Актуальні проблеми сучасної медицини (Apr 2018)
Non-specific factors of immunity in the pathogenesis of bronchial asthma in children
Abstract
The role of nonspecific immunity factors in the pathogenesis of bronchial asthma in children with different clinical forms and degrees of severity of its course has been investigated in the work. A total of 228 children with BA who were aged from 5 to 14 years were examined. We determined the complement titer (C0) in the serum, components of complement C2 and C3a, the protein component of blood serum of properdin, and the level of total serum IgE. The data were statistically processed using Student's t-test. In patients with non-allergic form of BA, the greatest increase in deviation from the norm was noted in relation to the circulating immune complexes (CIC)(t = 16.74). The second ranking place occupies an increased content of C3a (t = 8.21), then in descending order from IgE (t = 4.55) to C0 (t = 1.89). Rating of the degree of deviation from the norm of indices of nonspecific immunity in patients with atopic BA has shown that, in contrast to patients with non-allergic form of BA, the main pathogenetic role belongs to reactive hypersensitivity (IgE; t = 17,39). The value of immunocomplex hypersensitivity in atopic form of BA is in the second ranked place. In children with mixed BA, an intermediate pathogenetic variant was identified, which consisted in approximately equal activity of both immunocomplex and reactive reactions with a certain dominant of the first: from CIC (t = 13.66) to IgE (t = 11.19). Thus, the obtained data confirm that in the pathogenesis of bronchial asthma in children is involved immunocomplex immunological mechanism (type III according to Gell-Coombs), which enhances immunospecific reactions, aggravating the severity of the course of the disease. In the blood serum of children with bronchial asthma, there is a decrease in the protein component properdin, which is consumed to activate the alternative (properdin) complement pathway through C3a, nonspecific immunological mechanisms are able to stimulate and maintain chronic allergic inflammation in the bronchopulmonary system in children with bronchial asthma.
