Biomarkers of Inflammation in Peripheral Blood during Treatment with Inhaled Corticosteroids in Patients with Asthma
Article Sidebar
Main Article Content
Abstract
BACKGROUND: The main attribute of asthma is inflammation, which leads to airway remodelling, bronchial hyper-reactivity and reversible or partly reversible airway obstruction. According to GINA, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular, mast cells, eosinophils (Eo), and T lymphocytes. Many cells and mediators take part in creating the asthmatic inflammatory reaction, but eosinophils play a central role.
AIM: The aim of this study was to show the values of biological inflammatory markers (IL-5, Eo, and ECP) during treatment with ICS by non-invasive methods.
MATERIAL AND METHODS: This study includes 30 patients of the Pulmonology and Allergology Clinic, Skopje, with confirmed asthma, treated with ICS. In all of the patients, we followed Eo count, ECP and IL-5 in peripheral blood at the beginning of the study, after 2 and six months treatment. Following the parameters during treatment with ICS we registered changes in all of the tested parameters.
RESULTS: Our results show high level of the tested biomarkers at the beginning of the study, IL-5 in all patients (100%), Eosinophils in 80%, and ECP in 90% of the asthmatics. Following the parameters during treatment with ICS we registered changes in all of the tested parameters.
CONCLUSIONS: Our conclusion is that the ICS objectively suppress the inflammatory reaction in asthma and the biologic markers (IL-5, Eo and ECP), which we have followed, can measure the accomplished effect. They could be used in everyday practice, not only as diagnostic parameters but also as valid therapeutic guides in the treatment of asthma.
Downloads
Plum Analytics
Article Details
References
Global Strategy for Asthma Management and Prevention, 2015,1-8.
Lacy P, Moqbel R. Immune effector functions of eosinophils in allergic airway inflammation. Curr Opin Allergy Clin Immunol. 2001;1(1):79-84. https://doi.org/10.1097/00130832-200102000-00014 PMid:11964674
Bjornsdottir US, Quan S, Busse W. Eosinophilis and asthma, Asthma and Rhinitis, Taunton, Massachusetts, 1995: 328-346.
Bardin GP, Johanston LS, Holgate TS. The anti - inflammatory basis of asthma and its implications for treatment, The UCB Inst. of Allergy Press, 1992: 5-24.
Sarmiento EU, Espiritu BR, Gleich GJ, Thomas LL. IL-3, IL-5, and Granulocyte-Macrophage Colony-Stimulating Factor Potentiate Basophil Mediator Release Stimulated by Eosinophyl Granule Major Basic Protein. Amer Assoc Immunol, 1995:2211-2220. PMid:7543541
Howel JBL. Definitions and Historical Perspective, The role of Inflammatory Processes in Airway Hyperresponsiveness, Black Sci Public. 1989: 8-10.
Broide DH, Gleich GJ, Guomo AJ et al.: Evidence of ongoing mast cell and eosinophil degranulation in symptomatic asthma airway. J Allergy Clin Immunol. 1991; 88: 637-648. https://doi.org/10.1016/0091-6749(91)90158-K
Ohno I, Nitta Y, Yamauchi K et al. Transforming growth factor beta 1 (TGF beta 1) gene expression et eosinophils in asthmatic airway inflammation. Abstract. Am J Repir Cell Mol Biol. 1996; 15: 404-409. https://doi.org/10.1165/ajrcmb.15.3.8810646 PMid:8810646
O'Birne PM. The natural history of asthma. Eur Respir Rew. 1996; 3(32): 23-26.
Lemanske RF. Asthma: targeting the early treatment of asthma in children and adults. Eur Respir Rew. 1996; 3(32): 27-30.
Bardin GP, Johanston LS, Holgate TS. The anti - inflammatory basis of asthma and its implications for treatment, The UCB Inst. of Allergy Press, 1992: 5-24.
