Clinical and immunological features of bronchial asthma phenotype with obesity in children

E.V. Churyukina, A.A. Lebedenko, G.A. Galkina, M.V. Dudareva, M.A. Levkovich

Rostov State Medical University, Rostov-on-don, Russia

ALLERGOLOGY AND IMMUNOLOGY IN PEDIATRICS, Volume 54 • Number 3 • September 2018, pp. 14 – 20
DOI: 10.24411/2500-1175-2018-00012

Abstract

The paper presents the results of a study of 82 adolescents aged 12 to 16 years, of which 42 patients suffering from bronchial asthma (BA), divided into 2 groups, taking into account the z-Score index (SDS BMI), and 40 healthy children without respiratory pathology, with normal body weight (SDS BMI 0-1), who made up the control group. General clinical, anamnestic features, parameters of external respiration function, cytokine and immune statuses of each group of children were studied. Identified the clinical features of this phenotype of asthma and changes of the immune status of patients with bronchial asthma with obesity, namely: stimulation of T – and b-cellular link; increased parameters of oxidative metabolism of neutrophils, decreased reserve capacity of oxygen-dependent phagocytosis, which in combination with elevated concentrations of proinflammatory cytokines (IL-6, TNF) and CRP, as well as serum IgA levels, total IgE in comparison with the data of patients without obesity BA and control group – associated with systemic inflammation, leading to increased activity of allergic inflammation of the respiratory tract. In this case, the correlation analysis revealed a strong direct relationship between b-lymphocytes (CD19+) and the index of the ratio of waist (WS) and hip volume (HV), indicating the ability of abdominal fat deposition to activate, including the humoral link of the immune system.

References

Сизякина Л.П., Чурюкина Э.В. Клинико-иммунологическая характеристика фенотипа бронхиальной астмы с синдромом вторичной иммунной недостаточности // Российский аллергологический журнал. 2015. № 2. С. 11–14. http://rusalljournal.ru/
Чурюкина Э.В. Эффективность иммуномодуляторов в комплексном лечении больных тяжелой гормонозависимой бронхиальной астмой :дис. … канд. мед. наук. ГОУВПО «Ростовский государственный медицинский университет». Ростов-на-Дону, 2007.
Мицкевич С.Э. Фенотипы бронхиальной астмы у детей и дифференцированная тактика диагностики и лечения // Вестник Челябинского государственного университета. 2014. № 4 (333). Образование и здравоохранение. Вып. 3. С. 79–85.
Шартанова Н.В., Суровенко Т.Н., Глушкова Е.Ф. Сочетание бронхиальной астмы и ожирения: современные представления о проблеме // Аллергология и иммунология. – 2015. № 2–3. С. 40–49.
Игнатова Г.Л., Макарова Е.А. Бронхиальная астма и ожирение: клинико-патогенетические аспекты выделения нового фенотипа заболевания // Современные проблемы науки и образования. 2016. № 4. URL: , id=25017
Boulet L.P. Asthma and obesity // Clin. Exp. Allergy. 2013. Vol. 43, № 1. P. 8–21.
An official American Thoracic Society Workshop report: obesity and asthma / A.E.Dixon, F.Holguin, A. Sood et al. // Proc. Am. Thorac. Soc. 2010.Vol. 7,№ 5. P. 325–335.
Tantisira K.G., Weiss S.T. Complex interactions in complex traits: obesity and asthma // Thorax. 2001. Vol. 56, Suppl. 2. P. 64–73
Beuther D., Sutherland E. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemilogic studies // Am.J.Respir. Crit. Care Med. Apr 2007. Vol. 175,№7. P. 661–666.
Dietary restriction and exercise improve airway inflammation and clinical outcomes in overweight and obese asthma: a randomized trial / H.A.Scott, P.G.Gibson, M.L. Garg et al. // Clin. Exp. Allergy. 2013. Vol. 43, № 1. P. 36–49.
DietzW.H., RobinsonT.N. Clinical practice. Overweight children and adolescents // N. Engl. J. Med. 2005.Vol. 352.P. 2100–2109.
Чурюкина Э.В., Сизякина Л.П. Патогенетические аспекты формирования различных вариантов бронхиальной астмы // Российский аллергологический журнал. 2017. № 1. С. 194–196. http://rusalljournal.ru/
Recent advances in the relationship between obesity, inflammation and insulin resistance / J.Bastard, M.Maachi, C.Lagathu et al// Eur. Cytokine Netw. Mar 2006. Vol. 17, № 1.P. 4–12.
Pretolani M., Goldman M. Cytokines involved in the downregulation of allergic airway inflammation // Res. Immunol. 1997. Vol. 148, № 1. P. 33–38.
Defective leptin/leptin receptor signaling improves regulatory T-cell immune response and protects mice from atherosclerosis / S.Taleb, O.Herbin, H. Ait-Oufellaet al.// Arterioscler. ThrombVasc Biol. Dec 2007. Vol. 27, № 12.Р. 2691–2698.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, revised 2017. ⦋cited 2017 May 17⦌. Availablefrom: www.ginaasthma.org
Чурюкина Э.В., Голошубова Е.А. Оптимизация алгоритма спирометрической верификации диагноза бронхиальной астмы // Российский иммунологический журнал. – 2015. Т.9, № 5. С. 240. http://www.immunoforum.ru
Ковальчук Л.В., Чередеев А.Н. Методические рекомендации по оценке иммунного статуса. М., 1984. С.55.
AdeniyiF.B., YoungT. Weightloss interventions for chronic asthma // Cochrane Database Syst. Rev. 2012. Vol. 7. D009339.
Body fat distribution and inflammation among obese older adults with and without metabolic syndrome. Health ABC Study /J.Y.Koster, S.Stenholm, D.E. Alley et al. // Obesity (Silver Spring). 2010.Vol. 18.P. 2354–2361.

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Churyukina EV, Lebedenko AA, Galkina GA, Dudareva MV, Levkovich MA. Clinical and immunological features of bronchial asthma phenotype with obesity in children. Allergology and Immunology in Pediatrics. 2018;54(3):14-20. (In Russ.) https://doi.org/10.24411/2500-1175-2018-00012

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E.V. Churyukina
email: echuryukina@mail.ru.