Comparison of Immune Response between Pediatric Bronchial Asthma and Sinusitis / 소아알레르기및호흡기학회지

ABSTRACT

PURPOSE: Bronchial asthma and sinusitis have been grouped together and classified as one airway-related disease, with the same underlying inflammatory etiology. Through serological examination, we ascertained a difference in the immune response between bronchial asthma and sinusitis. METHODS: We measured the peripheral blood eosinophil count, total IgE and specific IgE to 7 aeroallergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Alternaria, cockroach, cat, dog and pollen), and interleukin (IL)-4 and interferon (IFN)-gamma of 118 school-aged patients who visited Dong-A University Medical Center and Busan Medical Center from March 2005 to February 2008. We divided these patients into 31 diagnosed with sinusitis (Group A), 36 diagnosed with bronchial asthma (Group B), and 51 diagnosed with both sinusitis and asthma (Group C). RESULTS: The peripheral blood eosinophil count and total IgE were markedly lower in group A. Dermatophagoides pteryonyssinus and Dermatophagoides farinae had higher sensitization rates than other aeroallergens in groups B and C. The sensitization rates to Alternaria and dog were higher in group C than in group B, and the sensitization rates to cat and pollen were higher in group B than in group C. In group C, clinical symptoms occurred evenly and allergic rhinitis was concurrent, similar to group B; however, the sensitivity of the bronchial provocation test was higher than in group B. Serum IL-4 in group B and C were significantly higher than in group A (P<0.001), and serum IFN-gamma was significantly higher in group A than in group C (P<0.027). CONCLUSION: Bronchial asthma was primarily related to IL-4 and Th2 cytokines, while sinusitis was primarily related to IFN-gamma and Th1 cytokines. According to the degree of association between the 2 diseases, various immune responses were observed.