Pathophysiological relation between the systemic inflammation and the state of small airways in mild asthma with obesity

The aim of present study was to establish the relationship between the level of blood serum cytokines and indexes of pulmonary function as well as to identify the markers of evolving dysfunction of small airways in obese patients with partially controlled mild bronchial asthma. We have examined 53 patients with mild asthma of partially controlled clinical course complicated with obesity (I-II degree). The control group consisted of 25 healthy volunteers. All participants underwent spirometry, bodyplethysmography. Tumor necrosis factor alpha (TNFα), interferon gamma (IFNγ), interleukins (IL) IL2, IL-4, IL-6, IL-10, IL-17A were determined in blood serum. In the patients with partially controlled mild asthma, an increase in IL-17A by 55.8%, and IL-4 by 44.9% was detected, regardless of body mass. According to the results of cluster analysis, two sub-groups were discerned, depending on the state of the small airways and the levels of pro- and anti-inflammatory cytokines. The dysfunction of small airways was shown to be accompanied by hypercytokinemia being more common in bronchial asthma with predominant Th1-and Th17-immune responses. We have revealed an association between IL-17A, IL-6 levels and functional indices reflecting the state of the small airways, as well as correlation between IFNγ and the indices of bronchial obstruction. The features of pulmonary function were found to be dependent on the cytokine status in mild asthma with obesity. Two immuno-functional variants were identified, differing in activity of systemic inflammation, type of immune response, and functional state of the small airways. The revealed relationships allow us to consider IL-17A, IL-6 and IFNγ as markers of small airways dysfunction in mild asthma of partially controlled clinical course associated with obesity

Natriuretic Peptide in Patients with Metabolic Syndrome

The present research aimed at studying the atrial and brain natriuretic peptide (NUP) levels in the blood plasma of patients with Metabolic Syndrome (MS). The research includes 52 patients in total, of which 40 patients with MS constitute the observation group while 12 conventionally healthy people comprise the control group. An increase in the NT-proBNP at 20% (p<0.05) and proANP at 67.8% (p<0.05) was observed in the blood plasma of the patients with MS. We observed a strong correlation between the atrium and brain NUP in the plasma and insulin and the insulin resistance index (IRI) that allows us to consider the NUP levels as the markers of early diagnosis of MS

REGULATION OF IMMUNE RESPONSE OF PATIENTS WITH PARTIALLY CONTROLLED vs CONTROLLED BRONCHIAL ASTHMA

A control group included seventeen conditionally healthy people (Group 1). Eighty-eight patients with proven bronchial asthma (BA) at the age of 22 to 48 were enrolled into the study. I.e., Group 2 included nine patients with well-controlled BA. Group 3 included persons with partially controlled BA (n=79). There were 8 people with easily treated BA in group 2, and 57 such cases in Group 3. The levels of interleukins (IL-4, IL-10, IL-17A), interferon-γ (IFNγ), and tumor-α necrosis factor (TNFα) were monitored by means of flow cytometry technique. The parameters of cellular immunity were registered by flow cytofluorimetry assays. Phagocytosis indicators were studied by means of D. Mayansky method, metabolic activity of neutrophils, by the B.Park method, as modified by E.Shmelev. Evaluation of cellular immunity did not reveal statistically significant differences for distinct CD subpopulations between healthy controls and BA patients. The patients with controlled and partially controlled BA exhibited some changes in cytokine concentrations, i.e., increased IL-4, IL-17А, IL-10 and TNFα levels; changes in phagocytosis and oxygen dependent bactericidal activities of neutrophils. We have revealed higher concentrations of IL-4, IL-17А in the less controlled BA (group 3) , as compared with group 2. TNFα induction remained at significantly higher level in both groups of BA patients, exceeding mean control values by 2.3 times. The degree of IL-10 production in group 2 with controlled BA was significantly higher than in group with partial disease control (group 3, p &lt; 0.001), thus suggesting application of IL-10 levels as an index of active inflammation control. Patients with BA (groups 2, 3) exhibited a decrease of basal IFNγ, as compared to healthy people (p &lt; 0.001). In group 3 (partial control), this parameter was 3-fold lower than in healthy persons. Evaluation of monocyte/phagocyte functions showed statistically significant differences between BA patients and healthy persons. Functional reserve of granulocyte activity and oxidative metabolism were decreased to a similar degree in the patients with well-controlled and partially resistant BA, thus showing their independence on the quality of disease control