Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press157510.36691/RJA1575Original studiesОригинальные исследованияResearch ArticleThe role of IL-33 and IL-1β in the development of persistent allergic rhinitis in overweight/obese childrenРоль IL-33 и IL-1β в развитии персистирующего аллергического ринита у детей с избыточной массой тела/ожирениемhttps://orcid.org/0000-0003-2655-12846007-1896KorolevaAnna E.КоролеваАнна Евгеньевна
Russian Federation

MD

anna.ochkurenko@gmail.comhttps://orcid.org/0000-0001-9141-53482518-3769BekezinVladimir V.БекезинВладимир Владимирович
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

smolenskbvv@yandex.ruhttps://orcid.org/0000-0001-8863-1103SergeevaIrina N.СергееваИрина Николаевна
Russian Federation
serg.irina72@mail.ruVolkovaElena A.ВолковаЕлена Александровна
Russian Federation
VL-71@yandex.ruhttps://orcid.org/0000-0002-7806-94848937-1230MeshkovaRaisa Ya.МешковаРаиса Яковлевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

meshkova.raisa@yandex.ruSmolensk State Medical UniversityСмоленский государственный медицинский университетSmolensk Regional Children’s Clinical HospitalСмоленская областная детская клиническая больницаChildren’s Clinical HospitalДетская клиническая больницаSmolensk Clinical Hospital № 1Клиническая больница № 1, Центр аллергологии-иммунологии22122022051220221944724821210202214122022Copyright ©; 2022, Pharmarus Print MediaCopyright ©; 2022, Фармарус Принт Медиа2022Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1575

BACKGROUND: Few works were devoted to the study of the role of cytokines in children with allergic rhinitis (AR) with comorbid obesity.

AIMS: To study the level of cytokines interleukin (IL)1β, IL-33, IL-6, tumor necrosis factor (TNF)-α, and total IgE in the blood serum of overweight/obese children with intermittent and persistent AR.

MATERIALS AND METHODS: This cross-sectional observational study analyzed 69 children aged 7–10 years with AR in the remission period and was conducted from November 2020 to February 2021. All children went through a comprehensive examination for 3 days, including the definition of the serum concentrations IL-1β, IL-33, IL-6, TNF-α, and total IgE. Before blood sampling, children did not use nasal glucocorticosteroids, antileukotriene drugs for the last 4 weeks, and antihistamines for the last 7 days. Bioimpedansometry was used to assess the body weight by calculating the %FM (percentage of body fat mass).

RESULTS: The study included 44 children with AR and overweight/obesity (group I) and 25 children with AR and normal body weight (group II). The analysis of AR showed that in group I, intermittent AR was detected in 11 (25.0%) children (subgroup IA), whereas a persistent course was found in 33 children (75.0%) (subgroup IB). In group II, intermittent AR was detected in 13 (52.0%) children (subgroup IIA), whereas persistent AR in 12 children (48.0%) (subgroup IIB). The level of IL-1β in the blood serum was significantly higher in the subgroup IB than in subgroup IA (p=0.009). The concentration of IL-33 in children with persistent AR and obesity was significantly lower than that in children with intermittent AR and obesity (p=0.039). The level of IL-33 in the serum negatively correlated with %FM in group IA (r=-0.6673, p=0.035). The concentration of IL-1β negatively correlated with %FM in group IIB (r=-0,738, p=0,037). The levels of IL-6, TNF, and total IgE in obese children did not depend on the severity of AR.

CONCLUSIONS: The predictors of persistent AR in children with obesity are a decrease in the level of IL-33 and an increase in IL-1β in the blood serum. The negative correlation between the degree of obesity and IL-33 concentration in children with intermittent AR opens a window of opportunity for the personified management of children with AR and comorbid obesity.

Обоснование. Имеются немногочисленные работы по изучению роли цитокинов у детей с аллергическим ринитом на фоне ожирения.

Цель ― изучить уровень концентрации цитокинов IL-1β, IL-33, IL-6, TNF-α и общего IgE в сыворотке крови при интермиттирующем и персистирующем течении аллергического ринита у детей младшего школьного возраста с избыточной массой тела/ожирением.

Материалы и методы. Проведено одномоментное обсервационное исследование 69 детей в возрасте 7–10 лет с аллергическим ринитом в период ремиссии с ноября 2020 г. по февраль 2021 г. Всем детям в течение 3 дней осуществлялось комплексное обследование, включавшее определение содержания IL-1β, IL-33, IL-6, TNF-α и общего IgE. Перед взятием крови на анализ дети не должны были принимать назальные глюкокортикостероиды, антилейкотриеновые препараты в течение последних 4 нед, антигистаминные препараты ― в течение последних 7 дней. Для оценки жировой массы тела применяли биомпедансометрию с вычислением процента жировой массы тела (%ЖМТ).

Результаты. В исследование включены 44 ребёнка с аллергическим ринитом и избыточной массой тела/ожирением (группа I) и 25 детей с аллергическим ринитом и нормальной массой тела (группа II). Показано наличие интермиттирующего течения АР в I группе у 11 (25,0%) (подгруппа IA) и персистирующего течения у 33 (75,0%) (подгруппа IБ) детей, в группе II — у 13 (52,0%) (подгруппа IIА) и 12 (48,0%) (подгруппа IIБ) соответственно. Установлено, что уровень IL-1β в сыворотке крови был достоверно выше в подгруппе IБ по сравнению с детьми подгруппы IA (р=0,009). Концентрация IL-33 у детей с персистирующим аллергическим ринитом и ожирением была достоверно ниже по сравнению с детьми с интермиттирующим аллергическим ринитом и ожирением (р=0,039). Уровень IL-33 в сыворотке крови обратно коррелировал с %ЖМТ у детей подгруппы IА (r=-0,667; р=0,035). Концентрация IL-1β обратно коррелировала с %ЖМТ у детей подгруппы IIБ (r=-0,738; р=0,037). Уровни IL-6, TNF-α и общего IgE у детей с ожирением не зависели от характера течения аллергического ринита.

Заключение. Впервые установлено, что предикторами персистирующего течения аллергического ринита на фоне ожирения у детей являются снижение концентрации IL-33 и повышение IL-1β в сыворотке крови. Выявленная обратная корреляционная связь между %ЖМТ и концентрацией IL-33 у детей с интермиттирующим течением аллергического ринита открывает окно возможностей для персонифицированной тактики ведения детей с аллергическим ринитом и ожирением.

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