INDICATORS OF THE CYTOKINE PROFILE AND STANDARD IMMUNOGRAM IN THE CONTROLLED AND UNCONTROLLED COURSE OF BRONCHIAL ASTHMA IN CHILDREN

Bronchial asthma in children is a multifactorial disease, but it is based on atopic inflammation, which is the focus of the main methods of research and therapy of this pathology. However, if we evaluate not only the fact of the appearance of bronchial asthma in a particular patient, but also consider its course in more detail, and especially the possibility of achieving control over the disease, then indicators of not only atopic inflammation, but also local inflammation in general, acquire great influence, which is one of the reasons for the continuing high percentage of uncontrolled and partially controlled course bronchial asthma in children.

The purpose of this work is to identify changes in cytokine status indicators and immunograms – markers of the risk of uncontrolled bronchial asthma.

167 patients with bronchial asthma were examined, who, based on a standard clinical and instrumental examination, according to the criteria of clinical recommendations, were divided into two groups - controlled (70 people) and partially controlled and uncontrolled (97 children). All of them had their cytokines and IgA, M, G, E levels determined, in blood serum by ELISA, subpopulations of lymphocytes by flow cytometry, indicators of neutrophilic phagocytosis by light microscopy.

In the group with uncontrolled asthma, the following significant differences were noted: a decrease in the level of IL 7, 9 and an increase in IL 8, there is also a higher level of B lymphocytes, Ig E and M, and a lower level of Ig A, similar changes, but less pronounced, were previously detected in other studies when comparing patients with bronchial asthma and conditionally healthy, as well as mild and severe course diseases. There were no significant differences in the other studied indicators.

It is noteworthy that the greater influence on the control of the disease in bronchial asthma is not exerted by atopic cytokines responsible for the very fact of atopic inflammation, but by cytokines of general inflammation, such as interleukins 7, 8, 9, regulating the severity of inflammation in general, the role of IL8 as a cytokine of granulocyte chemotaxis regulating local inflammation is especially interesting.