Influence of drugs of protocol therapy on the production of pro-inflammatory cytokines of t-lymphocytes of children with bronchial asthma

Abstract

ABSTRACT. At the current stage of solving the problem in the pathogenesis of atopic BA in moderate-severe and severe course of the disease, the leading role is played by pro-inflammatory cytokines of T-lymphocytes and factors of the late phase of allergic inflammation. Goal. To determine the effect of the drugs of the therapy protocol recommended by GINA (2021) and the Ministry of Health of Ukraine No. 2856 on the production of pro-inflammatory cytokines in children with AD. Materials and methods. The study was conducted in 106 patients with BA and 20 healthy children aged 5 to 14 years in the period of disease remission before and after therapy. The impact of the protocol therapy scheme on the production of pro-inflammatory cytokines and their antibody control in children with different degrees of severity of the course of the disease was evaluated. The results. In asthma in children with a mild persistent course, protocol therapy reduces the release of mediators of the early phase of the allergic disease and the partial production of pro-inflammatory cytokines, which leads to clinical remission of the disease. With a moderately severe persistent course of AD, the influence of protocol therapy drugs reduce the level of production of pro-inflammatory cytokines to weakly positive values, which indicates incomplete control of therapy and unstable clinical remission. In severe persistent AD, protocol therapy partially reduces the production of pro-inflammatory cytokines, but does not affect the late phase of allergic inflammation and the autoimmune component of the pathogenesis of the disease. Conclusions. The recommended GINA protocol therapy (2021) eliminates the early phase and does not affect the late phase of allergic inflammation and the autoimmune component. This requires the development of additional therapy for moderate and severe asthma in children.