Peculiarities of Bronchial Hyperactivity in Children with the Phenotype of Late Onset Asthma Depending On Acetylation Status.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 11
Abstract
Goal: To assess the indices of non-specific reactivity of the bronchi in children suffering from asthma of a late onset considering acetylated status of patients. Material and methods: 72 children suffering from BA of late onset (after six years of age) were examined on the basis of the Pulmonological Department of the Regional Pediatric Clinical Hospital (Chernivtsi). The patients were distributed into two clinical groups depending on acetylation status. The first clinical group (І) included 34 children with LOA phenotype and slow acetylation character, and the second group (ІІ) included 38 children suffering from LOS and quick acetylation phenotype. An average age of the representatives from І clinical group was 11,3±0,6 years, children from the group of comparison – 11,1±3,4 years (р>0,05). The groups did not differ reliably by the main clinical signs. The bronchi lability was assessed using graduated jogging with inhalation of 200 mkg of salbutamol test and further calculation of Bronchospasm Index (BSI, %), Bronchodilatation Index (BDI, %), and of Bronchus Lability Index (BLI, %). Investigation of hypersensitivity of the bronchi to direct spasmogenic factors was carried out by means of standardized inhalation spirometric test with histamine considering recommendations on standardization of the study. The indices of histamine threshold concentration (HTC20) were used to determine hypersensitivity of the respiratory tract. In addition, genetic marker was determined – the character of acetylation by Prebsting-Gavrylov’s method modified by Tymofeyeva, which characterized peculiarities of II phase of the xenobiotic biotransformation system. Results and discussion: On the basis of the presented data a tendency to more pronounced bronchial lability was found (mainly at the expense of considerable bronchospasm in response to the dosed physical exercise) in children with LOA and low acetylation status as compared with the rapid acetylation. Thus, positive bronchospastic test was found in 44,2% of patients with slow acetylation and only in 26,0% of children with rapid acetylation status (Pφ<0,05). The indices of the risk of bronchospasm in response to the dose physical exercise in patients with slow acetylation phenotype compared with rapid acetylation were the following: relative risk – 1,7 [95%CІ: 1,04-2,6] in case of odds ratio – 2,2 [95%CІ: 0,8-5,9]. At the same time, slow acetylation phenotype increased a relative risk of pronounced bronchial lability 2,9 times [95%CІ: 1,9-4,6] in case of odds ratio – 4,7 [95%CІ:1,6-14,2]. Pronounced bronchial hypersensitivity is determined (HTC20<2,0 mg/ml) to occur in 25% representatives of ІІ clinical group and 8% of children from the group of comparison. The indices of the risk promoting development of pronounced respiratory tract hypersensitivity in children suffering from LOA with rapid acetylation type compared with slow acetylation were the following: relative risk – 3,2 (95% CІ: 2,0-5,2) with odds ratio 4,0 (95% CІ: 0,7-21,6). Conclusions: There was established, that the relative risk of a distinct hypersensitivity of the airways increased 3,2 times, the odds ratio of the event was equal to 4,0, in children with late-onset asthma late with rapid type of acetylation as compared to slow acetylators.
Authors and Affiliations
Olha Shakhova
Keywords
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