The role of microcirculatory changes in children with bronchial asthma during exacerbation and remission

The pathogenesis of bronchial asthma (BA) is based on chronic inflammation of the mucous membrane of the respiratory tract, caused by the influence of biologically active molecules, among which the intercellular adhesion molecule sICAM-1 plays a key role. Persistent inflammation of the airways in asthma leads to hemodynamic changes in the entire vascular system, including at the level of the microvasculature. The study of microrheological changes and immunobiological profile allows us to identify additional diagnostic criteria for the activity of the inflammatory process and the degree of control over the disease with the aim of a personalized approach to the management of patients with asthma. Purpose of the study. To determine changes in the microvasculature and the level of expression of sICAM-1 in children with asthma during exacerbation and remission. Materials and methods. 69 patients were examined (group 1 — 49 children with asthma, group 2 — 20 children of health groups I and II). The study of the microcirculatory profile was carried out using computer capillaroscopy of the nail bed, and the level of sICAM-1 in the blood serum was determined by enzyme immunoassay according to the laboratory protocol. Results. When comparing the main capillaroscopic parameters, changes were found in the form of a decrease in the length of the arterial part in group 1 (during exacerbation — 79.5±9.8 µm, during remission — 180.5±9.2 µm), compared to group 2 — 196±5.5 µm (p<0.05); widening of the venous part in group 1 — 49.6±2.8 µm and 48.1±1.8 µm, respectively, compared to group 2 — 39.9±2.4 µm (p<0.05); increase in the length of the perivascular zone in group 1 – 86.1±3.49 µm (exacerbation) and 84.8±3.92 µm (remission), compared to group 2 — 79.6±6.5 µm (p<0.05). The results of this study show that during an asthma exacerbation, there is a significant increase in the concentration of sICAM-1 molecules in the blood serum, which corresponds to the observed microcirculatory changes in the capillaries and reflects the activity of the inflammatory process in patients with asthma. Conclusion. In children with asthma, identified microcirculatory changes in the form of capillary remodeling and increased expression of sICAM-1, most significant during the period of exacerbation, can be used as additional criteria for assessing the activity of inflammation and disease control.