Bronchial asthma and obesity: features of systemic inflammation depending on the time of onset of asthma symptoms

BACKGROUND: Bronchial asthma (BA) is a complex heterogeneous polyetiological chronic disease. Pathophysiological mechanisms of interaction between bronchial asthma and obesity are of interest. AIMS: Evaluation of cytokine profile features in patients with bronchial asthma with obesity, depending on the time of asthma onset. MATERIALS AND METHODS: During the study, 180 people were examined: 150 patients with BA of varying severity, who were divided into groups based on BMI: group 1 included patients with BA with BMI from 18.5 to 25 kg/m2 (n=52), group 2 included patients with BA with BMI from 30 to 35 kg/m2 (n=98), the control group consisted of 30 people. Further, patients with asthma and obesity were divided depending on the time of asthma onset into the «Obesity + BA» group and the «BA + Obesity» group with asthma history of about 10 years. During the study, the severity of bronchial asthma was assessed using AST and ACQ tests, spirography with a bronchodilator test was performed, venous blood was collected to determine the cytokine profile (tumor necrosis factor-α; interleukins-2, 4, 6, 8, 10, 17; interferon-INF-γ), markers of systemic inflammation (C-reactive protein, fibrinogen). RESULTS: The phenotype of bronchial asthma in combination with obesity was characterized by a more severe course, worse disease control, while in the «Obesity + BA» group, more severe bronchial patency disorders were recorded. When analyzing the cytokine profile in the study groups, a significant imbalance of proinflammatory and anti-inflammatory cytokines was noted, which was most pronounced in the «Obesity + BA» group. According to the data obtained, it was noted that it is important to determine the ratio index of various cytokines with opposite activity (IL-2 / IL-4, IL-2 / IL-10, IL-8 / IL-10, IL-6 / IL-10, TNF-α / IL-10) to determine the severity of the inflammatory process and further treatment tactics for patients. CONCLUSIONS: Obesity leads to the formation and maintenance of systemic inflammation in the body and is a negative aggravating factor in the development and progression of BA.