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"Child`s Health" 7 (58) 2014

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Gender features and clinical and prognostic significance of markers neurogenic and allergic inflammation in children with asthma

Authors: Nedelskaya S.N., Akulova E.Y., Solodova I.V., Mazur V.I. - Zaporozhye State Medical University, Zaporozhye, Ukraine

Categories: Pediatrics/Neonatology

Sections: Clinical researches

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asthma, children, neuropeptides, interleukins.

Topics of allergic and neurogenic inflammation in the pathogenesis of bronchial asthma (BA) devoted a lot of research work. But most of the literature covering sided plane pathogenesis of asthma, determine or cytokine activity (leukocyte) level, or neurogenic. Today the lack of comprehensive research indicated both links that do not allow these components to balance the body and integrally assess their impact on the patient's with asthma. Still no information on the concentration in the blood serum of these mediators, depending on the degree of control of asthma is not known, whether there are gender differences mentioned indicators and so on. All the above listed research gaps cause asthma complexity of the problem and the urgency of further research of allergic and neurogenic mechanisms of inflammation in children with asthma, which in turn is the key to the effectiveness of treatment of asthma.

The purpose of the study. Determine the level of neuropeptides VIP, Subst. P and interleukins IL-2, IL-4, IL-5, IFN-gamma in children with asthma with controlled and uncontrolled disease course; establish the existence of gender differences in this contingent of children; identify the impact of the duration of the disease at the level of these indicators; determine the possibility of using the specified parameters as diagnostic criteria for controllability of the disease.

Materials and methods. Concentration levels of neuropeptides VIP, Subst. P and interleukins IL-2, IL-4, IL-5, IFN-gamma was determined in serum by ELISA in 34 children with asthma aged 10-17 years. The children were examined twice - at uncontrolled and controlled of asthma. The survey results were presented in the form of statistical averages - arithmetic mean, median and average error to determine the reliability of the differences used Mann-Whitney test. No reliable difference was considered at p ≤ 0, 05.

Results. Levels of neuropeptide Subst. P and interleukins IL-2, IL-4, IFN-gamma had no statistically significant gender differences. Also, they did not change statistically during anti-inflammatory therapy of asthma. The analysis established the presence of gender differences in VIP and IL-5, namely VIP level was statistically lower in boys with uncontrolled of asthma compared with healthy boys - respectively 0,03 ± 0,003 pg/ml and 0,07 ± 0 , 01 pg/ml (p = 0.002) and the level of IL-5 in boys with uncontrolled of asthma almost 8 times increased compared with a group of healthy boys - respectively 1,46 ± 0,27 pg/ml vs. 0.18 ± 0,12 pg/ml (p = 0.02). Gender susceptibility to boys with asthma may be associated with a decrease in serum levels of endogenous VIP as a bronchodilator and an increase in the level of IL-5 as interleukin allergic inflammation. After a course of anti-inflammatory therapy and transition process to a controlled form, regardless of the duration of illness, increased levels of VIP and IL-5 - reduced to the corresponding parameters of healthy children, namely at a controlled flow of asthma as 5 years, and over 5 years VIP level increases - according to 0,05 ± 0,005 pg/ml and 0,05 ± 0,004 pg/ml; IL-5 - falling under 0,46 ± 0,14 pg/ml and 0,74 ± 0,13 pg/ml. Patients girls statistically significant fluctuations in VIP and IL-5 in the transition to a controlled form of the disease is not established.


1. Neuropeptide levels Subst. P and interleukins IL-2, IL-4, IFN-gamma had no statistically significant differences between patients with asthma and healthy children is also not established gender differences statistically significant fluctuations in concentration depending on the degree of asthma control and duration of disease.

2. Analysis of the levels of VIP and IL-5 set of gender-dependent fluctuations: VIP level was statistically lower and the level of IL-5 - boys higher in patients with uncontrolled form of asthma compared with healthy boys.

3. Possible to assume that a predisposition to asthma and a higher incidence of asthma in boys is associated with decreased levels of VIP as a bronchodilator and increased levels of IL-5 as interleukin allergic inflammation.

4. Upon reaching the control of asthma, regardless of the duration of the disease there was an increase of VIP and decrease of IL-5 levels according to the performance of healthy children.

5. May suggest the use levels of VIP and IL-5 as diagnostic markers of treatment efficacy and controllability exponent of asthma.


1. Besh,  L.V. (2012). Bronkhial'na astma u ditey: sympozium [Bronchial asthma of  children:  symposium]. Zdorov'e rebenka - health of the child. 8(43), 8-20 [in Ukrainian].

