Return to search

Uticaj šestomesečne inhalatorne kortikosteroidne terapije na vrednosti interleukina-33 u serumu kod dece sa alergijskom astmom / The effect of six-month inhaled corticosteroid treatment on IL-33 serum levels in children with allergic asthma

<p>Uvod: Interleukin 33 (IL-33) ima značajnu ulogu u inflamatornim i autoimunskim oboljenjima, ali se sve vi&scaron;e proučava njegov značaj u imunopatogenezi različitih alergijskih oboljenja, uključujući i alergijsku astmu (AA). Cilj: Ispitivanje vrednosti IL-33 u serumu pacijenata sa AA pre i posle &scaron;estomesečne inhalatorne kortikosteroidne terapije (ICS Th) i povezanosti dobijenih vrednosti IL-33 sa određenim kliničkim i laboratorijskim karakteristikama ovih pacijenata. Metode: Vrednost IL-33 u serumu određena je kod 61 pacijenta sa AA pre započinjanja i posle sprovedne &scaron;estomesečne ICS Th i kod 30 zdrave dece. U obradi podataka primenjene su standardne metode deskriptivne i analitičke statistike. Rezultati: Kod pacijenata sa nelečenom AA, serumske vrednosti IL-33 su signifikantno veće u odnosu na pacijente kod kojih je sprovedena &scaron;estomesečna ICS Th (p&lt;0,05), kao i u odnosu na zdravu decu (p&lt;0,01). Pacijenti sa AA koji su tokom 6 meseci lečeni sa ICS Th i zdrava deca imaju slične vrednosti IL-33 u serumu (p&gt;0,05). Kod pacijenata sa AA pre započinjanja i 6 meseci posle primene ICS Th ne postoji signifikantna korelacija između vrednosti IL-33 u serumu i eozinofilnih granulocita periferne krvi (p&gt;0,05), eozinofilnih granulocita u nazalnom sekretu (p&gt;0,05) i ukupnog IgE u serumu (p&gt;0,05). Kod pacijenata sa nelečenom AA postoji signifikantna negativna korelacija između vrednosti serumskog nivoa IL-33 i sledećih parametara plućne fukcije: FEV1 (p&lt;0,05), FEV1/FVC (p&lt;0,05), PEF(p&lt;0,05) i MEF 25/75 (p&lt;0,05). Posle &scaron;estomesečne ICS Th pobolj&scaron;ava se plućna funkcija, odnosno dolazi do porasta brzine protoka vazduha u disajnim putevima kao i promena u plućnim volumenima u zavisnosti od stepena opstrukcije u odnosu na vrednosti pre uključenja antiinflamatorne terapije (FEV1, FVC, FEV1/FVC, PEF, MEF 25/75, za sve vrednosti p&lt;0,01). Dok je signifikantna negativna korelacija dokazana između IL-33 i vrednosti FEV1 (p&lt;0,01), FVC (p&lt;0,01) i PEF (p&lt;0,05). Zaključak: Serumski nivo IL-33 je značajno povi&scaron;en kod dece sa nelečenom, odnosno nekontrolisanom AA. &Scaron;estomesečna primena ICS dovodi do značajne redukcije IL-33 u serumu čije su vrednosti u negativnoj korelaciji sa vrednostima FEV1, FVC i PEF, odnosno pozitivnoj korelaciji sa težinom i kontrolom AA. Rezultati na&scaron;e studije ističu da IL-33 ima značajnu ulogu u imunopatogenezi AA. Određivanje serumske vrednosti IL-33 može biti koristan indikator težine AA.</p> / <p>Introduction: Interleukin 33 (IL-33) plays a significant role in inflammatory and autoimmune diseases, but its significance in the immunopathogenesis of various allergic diseases including allergic asthma (AA) has gained increasing attention in research over recent years. Objective: Testing serum levels of IL-33 in patients with AA before and after a six-month inhaled corticosteroid therapy (ICS Th) and correlation of IL-33 values with specific clinical and laboratory characteristics of these patients. Methods: Serum levels of IL-33 were determined in 61 patients with AA prior to the initiation of ICS Th and following the six-month ICS Th as well as in 30 healthy children. Data processing was performed applying standard methods of descriptive and analytical statistics. Results: In patients with untreated AA, serum levels of IL-33 were significantly higher as compared to the patients who have received a six month ICS Th (p &lt;0.05) as well as to healthy children (p &lt;0.01). Patients with AA, who were treated with ICS Th for six months, and healthy children have similar serum IL-33 (p&gt; 0.05). In patients with AA, significant correlation between serum IL-33 levels and eosinophilic peripheral blood granulocytes (p&gt;0.05), eosinophilic granulocytes in nasal secretion (p&gt;0.05) and the total IgE in serum has not been observed for the period prior to initiation and 6 months after the administration of ICS Th. In patients with untreated AA, there is significant negative correlation between serum IL-33 and the following pulmonary functions test results: FEV1 (p&lt;0.05), FEV1/FVC (p&lt;0.05), PEF (p&lt;0.05) and MEF 25/75 (p&lt;0.05). After a six-month ICS Th, significant improvement of pulmonary functions was evident, that is, increase in airflow speed and lung volume change as compared to the values determined before the initiation of the anti-inflammatory therapy (FEV1, FVC, FEV1/FVC, PEF, MEF 25/75, for all values p&lt;0.01). Significant negative correlation between IL-33 and the values of FEV1 (p&lt;0.01), FVC (p&lt;0.01)and PEF (p&lt;0.05) has been established. Conclusion: Serum level of IL-33 is significantly elevated in children with untreated, i.e., uncontrolled AA. A six-month ICS Th asthma treatment results in significant reduction of serum levels of IL-33. This level is negatively correlated with FEV1, FVC and PEF values while positively correlated with the severity of the disease and control of AA. The results of our study point out that IL-33 plays an important role in the immunopathogenesis of AA. Quantification of serum IL-33 levels can be a useful indicator of the severity of AA.</p>

Identiferoai:union.ndltd.org:uns.ac.rs/oai:CRISUNS:(BISIS)108237
Date10 April 2019
CreatorsMilanović Borko
ContributorsVijatov-Đurić Gordana, Jovanović-Privrodski Jadranka, Atanacković-Marković Marina, Stojanović Vesna, Konstantinidis Nada, Petrović Slobodanka
PublisherUniverzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, University of Novi Sad, Faculty of Medicine at Novi Sad
Source SetsUniversity of Novi Sad
LanguageSerbian
Detected LanguageUnknown
TypePhD thesis

Page generated in 0.003 seconds