THE LEVEL OF REACTIVE OXYGEN SPECIES AS A MARKER OF ASTHMA SEVERITY IN CHILDREN.

OBJECTIVE: The aim of the research was to assess the reactive oxygen species (ROS) levels in granulocytes of patients with asthma. PATIENTS AND METHODS: Materials and methods: The study involved 35 children aged 5 to 17 years. 26 children with persistent asthma, partially controlled course in the period of exacerbation were divided into groups: 1 group - mild asthma (n = 12), group 2 - moderate asthma (n = 7) group 3 - severe asthma (n = 7) and control group included almost healthy children (n = 9). ROS levels in granulocytes were evaluated using BD FACSDiva™. The spirographic complex was used to assess the function of external respiration. RESULTS: Results: The level of ROS in granulocytes of patients with severe asthma was significantly reduced compared with children in the control group and patients with mild and moderate asthma (p1-3 = 0.0003, p2-3 = 0.0017, p c-3 = 0.0150). The concentration of ROS in granulocytes ≤ 285 a.u. was prognostically significant with high specificity and sensitivity with severe asthma. CONCLUSION: Conclusions: The concentration of ROS levels in neutrophils in patients with severe asthma probably reflected the suppression of their products, which suggests the depletion of the reserve capacity of neutrophils. Decreased concentrations of reactive oxygen species in children with asthma can be considered as a possible marker of asthma severity.

Is Willebrand Factor Indicative of Chronic Inflammation in Children with Asthma?

OBJECTIVE: To improve our knowledge and to understand how the level of von Willebrand factor indicates the development of chronic inflammation in children with recurrent wheezing and asthma. MATERIAL AND METHODS: It was a prospective cohort study. This study was conducted in children with recurrent wheezing and asthma who were referred to a children's hospital during 2017-2018. Patients were divided into 3 groups depending on the number of episodes of wheezing. Patients were examined for von Willebrand factor levels at admission and after treatment. Data analysis was performed with Statsofta Statistica Version 8 (Tulsa, OK). RESULTS: WF1 levels in Group 2 and 3 children statistically significantly increased in comparison with the control group (p<0.001). WF2 levels remained elevated only in Group 3 patients (p<0.001). WF2 levels in Group 1 and 2 decreased to the indices of the control group (p>0.05). The WF2 significantly decreased after treatment in Group 2 children (p=0.0000, T=0) and Group 3 (p=0.0000, T=0). CONCLUSION: levels of Willebrand factor indicate the presence of endothelial dysfunction. The level of Willebrand factor in the peak period of wheezing depends on the number of episodes of wheezing in history. Persistent high rates of Willebrand factor, even after the relief of clinical symptoms, indicates the present of chronic inflammation and can be regarded as the formation of asthma in children.

Are level of IL-13 and IL-4 predictive for formation of chronic inflammation in children with asthma?

INTRODUCTION: Asthma diagnosis in young children may represent a clinical challenge. There are no standard prognostic and dia-gnostic methods. The aim of the study was to evaluate the clinical and prognostic assessment of IL-4 and IL-13 concentrations in children with recurrent wheezing. MATERIAL AND METHODS: The study included 96 children with recurrent wheezing. 81 patients were diagnosed as transient wheezing, 15 patients with asthma, and 25 healthy children were selected as controls. The concentrations of IL-4 and IL-13 were analyzed in exhaled breath condensate (EBC) using an enzyme-linked immunosorbent assay (ELISA). Data analysis was performed using Statsoft Statistica Version 8 (Tulsa, OK) and the statistical program MedCalc version 17.2. RESULTS: Both IL-4 and IL-13 concentrations were significantly higher in DDA (21.13 pg/mL, 26.13 pg/mL, respectively) and TW (13.86 pg/mL, 18.3 pg/mL, respectively) groups as compared to healthy controls (3.37 pg/mL, 16.35 pg/mL, respectively; p<0.001), and the highest rates were observed in children with diagnosed asthma (p < 0.001, DDW vs TW, respectively). IL-4 concentration higher than 18.45 pg/mL (with sensitivity 86.7% and specificity 80%) and IL-13 concentration higher than 20.17pg/ /mL (with sensitivity 100% and specificity 76.7%) in EBC in children with wheezing recurrence can be considered as a possible predictor of asthma development. CONCLUSIONS: The concentration of the anti-inflammatory cytokines IL-4 and IL-13 were significantly increased in children with recurrent wheezing and the highest rates were found in asthma developing children. The concentrations of IL-4 and IL-13 in chil-dren with wheezing can be considered as a possible predictor of asthma development.