Медицинская иммунология (Aug 2017)
IMMUNOLOGICAL MARKERS OF UNCONTROLLED ATOPIC BRONCHIAL ASTHMA IN CHILDREN
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.
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