2. Hryhor'eva V.A.,  Mel'nikova Y.M., Mizernitskii Yu.L. (2011). Sovremennye predstavleniia o roli  neiroimmunnykh zven'ev v patoheneze zabolevanii orhanov dykhaniia  [Modern views on the role of neuroimmune links in the pathogenesis of respiratory diseases]. Russian Bulletin Perinatology and Pediatrics - Rossisii vestnyk perynatolohii i pedyatrii.4, 36-40 [in Russian].

3.  Zurochka A. V., Shestakova S.V., Kvyatkovskaia, S. V., Dvorchik E. E. (2009). Otsenka immunnoho statusa i produktsii tsitokinov u bol'nykh atopicheskoi i smeshannoi bronkhyal'noi astmoi [Evaluation of the immune status and cytokine production in patients with atopic asthma and mixed].  Medical Immunology - Medytsynskaya ymmunolohyya. 2-3,  279-286 [in Russian].

4. Myzernytskii Yu.A. (2010). Sovremennye aspekty bronkhyal'noi astmy u detei [Modern aspects of asthma in children].  M.: B.Y. 44 s. [in Russian].

5. Natsyonal'naia prohramma Bronkhyal'naia astma u detei. Stratehiia lecheniia i profylaktyki (2012). [National program "Bronchial asthma in children. Treatment and prevention strategy]. 4-e izd., pererab.iy dop. – M.: Oiyhinal – maket, 184 s. [in Ukrainian].

6. Nedel'skaia S.N., Yartseva D.A. (2011). Kontrol' bronkhyal'noi astmy u detei: opredelenie i vozmozhnosti dostyzheniia [Control of asthma in children: definition and ability to achieve ]. Klіnіchna іmunologіia. Alergologіia. Іnfektologiya - Klinichna imunolohiia. Alerholohiia. Infektolohiia. 9-10 (48-49), 12-18 [in Ukrainian].

7. Okhotnikova O.M. (2011). Bronkhial'na astma u ditei [Asthma in children]. Mistetstvo likuvannia-Art of treatment. 1, S.41-51 [in Ukrainian].

8. Protokoly diahnostiky ta likuvannii alerholohichnykh khvorob u ditei [The protocols for diagnosis and treatment of allergic diseases in children]. Order of Ministry of Health Ukraine - nakaz MOZ Ukrayiny,  27.12.2005, № 767. [in Ukrainian].

9. Sultanova N.H. (2011). Analiz mezhsistemnoho vzaimodeystiia ryada neiroimmunnykh pokazatelei pri atoiycheskoy bronkhyal'noy astme u detey [Analysis of the interaction of a number of intersystem neuroimmune parameters in atopic asthma in children]. Tsytokiny i vospalenie – Cytokines and Inflammation. 1, 18–23 [in Russian].

10. Chernysheva O.E., Yulysh E.Y. (2010). Sovremennye predstavleniia o patoheneze bronkhial'noy astmыy [Modern concepts of the pathogenesis of asthma]. Sovremennaia  pedyatriia - Contemporary Pediatrics.-2(30), 67-71 [ in Russian].

11.Chuchalyn A.H. , Kolhanova N. A. , Zykov K. A. (2010). Respiratornaia infektsiia y rol' syvorotochnykh biomarkerov pri obostrenii atopicheskoi bronkhyal'noi astmy [Respiratory infection and the role of serum biomarkers in atopic asthma exacerbation]. Pul'monolohiia – Pulmonology. 3, 46-52 [in Russian].

12. Alves G.J., Palenno-Neto J. Neuroimmunomodulation: the cross-talk between nervous and immune systems. Rev. Bras. Psychiat. 2007; 29: 4: 363-369.

13. Arif A.A. The association between symptomatic asthma and neurobehavioral comorbidities among children. J Asthma 2010 Sep; 47 (7): 792-6.

14. Eiubova A.A., Sultanova N.G. Neuroimmune regulation in children with bronchial asthma. Georgian Med News. 2008 Mar; (156):78-80.

15. Global strategy for the diagnosis and prevention (Gina 2011) [Електроний ресурс]. Режим доступу: // http://www.ginastma.org /pdf/GINA_report_2011.pdf_

16. Pagotto U., Marsicano G., Cota D. The emerging role of the endocannabinoid system in endocrine regulation and energy balance. Endocr. Rev. 2006; 27: 73–100.

17. Russell J.H. Interaction between the immune and central nervous systems. Immunol. Res 2005; 32: 1-3: 225-229.

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