Predictability and risk factors of severe bronchial asthma in children

  • ОГЛЯД ЛІТЕРАТУРИ
  • Published 2015

Abstract

АСТМА ТА АЛЕРГІЯ, No 2 • 2015 Bronchial asthma (BA) – one of famous multifactorial chronic lung disease, which is formed on the combined influence of genetic susceptibility and environmental factors. The disease most often occurs in childhood, but can start at any period of life. There is a hereditary predisposition to asthma. This is evidenced by the increased incidence of asthma relatives of patients. Each year, the disease kills 100 thousand people. The average mortality rate for the data received from 48 countries, corresponding to 7.9 per 100,000 population. According VOZ more than 300 million people worldwide suffer from asthma. However, despite this, finally calculate the risk of the disease can not be like predicting the disease, especially in children [1, 2]. Severe asthma in childhood is a serious medical and social problem. If asthma begins in early childhood, the prognosis is usually favorable: in 80 % of patients until period of puberty disease disappeared or become less pronounced. Approximately 20 % of patients after 45 years of disease are recurrence. Cases recovery of adult patients with asthma observed less frequently. Children’s asthma more difficult if it is combined with other allergic respiratory diseases or neurodermatitis. Mortality from asthma increases with age: in children, it is no more than 1 %, in adults – 2–4 % [3]. Severe asthma in children is a clinical form of the disease, which is characterized by constant day and night symptoms, frequent exacerbations, leading to reduced lung function parameters, a high level of bronchial hyperresponsiveness. Studies show that in the pathogenesis of asthma attracted many genes set which can vary in different ethnic groups. The study of genes associated with the development of asthma concerns 4 key areas: product immunoglobulin (Ig) E (atopy); the degree of severity of airway hyperresponsiveness; production of inflammatory mediators (cytokines and growth factors); determine the correlation between immune response and Th1-Th2-type. Predictors of severe asthma have a high index of atopyassociated gene polymorphism of interleukin-4 (IL-4). Currently installed more than 20 genes that are associated with atopy, and more than 100 genes associated with asthma. The influence of genetic factors on the formation of asthma and its phenotype showed their considerable heterogeneity. Established gene polymorphism ADRβ2 (Arg16Gly and Glu27Gln), which defines an increased likelihood of severe asthma. (Wechsler M. et al., 2006). Moreover, gene IL-4 receptor (IL4RA) and gene FcεRI β (encoding β-subunit receptor IgE), can be attributed to atopy genes and gene ADRβ2 to genes bronchial hyperresponsiveness [3, 4]. There is a high index of atopy known today as a predictor of severe asthma, as evidenced by the results of several studies, is to deploy the disease phenotype requires a genetic predisposition and exposure to adverse environmental factors. Genetic markers were studied in a number of scientific works of local and foreign researchers. Thus, in many studies there are indications of severe asthma association in children and IL-4 gene, polymorphism due 590T and 717S G + IL-4 gene, HLA-DRB1 genotype; high levels of Ig E (510 IU/ml with severe and 198 IU/ml in medium-heavy BA); high levels of IL-4 (189 pg/ml in severe and 47 pg/ml in medium-heavy BA); BA mother; concomitant atopic dermatitis. There are several groups of candidate genes for asthma – a key genes (genes cytokines – IL4, IL17A, IL17F) and heny-”modifiers” (detoxification system genes – CYP1A1). A lot of studies genes cytokine networks that play a crucial role in the development of allergic inflammation of the bronchi. However, just Predictability and risk factors of severe bronchial asthma in children

Cite this paper

@inproceedings{2015PredictabilityAR, title={Predictability and risk factors of severe bronchial asthma in children}, author={ОГЛЯД ЛІТЕРАТУРИ}, year={2015} }