On the value of certain genotypic properties for forming exercise-induced bronchial asthma in children
Keywords:children, exercise-induced bronchial asthma, bronchial tubes lability, glutathione transferase genes, NO-synthases
Introduction. Exercise-induced bronchial asthma is a separate phenotype of bronchial asthma (BA) that defines an exercise-associated transitory obstruction of bronchial tubes, especially decrease of the forced expiration volume for 1 sec. (FEV1) by 10 % and more of an output quantity after the relevant bronchial provocation test. At the same time there is not sufficient elucidation of the role of genetic component especially GSTT1 і GSTM1 gene deletions and\or mutational polymorphism of еNOS gene in development of exercise-induced bronchial asthma in children.
Aim. To study the value of deletion (GSTT1 and GSTM1 genes) and mutational (еNOS gene) polymorphism in formation of bronchial tubes lability in children with exercise-induced bronchial asthma to optimize individual medioprophylactic recommendations.
Materials and methods. During the study there were examined 102 school-aged children with BA in pulmo-allergology department of RSCH in Chernovtsy. To verify the exercise-induced bronchial asthma (EIBA) there was studied an exercise tolerance of patients and their bronchial tubes lability in the response to the dosed run and bronchomotor test with inhalation with 200 mkg of salbutamol. And the received results were represented as a bronchial tubes lability indicator (BTLI, %) and its components – bronchospasm index (BSI, %) and bronchodilation index (BDI, %). 2 clinical groups were formed in examination of children. The first (I, main) included 50 schoolchildren with EIBA and the comparative one (II group) – 52 children with BA without the signs of exercise-induced bronchospasm (EIBS).
Results of research. There was established that the “null” genotype of aforesaid genes is three times more often (10,0 % against 3,85 %, P<0,05)in children with exercise-induced bronchial asthma and mutations of еNOS gene ( GT, ТТ genotype) take place in every second children. There was detected that the highest bronchospasm indicators are in patients with GSTT1delM1+ (ІБС 24,2 % genotype , BTLI 35,4 %), and bronchodilation ones – in children with GSTT1+M1del genotype (BDI 21,0 %, BTLI 39,3 %). At exercise-induced bronchial asthma the highest bronchial tubes lability indicators are in children without mutation of eNOS gene exactly at the expense of bronchodilation test with salbutamol (BDI 19,8 %, BTLI 40,0 %).
Conclusions. The “null” genotype of GSTT1 and GSTM1, genes more often takes place in children with exercise-induced bronchial asthma and the highest bronchospasm indicators are in patients with GSTT1delM1+ genotype. The mutations of eNOS gene (GT, ТТ genotypes) take place in every second child with bronchial asthma but the gene mutation has no essential influence of an intensity of bronchospasm at the same time decreasing the results of bronchomotor tests with salbutamol
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