THE COMPLEX CHARACTERISTIC OF EOSINOPHIL LEVEL OF INFLAMMATION IN PATIENTS WITH BRONCHIAL ASTHMA IN THE COLD-INDUCED BRONCHOSPASM

Eosinophilic segment of airway inflammation is one of the basic links of the pathogenesis of asthma. The aim of this work was a complex characteristic of eosinophilic inflammation in relation to clinical and functional parameters of the disease in patients with asthma during cold-induced bronchospasm. The study involved 94 patients with uncontrolled asthma (17.5±0.6 ACT points). In the patients there was assessed the lung function before and after the test of isocapnic hyperventilation with cold air (IHCA); there was done sampling and cytology of induced sputum (IS) and spontaneously produced sputum before and after IHCA, as well as analysis of peripheral blood. The forced expiratory volume in the first second (FEV₁) amounted to an average of 95.6±1.8% of predicted. In the cellular composition of IS, on average, in the general group, an increased percentage of eosinophils and neutrophils was found, which significantly increased under the effect of the cold trigger (eosinophils from 9.8±1.07 till 13.3±1.0%, p=0.011; neutrophils from 48.9±1.53 till 52.8±1.36%, p=0.022). By the results of the airways response to IHCA there were formed two groups: group 1 (n=33) with cold airway hyperresponsiveness (CAHR) and group 2 (n=61) with no signs of CAHR. According to anamnesis, 48% of patients in group 1 and 66% of patients in group 2 (χ²=1.95; p>0.05) had irregular anti-inflammatory treatment or did not have any. Patients of group 1 compared with group 2 had a lower level of ACT (15.6±1.0 and 18.6±0.8 points, p=0.021) and МОС_25-75 (66.1±4.0 and 76.9±3.5%; p=0.035). A high baseline level of IS eosinophils (≥2% eosinophils in IS) was in 81% of patients of group 1 and in 85% of patients of group 2 (p>0.05). Exposure to cold air led to an increase in the granulocyte cell elements of IS in both groups. In the analysis of peripheral blood, the absolute number of eosinophils in patients of group 1 was higher than in group 2 (186.0 [156.0; 224.0] and 129.0 [112.0; 192.0] in 1 µl; p=0.007). A close correlation was found between ACT (points), baseline values of small airways patency (МОС₇₅) and the absolute number of eosinophils in the peripheral blood (r=-0.33; p=0.031 and r=-0.31; p=0.025, respectively). Thus, patients with a lack of asthma control are characterized by induction of granulocytic cell inflammation in the bronchi under the influence of a cold trigger. A decrease in the level of asthma control and lung function in patients with CAHR is associated with an increase in the absolute number of eosinophils in peripheral blood.

mild asthma, uncontrolled asthma, cold airway hyperresponsiveness, eosinophilic inflammatory bronchial pattern

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