BIOMARKERS OF INFLAMMATION AT BRONCHIAL ASTHMA IN CHILDREN WITH ALTERNATIVE DEBUT OF THE DISEASE

Abstract

Objectives - to analyze the activity of the inflammatory process in the airways of childrenwith bronchial asthma depending on different onset of the disease.Material and methods. Keeping to the principles of bioethics a comprehensiveretrospective examination of 319 children suffering from BA was performed. In 257children (clinical group I) bronchial asthma developed against a background of chronicobstructive bronchitis. The second clinical group included 43 children, in whom asthmadebuted after community-acquired pneumonia. The third (III) clinical group consistedof 19 children in whom asthma was first verified after inpatient treatment for asthmaticstatus.Results. According to the severity of bronchial asthma, it was found that the representativesof the III clinical group, compared with other patients, significantly more often had a severecourse of the disease. For patients of the I clinical group in the debut it is characterizedby increased eosinophils and decreased neutrophil counts in sputum, for patients ofgroup II - increased eosinophils and epitheliocytes, but a decrease in lymphocytes, andfor children of clinical group III - low eosinophils sputum with a simultaneous increasein neutrophils. In particular, a statistically significant increase in the content of VEGF,a decrease in the content of cationic proteins, MMP-9, and interleukins-6, and -13 inthe sputum indicates the predominance of neoangiogenesis in children of clinical groupIII. Instead, in the representatives of the II clinical group the remodeling processes weremainly caused by the inflammatory process with the release of intracellular eosinophiliccationic proteins.Conclusion. These data indicate the discrete nature of the type and severity of theinflammatory process of the respiratory tract in the dynamics of observation in childrenof clinical comparison groups, which suggests the presence of certain phenotypicdifferences due to the alternative onset of the disease, which in its turn was determinedby different triggers. Such deviations of the inflammatory process indicate that patientswith asthma require a personalized approach to differentiated diagnostic monitoring andtargeted anti-inflammatory treatment, taking into account the peculiarities of the onsetof the disease.