Barnes PJ, Pedersen S, Busse W. Efficacy and Safety of Inhaled Corticosteroids. Resp Crit Care Medic. 1998;157(3):1-53. https://doi.org/10.1164/ajrccm.157.3.157315 PMid:9520807
Laitinen LA, Laitinen A, Heino M, Haathela T. Eosinophylic airway inflammation during exacerbation of asthma and its treatment with inhaled corticosteroids. Am Rev Respir Dis. 1991; 143(2): 423-427. https://doi.org/10.1164/ajrccm/143.2.423 PMid:1990962
Roca-Ferrer J, Mullol J, Lopez E, et al. Effect of topical antiinflammatory drugs on epithelial cell-induced eosinophil survival and GM-CSF secretion. Eur Respir J. 1997; 10: 1489-95. https://doi.org/10.1183/09031936.97.10071489 PMid:9230235
Evans PM, O'Connor BJ, Fuller RW, Barnes PJ, Chung KF. Effect of inhaled corticosteroids on peripheral eosinophil counts and density profiles in asthma. J Allergy Clin Immunol. 1993; 91: 643-9. https://doi.org/10.1016/0091-6749(93)90270-P
Linden M, Brattsand R. Effects of a corticosteroid, budesonide, on alveolar macrophages and blood monocyte secretion of cytocines: diferential sensitivity of GM-CSF, IL-1b and IL-6. Pulm Pharmacol. 1994; 7: 43-47. https://doi.org/10.1006/pulp.1994.1004 PMid:8003851
Remes S, Korppi M, Remes K, Mononen Savolainen I, Pekkanen J. Serum eosinophil cationic protein (ECP) and eosinophil protein X (EPX) in childhood asthma: the influence of atopy. Pediatr Pulmonol. 1998; 25: 167-174. https://doi.org/10.1002/(SICI)1099-0496(199803)25:3<167::AID-PPUL6>3.0.CO;2-J
Shields MD, Brown V, Stevenson EC, et al. Serum eosinophilic cationic protein and blood eosinophil counts for the prediction of the presence of airways inflammation in children with wheezing. Clin Exp Allergy. 1999; 29: 1382-1389. https://doi.org/10.1046/j.1365-2222.1999.00667.x PMid:10520059
Pavord I, Brightling C, Woltmann G, Wardlaw A. Non-eosinophilic corticosteroid unresponsive asthma. Lancet. 1999;353:2213-2214. https://doi.org/10.1016/S0140-6736(99)01813-9
Baba K, et al. Serum ECP helps determine Beclomethasone dosage in Asthmatics. J Asthma. 2000; 37: 399-408. https://doi.org/10.3109/02770900009055465 PMid:10983617
Simon HU. Eosinophil apoptosis-pathophysiologic and therapeutic implications. Allergy. 2000;55(10):910-915. https://doi.org/10.1034/j.1398-9995.2000.055010910.x PMid:11030370
Meltzer EO. Pharmacological treatment options for allergic rhinitis and asthma. Clinical and Experimental Allergy. 1998;28(2):27-36. PMid:9678824
Hellman C, Lonnkvist K, Hedlin G, Hallden G, Lundahl J. Down-regulated IL-5 receptor expression on peripheral blood eosinophils from budesonide-treated children with asthma. Allergy. 2002;4(57):323-328. https://doi.org/10.1034/j.1398-9995.2002.1o3482.x
Kips JC, Tournoy KG, Pauwels RA. New anti-asthma therapies: suppression of the effect of interleukin (IL)-4 and IL-5; Eur Resp J. 2001;17:499-506. https://doi.org/10.1183/09031936.01.17304990 PMid:11405532
Durham SR. Mechanisms of mucosal inflammation in the nose and lungs; Clinical and Experimental Allergy. 1998;28(2):11-16. PMid:9678822
Pedersen S. Comparative study designs and what they show. Respiratory Med. 2000;94(D): 40-43. https://doi.org/10.1016/S0954-6111(00)90124-0
Kaplan AP. Chemokines, Chemokine Receptors and Allergy. Int Arch Allergy Immunol. 2001; 124; 423-431. https://doi.org/10.1159/000053777 PMid:11340325