Features of Immune Response to Helicobacter Pylori Infection in Children with Bronchial Asthma
Introduction. The course of bronchial asthma in children is often accompanied by gastrointestinal (GI) diseases associated with H.pylori infection. The presence of H.pylori leads to the activation and maintenance of inflammatory process with release of cytokines and mediators of inflammation and subsequent systemic effects. Objective: to study the peculiarities of interferon gamma (IFN-γ) and interleukin (IL)-4, -5 and -13 production as markers of allergic inflammation severity in children with bronchial asthma infected with H.pylori. Materials and methods. There were examined 120 children with bronchial asthma aged 6 to 18 years. Identification of H.pylori was carried out with the help of breathing Helic-test (LLC AMA, Russia). Serum concentrations of IFN-γ and IL‑4, -5 and -13 were determined by enzyme-linked immunoassay (Diaclone test-kits, France) before and 7 days after the end of treatment for GI pathology. Statistical processing was performed using the methods of variation statistics implemented in the software package Statistica 6.1. Results. 78 children with bronchial asthma were diagnosed with GI disease, including 37 cases associated with H.pylori infection. To study the influence of H.pylori on the course of bronchial asthma, children were divided into 3 groups: I group — 37 children with bronchial asthma and GI pathology, infected with H.pylori, II — 41 H.pylori-negative children with bronchial asthma and GI pathology, III — 42 H.pylori-negative children with bronchial asthma without GI disorders. Duration of bronchial asthma in group I was 7.80 ± 0.17 years, in II — 5.90 ± 0.26 years, in group III — 3.90 ± 0.48 years (p < 0.05). The presence of H.pylori infection in children with bronchial asthma was accompanied by lower concentrations of IFN-γ compared to children of group II (8.47 ± 0.14 pg/ml and 9.69 ± 0.32 pg/ml, respectively, p < 0.05). The level of IL‑13 in the blood serum was significantly higher in children of I group versus patients of group II (8.74 ± 0.22 pg/ml and 7.21 ± 0.35 pg/ml, respectively, p < 0.05). Serum concentrations of IL‑4 and IL‑5 were increased in all studied groups compared to the control group and had no correlation with the presence of H.pylori infection. After the treatment of gastrointestinal pathology, there was an improvement in parameters of asthma control, which was associated with a significant reduction of IFN-γ and IL‑13 concentrations in group I, and IFN-γ, IL‑5 and -13 — in group II. Conclusion. The presence of H.pylori infection in children with gastroduodenal pathology occurring against the background of bronchial asthma is accompanied by an imbalance of the immune response, which manifested as reduced production of IFN-γ, IL‑4, and IL‑13 increase compared to H.pylori-negative children. Treatment of GI diseases is associated with a decrease in IFN-γ and cytokines mentioned above that clinically promotes the improvement of bronchial asthma control.
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