• Clinical and immunological characteristics of bronchial asthma in adolescents based on the results of long/term observation

Clinical and immunological characteristics of bronchial asthma in adolescents based on the results of long/term observation

SOVREMENNAYA PEDIATRIYA.2018.2(90):31-36; doi 10.15574/SP.2018.90.31

Koloskova O. K., Bezrukov L. O., Shahova O. O.
Higher State Educational Institution of Ukraine «Bukovinian State Medical University», Chernivtsi, Ukraine

Objective: to evaluate, basing on the results of long-term dynamic observation, clinical and immunological parameters of bronchial asthma (BA) in post-attack period in adolescents.
Material and methods. There has been performed a complex clinical and immunological examination of 42 adolescents with BA during the post-attack period of disease, when clinical manifestations of bronchial obstruction completely disappeared and after discontinuation of drugs that could affect the accuracy of the assessment of nonspecific hypersensitivity to direct and indirect stimuli, or, as well, immunological status of patients. In most children, the examinations were carried out repeatedly during the long-term follow-up.
Results. It has been found that absolute eosinophilic and neutrophilic count in each specific analysis of peripheral blood can be used to determine the overall inflammatory pattern of the body. The eosinophilic inflammatory blood pattern has been observed in 25 examined children (58.8%), but neutrophilic pattern — in 17 adolescents (41.2%). Upon that, the eosinophilic inflammatory pattern was accompanied by high or low percentage of neutrophils in the peripheral blood, while the non-eosinophilic pattern has been characterized by high absolute neutrophil count observed against the background of low eosinophilic blood content. There has been detected the positive relationship between the indices of the spontaneous nitroblue tetrazolium blood test (NBT-test) of eosinophils with eosinophilic inflammatory blood pattern which, on our opinion, pinpointed the fact that the inflammation of airways in children with BA is mainly determined by the activation of eosinophils, but the stimulation of neutrophilic blood leukocytes, as a marker of inflammation, has a more variable situational character.
Conclusions. The main component that may intensify the nonspecific airway hypersensitivity in adolescents in the post&attack period is the presence of a distinct eosinophilic pattern of inflammation (r=0.73), but the neutrophilic inflammatory pattern of the organism as well as activation of neutrophils according to the data of spontaneous NBT-test should be considered as less significant (r=-0.46 and r=-0.56, respectively).
Key words: bronchial asthma, adolescents, eosinophilic pattern.


1. Koloskova OK, Tarnavska SI. (2016). Inflammatory blood patterns as a sign of phenotypic heterogeneity of bronchial asthma in children. Sovremennaya pediatriya. 1(73): 116-119. doi 10.15574/SP.2016.73.116

2. Moskalenkо VF (Ed.). (2009). Biostatistics. Kyiv: Knyha plius.

3. Bruijnzeel PL, Uddin M, Koenderman L et al. (2015). Targeting neutrophilic inflammation in severe neutrophilic asthma: can we target the disease-relevant neutrophil phenotype? J Leukoc Biol. 4; 2: 98-104.

4. Dworski R, Simon H, Hoskins A еt al. (2011). Eosinophil and neutrophil extracellular DNA traps in human allergic asthmatic airways. J Allergy Clin Immunol. 127; 5: 1260-1266.

5. Gibson P. (2009). Inflammatory phenotypes in adult asthma: clinical applications. The Clinical Respiratory Journal. 3: 198-206.

6. Gibson PG. (2009). Tackling asthma phenotypes in community studies. Thorax. 64; 5: 369-370.

7. Pelaia G, Vatrella A, Busceti MT. (2015). Cellular mechanisms underlying eosinophilic and neutrophilic airway inflammation in asthma. Hindawi Publishing Corporation Mediators of Inflammation. https://doi.org/10.1155/2015/879783

8. Sol IS, Kim YH, Lee HS et al. (2014). Heterogeneity of asthma according to systemic inflammatory pattern in children. Allergy Asthma Respir Dis. 2(3): 165-170.

9. Wang F, He XY, Baines KJ et al. (2011). Different inflammatory phenotypes in adults and children with acute asthma. Eur Respir J. 38: 567-574.