Bronchial Asthma in Adolescents with Undifferentiated Connective Tissue Dysplasia: Role of Th17 Cytokines, Vitamin D and Microelement Imbalance
Abstract
Introduction. Bronchial asthma is a chronic inflammatory disease of the airways characterized by bronchial hyperreactivity and airway remodeling. In recent years, increasing attention has been paid to the role of undifferentiated connective tissue dysplasia (UCTD) in the development and progression of bronchial asthma in adolescents. Structural abnormalities of connective tissue may contribute to changes in the architecture of the bronchial wall, enhancement of inflammatory processes, and worsening of the clinical course of the disease. Aim of the study. To evaluate the role of Th17 cytokines (IL-17), transforming growth factor-β (TGF-β), vitamin D status, and the balance of trace elements (zinc and magnesium) in adolescents with bronchial asthma associated with undifferentiated connective tissue dysplasia. Material and methods. The study included 182 adolescents aged 12–17 years. The main group consisted of patients with bronchial asthma combined with UCTD (n=92), the comparison group included patients with bronchial asthma without UCTD (n=60), and the control group consisted of practically healthy adolescents (n=30). Clinical, laboratory, immunological and biochemical methods of investigation were used. The levels of IL-17, TGF-β, IgE, vitamin D, zinc, and magnesium were assessed. Results and discussion. Adolescents with bronchial asthma associated with UCTD demonstrated significantly higher levels of IL-17, TGF-β and IgE, as well as significantly lower levels of vitamin D, zinc and magnesium compared with the control group (p<0.05). Multivariate regression analysis revealed that elevated IL-17 levels and vitamin D deficiency were independent predictors of severe bronchial asthma. These findings indicate the involvement of immune dysregulation and connective tissue abnormalities in the processes of airway remodeling and disease progression. Conclusion. The obtained results suggest that adolescents with bronchial asthma associated with UCTD have pronounced immune and metabolic disturbances, which may contribute to the severity of the disease and its progression. Assessment of cytokine profile, vitamin D status, and trace element balance may be important for improving the diagnosis and management of bronchial asthma in this group of patients.
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