Dynamics of cytokines in patients with severe asthma with extracorporeal immune lymphocytes modification
Annotatsiya
Aim: To study the dynamics of interleukin-4 (IL-4) and gamma-interferon (γ-inf.) during the treatment of severe asthma with extracorporeal plasmapheresis with immune modification of lymphocytes (EIML). Methods: In 15 patients with exacerbation of severe bronchial asthma with hormone-dependent we used the standard baseline therapy (by GINA) with the method of plasmapheresis with EIML with prednisolone by V.V. Romanov (2002). The patients' age was 56,4 ± 8,04 years and experience of illness was 19,1 ± 5,9 years. Patients were underwent 2-3 EIML procedures with 10-14 day intervals. We investigated the dynamics of IL-4 and γ-inf. as well as value of Asthma Control Test (ACT-test)(by QualityMetric Incorporated) and forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) in 1 and 3 months after EIML course. Results: Initial value of IL-4 was 54,39 ± 6,47 pg / ml (normal range - 0-20 pg / ml) and γ-inf. was 19,6 ± 4,64 pg / ml (normally 0-25 pg / ml). After 1 month we noted non-significant decrease of IL-4 and increased γ-inf. But after 3 months level of IL-4 was significantly reduced to 19,9 ± 2,85 pg / ml, and the level of γ-inf. significantly increased to 48,5 ± 8,8 pg / ml. ACT-test before the study was 8,35 ± 0,78 points. After 1 and 3 months after treatment ACT scores rose to 16,7 ± 2,36 and 21,2 ± 1,81 respectively (p<0,05). FEV1 significantly increased from 51 % ± 3,52% to 71 % ± 4,9%, PEF - from 47 ± 3,03% to 69,1 ± 5,3% for 3 months. Conclusion: Improving of cytokines profile combined with the clinical condition of patients during the treatment of severe asthma with extracorporeal plasmapheresis with immune modification of lymphocytes.