Characteristics of the eosinophilic fenotype of bronchial asthma in children
Asiryan E.G., Titova N.D.
1 Vitebsk State Medical University, Vitebsk, Belarus
2 Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
The purpose of the work is clinical and laboratory examination of children with an eosinophilic phenotype of bronchial asthma.
Materials and methods. 160 children aged 5 to 18 years were examined: 130 patients with atopic bronchial asthma, 30 children of the control group. During the work, the level of eosinophils, the level of eosinophils carrying FcεRI+ and CD23+IgE+ receptor, the level of total IgE, IgE antibodies to domestic and epidermal allergens in the blood serum were determined, clinical and anamnestic data were studied.
Results. In children with atopic bronchial asthma, the relative and absolute content of eosinophils, as well as eosinophils carrying FcεRI+ and CD23+IgE+ receptors, is statistically significantly higher than in the control group (p<0.001). In 71 (54.62%) children with bronchial asthma, eosinophilia was detected, with 58 (81.69%) patients having a high level of eosinophils bearing the FcεRI + receptor and 56 (78.87%) children with a high level of eosinophils carrying CD23+IgE+ receptor. In the group of children with bronchial asthma, a correlation was established between the level of total IgE and the level of eosinophils carrying FcεRI+ (r=+0.389; p<0.01) and CD23+IgE+ receptors (r=+ 0.677; p<0.0001). In children with eosinophilia, in most cases, the hereditary nature of the disease is observed, the first manifestations of allergy are already present in the first year of life, concomitant allergopathology has been established. The optimal effect in the treatment of patients with eosinophilia was obtained with the appointment, as a basic therapy, of inhaled glucocorticosteroids, as well as short-acting β2-agonists for arresting episodes of bronchial obstruction. In most patients with asthma who have eosinophilia, serum levels of IgE antibodies to Dermatophagoides pteronyssinus, to the coat of the cat and the dog's coat are revealed, and positive skin scarification tests with these allergens are detected.
Conclusion. In children with atopic bronchial asthma, there are signs of an eosinophilic phenotype: eosinophilia, high expression of FcεRI+ and CD23+IgE+ receptors, increased levels of total IgE and IgE antibodies, positive skin tests with domestic and epidermal allergens, hereditary predisposition, effectiveness of inhaled glucocorticosteroids.