Aspects of immune status in the phenotype of bronchial asthma with obesity.

Author: Churyukina Ella Vitalievna

Federal State Budgetary Educational Institution of Higher Education «Rostov State Medical University», 

Federal State Budgetary Educational Institution of Higher Education «Kuban State Medical University»

Russia, Rostov-on-Don

Obesity is an important factor determining the phenotype of the severe asthma, worsens her control, is a cause of a violation of the physiology of respiration, exacerbating the pulmonary obstruction.

Objective: to study the immune status in patients with bronchial asthma (BA) with obesity.

Materials and methods: we examined 86 patients with BA of different severity. The obesity was diagnosed with the use of Quetelet index, and the coefficient of fat deposition centralization. The first group included the patients with the normal weight of the body (n = 30), the second group consisted of patients who are overweight (n = 30), the third group was made of patients with the obesity of I–II degree (n = 26). 22 healthy volunteers formed the control group. We used the complex of clinical, allergological and immunological examination methods.

Results: In the group of BA obese patients there was found a significant increase of lymphocytes level by 21.8% (36.4 ±2.5%), of CD3+ by 19.9% (83.8 ±2.0%), of CD19+ by 37.5% (16.5 ±2.1), increased levels of serum IgA, g/l (2.14 ±0.35) and decrease in total IgE IU/ml (96.80± 11.47) in comparison with BA patients with the normal body weight (28.6 ±2.4%; 67.2±3.2%; 10.3 ±1.3%, respectively) (р < 0.05); (IgA g/l 1.88 ±0.12; IgE IU/ml 211.79 ±197.63). Analyzing phagocytic activity of neutrophils, significant growth of metabolic activity of neutrophils and the index of neutrophils activation was found out in all the groups of BA patients in comparison with healthy patients. At the same time the reserve of oxygen-dependent  etabolism of neutrophils in BA overweight patients and obese patients was low. The  correlation analysis showed the direct dependence of CD3+ (r=0.59; р<0.01) and CD4+ (r=0.49; р<0.01) levels on the waist size and thighs size and the coefficient of fat deposition centralization. The strong correlation was found out between CD19+ and the coefficient of fat deposition centralization (r=0.9; р<0.01). Conclusion: These investigations showed that the combination of BA and obesity is followed by the increase of the system inflammation, which is proved by the increased number of leucocytes, their T and B-cellular links, the parameters of oxidative metabolism of neutrophils and the decrease of the reserve possibilities of phagocytosis.