THE STATE OF CYTOKINE STATUS AND ITS PATHOGENETIC ROLE AT THYROIDAL INSUFFICIENCY IN PATIENTS WITH BRONCHIAL ASTHMA

The aim of the research was to characterize the spectrum of cytokines and to evaluate their participation in the formation of thyroidal insufficiency profile in patients with bronchial asthma. The serum levels of thyrotropic hormone (TTH), general thyroxin (Т₄), general triiodothyronine (Т₃), free fractions of hormones (сТ₄ and сТ₃), interleukins 4 and 2 (IL-4, IL-2) and interferon-γ (IFN-γ) were determined at one time in 124 patients with uncontrolled bronchial asthma (Asthma Control Test >10 and ≤19 grades) and without evident pathology of thyroid gland with the help of immune-enzyme analysis. Depending on the basal level of TTH the patients with bronchial asthma were divided into three groups: the first group consisted of 58 (47%) patients with TTH level from 2.5 till 4.5 mUnits/l (I degree of thyroid insufficiency development), 22 (19%) patients with TTH level from 4.0 till 10 mUnits/l (II degree of thyroid insufficiency development) were included in the second group, the third group had 42 (34%) patients with TTH level lower than 2.5 mUnits/l (no thyroid insufficiency development). The mixed asthma was diagnosed in 79 (64%) patients, allergic asthma – in 45 (36%) patients. The obtained results were compared with the parameters of serum dehydroepiandrosterone-sulfate (DHEA-S) and basal cortisol. At the examination it was found out that steroids of adrenal cortex, cortisol (at the domination of atopic asthma criteria) and DHEA-S (at the mixed form of a disease) affect significantly the change of thyroid gland activity at bronchial asthma and control the proliferation and secretory activity of almost all immune-competent cells. The patients with uncontrolled asthma were revealed to have the variability of polarization levels of the immune response by Th1and Th2 types and the development of functional insufficiency of the thyroid gland of I-II degrees, which is associated with the 2.5-4 times domination of proinflammatory cytokines products (IL-2 and IFN-γ) over the synthesis of immunosuppressive ones (IL-4).

бронхиальная астма, цитокины, гормоны гипофизарно-тиреоидной системы, гормоны надпочечников, bronchial asthma, cytokines, hormones of hypophysial-thyroid system, adrenal hormones

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