CYTOKINES AS BIOMARKERS OF EOSINOPHILIC INFLAMMATION IN T2-ENDOTYPE OF BRONCHIAL ASTHMA
Introduction. The study of pathogenetic mechanisms of eosinophilic inflammation development in bronchial asthma is the basis for the development of an individual approach to the therapy of the disease. Aim. The aim of our research was to study the levels of individual cytokines: TSLP, IL-25, IL-33, IL-4, IL-5, IL-13 in patients with T2-endotype bronchial asthma and to conduct a comparative assessment of these parameters in allergic and non-allergic phenotype of the disease. Material and methods. We examined 53 patients with bronchial asthma (18-65 years old; mean age, 41,6 years), including 25 with allergic (group 1) and 28 with nonallergic phenotype of the disease (group 2). The levels of TSLP, IL-25, IL-33, IL-4, IL-5, IL-13 in serum were investigated in 30 patients by multiplex analysis. Statistical processing was performed using Microsoft Office Excel software package (2019). Results and discussion. The clinical features of the course of bronchial asthma in the patients of the studied groups are presented. High level of absolute eosinophil count in peripheral blood was registered in both groups of patients [(572,83±174,96) cells/μL and (470,32±131,73) cells/ μL]. At the same time, a direct correlation between the absolute number of eosinophils and IL-5 level was observed primarily in group 1 patients (rxy=+0,74). Only patients with allergic bronchial asthma had an elevated level of total serum IgE [(274,55±53,90) IU/ml; p <0,01) and a significantly higher level of IL-4 (344 pg/ml; p <0,05). A direct correlation (rxy=+0,52) was detected between the above indices. IL-13 values did not differ significantly in both groups. The level of TSLP and IL-25 was significantly higher in the patients of the 1st group, while the IL-33 values did not differ significantly. At the same time a direct correlation between IL-33 and IL-13 levels (rxy=+0,53), IL-33 and IL-5 (rxy=+0,65) in group 1 patients, and between IL-33 and IL-5 levels (rxy=+0,43) in group 2 patients was found. Conclusion. Differences in the secretion of the studied cytokines with regard to the clinical picture of the disease allow to make a differential diagnosis of different phenotypes of bronchial asthma belonging to the T2-endotype of the disease and to provide a personalized approach to the choice of therapy.