The aim. Special interest has been recently noted in the autoreactivity as one of the mechanisms of bronchial asthma (BA) pathogenesis. The purpose of the study was to determine levels of IgE- and IgG4-autoantibodies (autoAbs) to tissue antigens (Ag) - keratin, collagen III and VI types, myosin and elastin using adapted ELISA method in blood serum of 88 patients with bronchial asthma (BA) of different severity and clinical course. Results. We determined that in patients with BA the quantitative levels and frequency of Ig-EautoAbs to all those Ags were significantly enhanced and were more prominent in severe (59-81%) than in mild and moderate BA (p
Обоснование, В последние годы отмечен интерес к механизму аутореактивности как к одному из вероятных факторов формирования порочного круга патогенеза бронхиальной астмы (БА). Цель, Оценить аутореактивность по количественному определению содержания IgE и IgG4-аутоантител (аутоАТ) к тканевым антигенам (АГ) - кератину, коллагену III и VI типов, миозину и эластину в сыворотках крови больных БА с разным клиническим течением и степенью тяжести заболевания. Материалы и методы, В сыворотках крови 88 больных БА методом ИФА определяли уровни IgE- и IgG4-аутоАT к антигенам, представленным в тканях бронхиального дерева, а также содержание общего IgE, ИЛ-4 и ИЛ-10. Результаты, У лиц с БА синтезируются IgE-аутоАТ к тканевым антигенам: кератину, коллагену III и VI типов, эластину, миозину, количественное выражение и частота которых достоверно выше (59-81) у больных при тяжелом течении заболевания, чем при легкой и средней степени тяжести (р0,05). Показана связь между IgE-аутореактивностью и клиническим течением БА, характеризующаяся увеличенным содержанием и частотой выявления IgE-аутоАТ к тканевым АГ в период ремиссии и при длительном течении заболевания (более 5 лет). Выявлено также повышенное содержание IgG4-аутоАT к тканевым АГ у больных БА в сравнении со здоровыми лицами, уровень и частота которых снижались по мере увеличения степени тяжести заболевания. IgE-аутоАТ положительно коррелировали с уровнем общего IgE и ИЛ-4, а IgG4-аутоАT - с ИЛ-10. Заключение, IgE-аутоАТ, выявляемые у больных БА, отражают степень альтерации бронхолегочной ткани и количественно возрастают при тяжелом течении заболевания, тогда как IgG4-аутоАT могут свидетельствовать о степени активности регуляторного звена иммунитета.The aim. Special interest has been recently noted in the autoreactivity as one of the mechanisms of bronchial asthma (BA) pathogenesis. The purpose of the study was to determine levels of IgE- and IgG4-autoantibodies (autoAbs) to tissue antigens (Ag) - keratin, collagen III and VI types, myosin and elastin using adapted ELISA method in blood serum of 88 patients with bronchial asthma (BA) of different severity and clinical course. Results. We determined that in patients with BA the quantitative levels and frequency of Ig-EautoAbs to all those Ags were significantly enhanced and were more prominent in severe (59-81) than in mild and moderate BA (p0.05) and were decreased during BA exacerbation. We also found increased frequency of detection and higher levels of IgE-Abs in long-term disease natural course (more than 5 years). The levels of IgG4-Abs to all listed Ags in patients with asthma was also enhanced compared with healthy people, but its levels oppositely decreased as the disease severity worsened. The frequency of elevated IgG4-autoAbs had higher prevalence among patients with mild BA. Direct correlation between the IgG-4autoAbs and IL-10 in the serum of patients with BA mild and moderate severity was indicated. Conclusions. IgE-autoAbs, when detected in patients with asthma, reflect the degree of lung tissue alterations and correlate with the disease severity, while IgG4-autoAT could indicate the functional activity of immune regulatory mechanisms.
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