Modern Pediatrics. Ukraine. (2026).3(155): 10-16. doi: 10.15574/SP.2026.3(155).1016
Kryuchko T. O., Klymko D. O., Morokhovets G. Yu., Izmailova O. V.
Poltava State Medical University, Ukraine

For citation: Kryuchko TO, Klymko DO, Morokhovets GYu, Izmailova OV. (2026). The problem of early diagnosis of pulmonary fibrosis in patients with bronchial asthma. Modern Pediatrics. Ukraine. 3(155): 10-16. doi: 10.15574/SP.2026.3(155).1016.
Article received: Jan 20, 2026. Accepted for publication: Apr 13, 2026.

Aim – to assess the level of transforming growth factor-β1 (TGF-β1) in children with bronchial asthma (BA) who have a history of bronchopulmonary dysplasia (BPD) and vaping, as well as to determine its association with the clinical manifestations of the disease and pulmonary function parameters.
Materials and methods. A single-center observational study was conducted involving 30 children (ages 12-17), divided into three groups: control (n=10), BA+BPD (n=10), and BA+vaping (n=10). All participants underwent a clinical examination and spirometry (forced expiratory volume in one second – FEV₁), and total immunoglobulin E (IgE) and TGF-β1 levels were determined using a solid-phase enzyme-linked immunosorbent assay. In the BA+vaping group, the duration and intensity of vaping were assessed.
Results. Children with asthma showed a statistically significant increase in TGF-β1 levels compared with the control group, with the highest values observed in patients with a history of both BA and BPD. A direct association was found between TGF-β1 and the frequency of nocturnal symptoms, and an inverse association with FEV₁. In the asthma+vaping group, vaping intensity was associated with elevated IgE levels and worsened pulmonary function test results.
Conclusions. Elevated TGF-β1 levels are associated with a more severe course of asthma. A history of BPD and vaping are risk factors, while TGF-β1 is a promising biomarker for the early diagnosis of pulmonary fibrosis.
The study was conducted in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the patients.
The authors declare no conflict of interest.
Keywords: bronchial asthma, children, transforming growth factor beta 1 (TGF-β1), bronchopulmonary dysplasia, vaping, airway remodeling, pulmonary fibrosis.
REFERENCES

1. Allbright K, Villandre J, Crotty Alexander LE, Zhang M, Benam KH, Evankovich J et al. (2024). The paradox of the safer cigarette: understanding the pulmonary effects of electronic cigarettes. Eur Respir J. 63(6): 2301494. https://doi.org/10.1183/13993003.01494-2023; PMid:38609098 PMCid:PMC12077657

2. Ambalavanan N, Deutsch G, Pryhuber G, Travers CP, Willis KA. (2026). The evolving pathophysiology of bronchopulmonary dysplasia. Physiol Rev. 106(1): 197-237. https://doi.org/10.1152/physrev.00042.2024; PMid:40880213 PMCid:PMC12483330

3. Bousquet J, Toumi M, Sousa-Pinto B, Anto JM, Bedbrook A, Kaidashev I, et al. (2022). The allergic rhinitis and its impact on asthma (ARIA) approach of value-added medicines: as-needed treatment in allergic rhinitis. J Allergy Clin Immunol Pract. 10(11): 2878-2888. https://doi.org/10.1016/j.jaip.2022.07.020; PMid:35934308

4. Chitty JG, Lam M, Mao W, Royce SG, Bardin PG et al. (2025). Lung-specific TGFβ overexpression increases airway fibrosis and airway contractility in transgenic mice. Am J Physiol Lung Cell Mol Physiol. 329(2): L255-L265. https://doi.org/10.1152/ajplung.00017.2025; PMid:40586207

5. Cosío BG, Iglesias A, Shafiek H, Mosteiro M, Escribano I, Toledo-Pons N et al. (2025). The role of bronchial biopsy in the prediction of response to biologic therapy in severe uncontrolled asthma: a prospective study. Chest. 167(4): 945-955. https://doi.org/10.1016/j.chest.2024.11.045; PMid:39742914

