RESUMO
The aim of the work was to study clinical and pathophysiological features of endothelial dysfunction, structural and functional state of the left heart in patients with bronchial asthma (BA). The study included 290 patients. 250 of them presented with moderate or severe BA during exacerbation and within 12 months after the onset of observation, 40 healthy volunteers served as controls. The endothelial function was disturbed in 63 and 74% of the patients with moderate and severe BA respectively. They showed reduced endothelium-dependent vasodilation in combination with a significant increase of the plasma sDC31/ sPECAM-1 level. It is concluded that patients with BA develop structural and functional changes in the left ventricular myocardium proportional to the severity of BA which leads to diastolic dysfunction.
Assuntos
ADP-Ribosil Ciclase 1/sangue , Asma , Doenças Cardiovasculares , Endotélio Vascular , Molécula-1 de Adesão Celular Endotelial a Plaquetas/sangue , Adulto , Asma/complicações , Asma/diagnóstico , Asma/fisiopatologia , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Endotélio Vascular/imunologia , Endotélio Vascular/fisiopatologia , Feminino , Humanos , Inflamação/imunologia , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória/métodos , Fatores de Risco , Índice de Gravidade de Doença , Estatística como Assunto , Vasodilatação , Remodelação VentricularRESUMO
The study was aimed at measuring the number of CD38+ lymphocytes in peripheral blood and its relationship with a marker of endothelial dysfunction CD31/PECAM-1 in patients with moderate or severe bronchial asthma (BA) during exacerbation and 12 months after it. The study groups included 153 patients, the control one consisted of 40 subjects. Group 1 comprised 106 patients with moderate BA, group 2 patients with severe steroid-independent BA (n=61), group 3 patients with steroid-dependent BA (n=53). CD38+ lymphocytes were detected by immunocytochemical methods, IL-6, IL-4, IL-2, and TNF-α by solid-phase immunoenzyme assay. BA patients exhibited signs of systemic inflammation reflected in the two-fold and 2.5-fold increase of serum TNF-α and IL-6 levels respectively in the patients of group 1. TNF-α, IL-6 and C-reactive peptide levels increased by 3, 2 and 2.5-4 times in groups 2 and 3. Exacerbation of BA resulted in a 5-fold rise in the number of DC38 lymphocytes that persisted during the next 12 months suggesting a 15% increase in the level of sPECAM-1/sCD31 (a non-substrate ligand of CD38) associated with endothelial dysfunction. The study revealed positive correlation between elevated sPECAM-1/sCD31 levels and the number of CD38+ lymphocytes in all groups (r=0.456; p<0.05).
