Кинетика Fе²⁺-индуцированной хемилюминесценции плазмы при атопической бронхиальной астме и других проявлениях атопии

Изучена кинетика Fe2+ -индуцированной хемилюминесценции плазмы у 57 обследованных: с обострением атопической бронхиальной астмы, с аллергической риносинусопатией, поллинозом в форме риноконъюнктивального синдрома, атопическим дерматитом и у 15 здоровых доноров. Наряду со стереотипным повышением интенсивности хемилюминесценции при обострении атопических заболеваний, свидетельствующим об активации свободнорадикальных процессов, выявлены различия в исходном состоянии систем антиоксидантной защиты и варианты ответа на ацетилхолиновый тест в зависимости от уровня общего 1дЕ, наличия клинически выраженного бронхообструктивного синдрома в программе атопии и степени бронхиальной гиперреактивности. Обсуждается значение нарушений функционирования систем АОЗ на ранних стадиях формирования атопической бронхиальной астмы, на основании чего предложен дополнительный лабораторный критерий для выделения группы риска.

Seventeen patients with atopy symptoms (rhinitis, hay fever, allergic dermatitis) and without either clinical or spirometric bronchoconstriction signs have been examined along with 25 patients with mild atopic bronchial asthma exacerbation (ABA) and a control group of 15 healthy subjects. All the patients underwent the skin tests with standard set of allergens and the acetylcholine bronchial challenge test (Ach-test). Serum common IgE level have been detected by ELISA test. The antioxidant defence (AOD) condition and its changes during the Ach-test were estimated using indices of kinetics of Fe2+ -induced plasma chemiluminescence (ChL). As it was snown the increase of ChL intensity index was the most expressed in high inflammatory activity cases. It was not found any correlation between ChL intensity, atopy clinical manifestaion and IgE level. So it should be possible to define the ChL intensity as non-specific parameter which reflects the increase of free radicals plasma production and its involvement in inflammatory reactions forming. On the other hand a relationship between serum common IgE level and AOD was demonstrated in our investigation. In cases with IgE level higher than 300 U/ml the speed of ChL inhibition (V) was higher and intergrated ChL index (ChLI) was lower than in other patients. It was also shown that there was the correlation between non-specific bronchial hyperreactivity and AOD activity. Negative Ach-test results were accompanied by the increase of AOD activity after the test (the increase of V and the reduction of half-fading time of ChL — ChL). The similar AOD-response was found in patients with ABA and low Ach sensitivity, high IgE level and skin sensibilization to variety of antigens. On the contrary discordant AOD response (the reduction of V and the increase of ChL) was typical for patients with high Ach sensitivity. The involvement of free radicals and AOD in the initial stage of asthma forming in atopic patients is suggested by this discordant AOD response also in certain patients (35[%]) with hay fever and/or positive Ach-test. It should be possible to use this laboratory phenomen to distinguish patients with great risk of asthma development.