6. Course CW, Bush A, Kotecha S. (2026). Looking beyond bronchopulmonary dysplasia: prematurity-associated lung disease and its phenotypes. Lancet Respir Med. 14(1): 60-71. https://doi.org/10.1016/S2213-2600(25)00372-8; PMid:41319663

7. Dumpa V, Avulakunta I, Bhandari V. (2025). Effect of non-invasive ventilation on bronchopulmonary dysplasia. Semin Perinatol. 49(5): 152061. https://doi.org/10.1016/j.semperi.2025.152061; PMid:40057443

8. Frangogiannis N. (2020). Transforming growth factor-β in tissue fibrosis. J Exp Med. 217(3): e20190103. https://doi.org/10.1084/jem.20190103; PMid:32997468 PMCid:PMC7062524

9. Grunwell JR, Fitzpatrick AM. (2025). Asthma phenotypes and biomarkers. Respir Care. 70(6): 649-674. https://doi.org/10.1089/respcare.12352; PMid:40013975 PMCid:PMC12408891

10. Gul A, Yang F, Xie C, Du W, Mohammadtursun N, Wang B et al. (2023). Pulmonary fibrosis model of mice induced by different administration methods of bleomycin. BMC Pulm Med. 23(1): 91. https://doi.org/10.1186/s12890-023-02349-z; PMid:36944966 PMCid:PMC10029181

11. Liu Y, Nie H, Ding Y, Hou Y, Mao K, Cui Y. (2021). MiRNA, a new treatment strategy for pulmonary fibrosis. Curr Drug Targets. 22(7): 793-802. https://doi.org/10.2174/1874609813666200928141822; PMid:32988351

12. Lyzwinski LN, Naslund JA, Miller CJ, Eisenberg MJ. (2022). Global youth vaping and respiratory health: epidemiology, interventions, and policies. NPJ Prim Care Respir Med. ;32(1): 14. https://doi.org/10.1038/s41533-022-00277-9; PMid:35410990 PMCid:PMC9001701

13. Mallol J, Urrutia-Pereira M, Mallol-Simmonds MJ, Calderón-Rodríguez L, Osses-Vergara F, Matamala-Bezmalinovic A. (2021). Prevalence and determinants of tobacco smoking among low-income urban adolescents. Pediatr Allergy Immunol Pulmonol. 34(2): 60-67. https://doi.org/10.1089/ped.2021.0018; PMid:34107753 PMCid:PMC8329728

14. Mascarenhas D, Al-Balushi M, Al-Sabahi A, Weisz DE, Jain A, Jasani B. (2025). Pulmonary hypertension in preterm neonates with bronchopulmonary dysplasia: a meta-analysis. Arch Dis Child Fetal Neonatal Ed. 110(4): 344-352. https://doi.org/10.1136/archdischild-2024-327547; PMid:39603794

15. Maselli DJ, Sherratt J, Adams SG. (2025). Comorbidities and multimorbidity in asthma. Curr Opin Pulm Med. 31(3): 270-278. https://doi.org/10.1097/MCP.0000000000001162; PMid:40047208

16. Petrella F, Faverio P, Cara A, Cassina EM, Libretti L, Torto SL et al. (2025). Clinical impact of vaping. Toxics. 13(6): 470. https://doi.org/10.3390/toxics13060470; PMid:40559943 PMCid:PMC12197008

17. Plichta J, Panek M. (2025). Role of the TGF-β cytokine and its gene polymorphisms in asthma etiopathogenesis. Front Allergy. 6: 1529071. https://doi.org/10.3389/falgy.2025.1529071; PMid:39949968 PMCid:PMC11821632

18. Rhoads SL, Seluk L, Wechsler ME. (2025). Asthma therapeutics: past, present, and future. Pharmacol Rev. 77(4): 100062. https://doi.org/10.1016/j.pharmr.2025.100062; PMid:40449124

19. Sousa-Pinto B, Anto A, Berger M, Dramburg S, Pfaar O, Klimek L et al. (2022). Real-world data using mHealth apps in rhinitis, rhinosinusitis and their multimorbidities. Clin Transl Allergy. 12(11): e12208. https://doi.org/10.1002/clt2.12208; PMid:36434742 PMCid:PMC9673175