Regarding to the issue of the role of cytokines in the pathogenesis of asthma and the possibilities of anticytokine therapy



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Abstract

The study involved 210 people, of which 32 had mild bronchial asthma, 39 had moderate bronchial asthma, 39 had moderate bronchial asthma combined with chronic obstructive pulmonary disease, 38 had chronic obstructive pulmonary disease, 17 patients suffered from community-acquired pneumonia, 25 patients with essential hypertension and ischemic heart disease (comparison group) and 20 healthy patients. We assessed sIgE to mite allergens, dust allergens, and the mixed grass, trees, weeds and flower pollen allergens , Str. pneumon., Haemofil. influenzae, Neisseria perflava. The levels of interleukin-4, interleukin6, interleukinlO, interleukin-7, gamma-interferon, tumor necrosis factor were investigated. All patients were studied in the acute condition of the disease. We assessed the infectious potential and atopic potential in every patient. Results of the study allow to resume that cytokines levels, their combinations (cytokine profile) testing has not to be advisable for clinical diagnostics, assessement of the severity of the disease and treatment strategy including anti-cytokine therapy.

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Становится все более очевидной чрезвычайная гетерогенность бронхиальной астмы (БА). Более 30 лет назад, в 1977 г., мы указывали на наличие у больных БА семи клинико-патогенетических вариантов течения БА, названных в последующем фенотипами: инфекционнозависимого, атопического, гормонального, нервно-психического, аутоиммунного, выраженного адренергического дисбаланса и первично измененной реактивности бронхов [1]. Для каждого из этих вариантов были разработаны методы индивидуальной диагностики и терапии, результаты их апробации неоднократно публиковались. В последующем формулировка «первично измененная реактивность бронхов» была заменена на представления о БА физического усилия, дизовари-альном и аспириновом клинико-патогенетических вариантах (фенотипах) БА, совершенствовались методы индивидуальной диагностики и терапии, и повышалась их эффективность.
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About the authors

G B Fedoseev

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: fedoseevsp@mail.ru
Russia

V I Trofimov

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

K V Negrutsa

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

V G Timchik

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

V I Golubeva

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

V A Aleksandrin

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

T S Razumovskaya

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

K N Kryakunov

Academician I.P. Pavlov First St. Petersburg State Medical University

Russia

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