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دراسة العلاقة بين بعض المؤشرات المناعية وشدة المرض عند المصابين بالربو الارجي == Study of the relationship between some immunological markers and disease severity in allergic asthma patients
Author name:
یاسر باسم عبد الوهاب
General topic:
Biology
Specific topic:
Microbiology - Immunology
Degree:
Master
University:
University of Baghdad
Language:
Arabic
University location:
Baghdad
First pages:
24T3167 - p.pdf
Abstract:
This study was conducted to support the investigations of probable immunological changes in asthmatic patients and to study the relationship between some immunological markers and the clinically estimated asthma severity in order to find the more correlated immunological marker with asthma severity. This study involved 61 patients of both genders ( ٤٦ female and 15 male) of age varied between 13 to 53 years from recently diagnosed cases that arrived to the allergy institute of Baghdad or from steroids and other antiinflammatory therapy ceased patients and for a period that allow to carry out study tests without effecting the results, In addition to control group which consisted of 23 apparently healthy individuals.Skin test analysis of ten allergens showed a significant differences between asthma patients and healthy controls in rate of positive reactivity for at least one tested molds or grass allergens where they attained 43.1 % and 35.3% in patients’ group respectively, results also revealed that there was a significant differences in rate of reactivity for M4 allergen only with difference in asthma severity.Total and specific serum IgE were assessed by the Enzyme Linked Immunosorbent assay (ELISA). The geometric mean of serum total IgE was significantly higher in asthmatics than healthy controls, Another Significant elevation was revealed in asthmatics as compared to control in the rate of 100 IU/ml overlapped serum total IgE individuals, this rate also showed significant difference among the different categories of asthma severity. 83 IU/ml was suggested as a typical cut off value that differentiates asthmatic patients from healthy individuals.From other side, estimation of serum specific IgE for 10 allergens demonstrated significant differences in I203 allergen specific IgE levels in addition to specific IgE for food allergens (F25, F27, F33, F35 and F81) between asthmatics and healthy controls. Its ought to mention that specific IgE for food allergens (F25, F27 and F33) also recorded significant differences by difference in asthma severity which may refer actual effect for some food allergens in asthma pathogenesis .The results didn’t document any significant difference in levels of other immunoglobulins IgM, IgG, and IgA and complement component C4 in serum between asthmatic patients and control group, Whereas a significant elevation was documented in serum C3 level of asthmatics as compared to healthy controls which supports the studies that refered some complement component role in asthma pathogenesis. From other side, this study didn’t observe any significant differences in the levels of those immunoglobulins with difference in asthma severity. Total and differential white blood cells were estimated during the study, the results showed a significant elevation in mean of total white blood cells, eosinophils and neutrophils numbers in asthmatics’ blood as compared to control, while there were no significant differences in association with remaining white blood cells. The relationship between asthma severity and white blood cells was also assessed, the results showed a significant difference in geometric mean of total white blood cells and also lymphocytes numbers in asthmatics’ blood and asthma severity.The data demonstrated that there was a significant elevation in level of eosinophil cationic protein (ECP) in asthmatics’ serum (median = 40 ng/ml) as compared with control group (median = 15.5 ng/ml) , it was also observed that elevation in serum ECP level proportionate significantly increasing of asthma severity. This study suggested that 29 ng/ml of serum ECP as a typical cut off value of statistically significant denotation for differentiation between asthmatic patients and healthy individuals. The ratio of serum eosinophil cationic protein to blood eosinophils was calculated in this study, Despite not attaining the significance level between patients’ group and controls as regards this ratio, results showed a significant elevation in ECP/Eo associated with increasing ofasthma severity among different categories. During the study of correlation among some immunological markers that adapted in many allergy centers as preliminary diagnostic tests for asthmatic patients especially the determination of total serum IgE level and blood eosinophils number, there was no significant correlation between total serum IgE level and asthma severity, correlation between blood eosinophils and asthma severity was also not significant too (r = 0.16 and 0.01 respectively). Contrary to the previous results, Statistical analysis showed a significant positive linear correlation between ECP level and also ECP/Eo ratio and clinically estimated asthma severity (r = 0.41 and 0.43 respectively, P<0.01).According to results the ratio 0.38 Pg/Cell suggested as a typical cut off value for diagnosing severe persistent asthma and 137.5 ng/ml of serum ECP concentration also suggested as a typical cut off value for differentiating severe persistent asthma cases from other less severe categories. According to the results, Determination of serum ECP can be considered as a diagnostic tool for differentiating asthma cases from not, besides it reflects asthma severity significantly, whereas calculation of ECP/Eo ratio may be an effective marker in reflecting asthma severity which may be useful in monitoring asthma cases and in determining the recovery of disease severity during therapy stages but it has no benefit for diagnosing asthma cases where no significant differences were recorded between asthmatics and healthy controls
