Inflammatory Markers of Pulmonary Expirate in Children with Airway Remodeling In Bronchial Asthma.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 9
Abstract
Goal: of research is to study in the dynamics the informative value of the oxidatively modified proteins level in a pulmonary expirate of the school-age patients with bronchial asthma, depending on the degree of bronchial remodeling. Material and methods: To achieve the goal children suffering from persistent bronchial asthma (BA) were examined in parallel groups selected by means of simple randomized sampling using the “experiment-control” method. According to given analysis results at the beginning of the observation patients were divided into two groups of comparison. The first (I) group consisted of 47 patients with VEGF level in sputum exceeding 80.0 ng/ml and reaching 193.71±12.94 ng/l on average. The second (II) group included 49 children with average VEGF level in sputum not reaching the indicated median (49.55±1.24 ng/ml). Condensate of pulmonary expirate was obtained using a patented condenser for 10-15 minutes of free breathing, the usual amount of condensate was 1.5-2.0 ml. The total protein level (g/l) in it was determined by the method of Lowry O.H., the levels of alkaline and neutral 2,4-dinitrophenylhydrazone derivatives of aldehydes and ketones – by the method of Dubinina O.E. et al. According to the informed consent obtained from patients’ parents, biochemical study of PE condensate was performed three times: at the beginning of the monitoring, after 1.5, and after 3 years of observation. The bronchi lability was assessed using graduated jogging with inhalation of 200 mkg of salbutamol test and further calculation of Bronchus Lability Index (BLI, %). Results and discussion: In children from the I clinical group level of the extracellular eosinophilic cationic proteins in sputum averaged 2.78±0.24 pg/ml, while in the comparison group it was 1.77±0.21 pg/ml (P<0.05). Results of the dynamic evaluation of total protein level, aldehyde and ketone derivatives of dinitrophenylhydrazones levels in PE condensate of BA patients indicating the predominance of protein oxidative modification processes in patients with high level of bronchial remodeling markers in sputum. In the dynamics of anti-inflammatory treatment there were discordant changes in these indices of PE, which reflected the higher effectiveness of the standard anti-inflammatory therapy in children I group, possibly due to the eosinophilic nature of airway inflammation. However, in the dynamics of 3-year observation, activity of the oxidative processes in patients from the I group decreased, while in patients from the II group with normal indices in the condensate of RE at the beginning of observation, activity of the oxidative modification increased in the dynamics with the highest level after 1.5-2 years from the beginning of monitoring observation. At the same time, during the period of dynamic observation of the bronchial lability index gradually reduced from year to year only in children from the I group: at the initial examination – 22.14%, and at the final one – 13.28% and the representatives of the II clinical group had an average BLI of 18.55% and 23.89% respectively. Thus, it can be assumed that in children with high level of bronchial remodeling marker in sputum, despite the decrease in the activity of inflammatory process, apparently there was a realization of the risk of structural changes in the airways, as evidenced by the signs of protein release and formation of the bronchial wall rigidity. Conclusions: Examination of the condensate of pulmonary expirate at the beginning of observation give reason to suggest that in children with high level of bronchial neoagnogenesis biomarker (VEGF) in sputum the standard control treatment causes a decrease in the severity of the protein oxidative modification, but at the same time protein release increases and bronchial lability decreases. In the process of dynamic observation in children with asthma from the reference by the parameters of bronchial remodeling group the activity of protein oxidation as well as bronchial lability increases in spite of the standard treatment.
Authors and Affiliations
Tetiana Bilous
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