SOVREMENNAYA PEDIATRIYA.2017.3(83):91-94; doi 10.15574/SP.2017.83.91

Koloskova O. K., Bezrukov L. O., Bilous T. M., Tarnavska S. I.
Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Chernivtsi

Aim. To investigate the influence of acetylation processes on the emergency treatment peculiarities of asthma attacks in school-aged patients with signs of exercise-induced asthma.

Materials and methods. The 1st and 2nd degree comprehensive clinical and immunological examination of 84 children with asthma has been performed. The genetic marker, namely the type of acetylation by V.M. Prebsting — V.I. Gavrilova method in Tymofeyeva's modification, was determined in all children. Two clinical groups were formed: the first group included 41 children with exercise-induced asthma phenotype (EIAP) and the II group was comprised of 43 patients with asthma without exercise-induced bronchoconstriction (AWEIB).

Results. In patients with EIAP the risk of preserving severe bronchial obstruction on the third day of asthma attack treatment was lower in the children with fast acetylation type. Moreover, the most effective was the initial therapy of asthma attack that included a combination of systemic corticosteroids with quickrelief β₂-agonists and/or theophylline derivatives in case of fast acetylation phenotype. In contrast, in the patients with AWEIB the reverse trend has occurred with preserve of the severity of attack and the need in combination therapy of attack in case of slow acetylation phenotype.

Conclusions. In children with EIAP the emergency treatment of asthma attacks was effective in the patients with fast acetylation phenotype, whereas the efficacy of emergency treatment in the patients with AWEIB was observed in cases of slow acetylators.

Key words: exercise-induced asthma, children, quick-relief therapy, acetylation phenotype.

References

1. Koloskova OK, Tarnavs'ka SI, Dons'ka TV, Kolisnyk ID. (2015). Clinical and medical history of asthma phenotype features late start, depending on the characteristics of acetylation status. Bukovyns'kyy medychnyy visnyk. 19: 69-72.

2. Koloskova OK, Ivanova LA. (2012). Phenotypic features of asthma in school-age children. Perinatologiya i pediatriya. 3(51): 96-98.

3. Mykalyuk LV, Koloskova OK. (2013). Pathogenetic relationships ekogenetic factors in the formation of asthma in children. Klinichna ta eksperymental'na patolohiya. 12; 1(43): 90-193.

4. Pershyn HN. (1971). Methods of experimental chemotherapy. M, Medytsyna: 454-457.

5. Unified clinical protocols of primary, secondary (specialized) medical care "Bronchial asthma in children". Nakaz MOZ Ukrayiny #868 vid 08 zhovtnya 2013 roku (dodatok 2,3).

6. Batra J, Sharma SK, Ghosh B. (2006). Arylamine N-acetyltransferase gene polymorphisms: markers for atopic asthma, serum IgE and blood eosinophil counts. Pharmacogenomics. 7(5): 673-682. https://doi.org/10.2217/14622416.7.5.673; PMid:16886893

7. Ullemar V, Vagnusson P, Lundholm C et al. (2015). Childhood asthma and hay fever, but specific high-risk genetic variants are not shared between diseases. Europ Respir J. 46: 1469-1472. https://doi.org/10.1183/13993003.congress-2015.OA1469

8. Anvari S, Vyhlidal CA, Dai H et al. (2015). Genetic Variation along the Histamine Pathway in Children with Allergic versus Nonallergic Asthma. American J of Respir Cell and Mol Biol. 53(6): 802-809. https://doi.org/10.1165/rcmb.2014-0493OC; PMid:25909280 PMCid:PMC4742940

9. Greenberg RS, Dansels SR, Flenders WD et al. (2004). Medical Epidemiology. 4th Edition. Norwalk, CT, Appleton&Lange: 196.

10. Pawlik A, Juzyszyn Z, Gawronska-Szklarz B. (2009). N-acetyltransferase 2 (NAT2) polymorphism in patients with atopic asthma. Arch Med Res. 40(4): 264-267. https://doi.org/10.1016/j.arcmed.2009.03.003; PMid:19608015

11. Tamer L, Calikoğlu M, Aras AN et al. (2006). Relationship between N-acetyl transferase-2 gene polymorphism and risk of bronchial asthma. Tuberk Toraks. 54(2):137-143. PMid:16924569