asthma underwent regular mono/combined basic therapy at high/ intermediate therapeutic doses. We performed a comparative analysis of cell population indices reflecting certain cellular immunity links, and determined significantly lower levels of CD3 + lymphocytes, as well as decrease in relative and absolute contents of CD4 + and CD8+ cells in the cohort with uncontrolled course of atopic bronchial asthma, as compared with controlled-course cohort. When evaluating concentrations of cytokines in peripheral blood serum of the patients with controlled and uncontrolled atopic bronchial asthma, we revealed significantly higher levels of IL-2, IL-4, and IL-10, as compared to control group. It was found that TNFα concentration is considerably higher in both cohorts of the patients, being 2to 3-fold higher than the levels of this cytokine in control group. When comparing the cohorts with different control of the disease course, we have found that TNFα concentration in the cohort with uncontrolled bronchial asthma is statistically higher than among children with controllable course of the disease. Hence, the following parameters may serve as potential markers of pediatric atopic bronchial asthma with uncontrolled course: low levels of total Т lymphocyte numbers in peripheral blood, and decreased counts of CD4 + , CD8 + cells; IgE hyperproduction; low contents of common IgA, and high concentration of TNFα in peripheral blood serum.
Highlights
Маркеры бронхиальной астмы у детей Markers of bronchial asthma in children ции межклеточных взаимодействий, осуществляемой цитокинами, в процессе формирования аллерген-специфического иммунного ответа
Что при дефиците IL-2 наблюдается повышенное содержание иммуноглобулинов классов IgE и IgG1 в сыворотке крови, что может косвенно свидетельствовать об активации Тh2-лимфоцитов
Поступила 21.04.2017 Отправлена на доработку 02.05.2017 Принята к печати 20.06.2017
Summary
В работе изучены показатели клеточного и гуморального звеньев иммунитета, а также уровни некоторых провоспалительных и противовоспалительных цитокинов в сыворотке периферической крови (IL-4, IL-10, IL-2 и TNFα) с целью определения маркеров неконтролируемого течения атопической бронхиальной астмы у детей. При оценке концентрации цитокинов в сыворотке периферической крови у больных с контролируемым и неконтролируемым течением атопической бронхиальной астмы отмечался статистически значимо высокий уровень IL-2, IL-4 и IL-10 в сравнении с группой контроля. При сравнении групп с различными уровнями контроля над течением заболевания, выявлено, что концентрация TNFα в группе больных неконтролируемой бронхиальной астмой статистически значимо выше, чем в группе с контролируемым течением заболевания. Медицинская Иммунология Medical Immunology (Russia)/Meditsinskaya Immunologiya образом, в качестве маркеров неконтролируемого течения атопической бронхиальной астмы у детей могут служить: низкий уровень общего количества Т-лимфоцитов в периферической крови и клеток с фенотипом CD4+, CD8+, гиперпродукция IgE, низкое содержание общего IgA и высокая концентрация TNFα в сыворотке периферической крови. Ключевые слова: атопическая бронхиальная астма, контролируемая астма, неконтролируемая астма, цитокины, иммуноглобулины, маркер заболевания
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