CLINICAL AND IMMUNOLOGICAL INFLAMMATORY PATTERNS OF BRONCHIAL ASTHMA IN OBESE PATIENTS

We aimed to investigate immunological patterns of inflammation and autoimmunity, in bronchial asthma (BA) associated with obesity. Materials and methods . 109 people aged from 17 to 58 years with various body weights have been examined in total, including 64 individuals with allergic diseases as bronchial asthma (BA) and allergic rhinitis (AR). We performed the measurement of the body mass index according to WHO criteria, and evaluation of the asthma severity and comorbid conditions. In the samples of peripheral blood we measured biochemical tests (cholesterol and its fractions), spontaneous and PHA-induced production of cytokines: IL-4, IL-10, IL-17, TNF-, and serum levels of C-reactive protein (CRP), leptin, total IgE and IgE-autoAT, specific for a number of tissue AH (epithelial keratin, collagen 3 and 6 types, elastin and myosin). Results . Our study showed that in both groups of adults, the obesity was associated with increasing of acute phase proteins, CRP, leptin and TNF-α in serum, being most enhanced in asthma group. Individuals with excess body weight are characterized by significantly an increased level of acute phase proteins (Westergren ESR, CRP) and pro-inflammatory cytokines (TNF-α) in serum, thereby confirming the involvement of systemic inflammation in the obesity pathogenesis. The phenotype of BA with obesity is characterized by overproduction of CRP and leptin, along with increased spontaneous production of IL-4 and TNF-α, and also revealed sIgE to self-antigen as keratin, that in total could indicate more prominent inflammatory pathways with the impairment of immune regulation in this endotype of patients. Conclusion . The revealed associations confirm the link between obesity, as a chronic inflammatory condition, with atopy and development of asthma with further immune-mediated inflammation of the conduction airways.