The goal of our research was to analyze the role of transforming growth factor-β1 (TGF-β1 ) in airway remodeling, inflammation, clinical course, treatment efficacy in patients with bronchial asthma (BA) according to the literature data, as well as determination of this biomarkers level in the blood of BA patients. Material and research methods. The publications is containing the results of studies on the role of TGF-β1 in the course of BA have been analyzed. The level of TGF-β1 in the blood was determined within enzyme-linked immunosorbent assay using kits “IBL International GMBH, Germany” in 553 BA patients and in 95 healthy individuals. Results. The article presents data about TGF-β1 influence on the processes of airway remodeling in BA patients, its role in microcirculation disorders, mucus production, eosinophilic inflammation and severity of clinical symptoms of the disease. The level of TGF-β1 expression was associated with disease control, severity and duration of the disease, despite conflicting data that require further study. In addition, there were presented recent research data about TGF-β1 as a marker of airway remodeling and as a therapeutic target in the treatment of BA patients. Glucocorticoids, tiotropium bromide, methylxanthines, selective inhibitors of TGF-β1 , resveratrol, simvastatin and montelukast and their mechanisms of influence were presented in detail. Significantly higher level of TGF-β1 in the blood of patients with BA was found (38.5 ± 0.7) pg/ml compared with healthy individuals (33.9 ± 1.0) pg /ml, p = 0.007. Conclusion. A significantly higher level of TGF-β1 was revealed in the blood of BA patients. In our opinion, a differentiated analysis of the content of this marker depending on the phenotype of the disease is important, which would explain the conflicting results of different studies, deepen understanding of its pathophysiological and clinical role in order to develop methods for slowing airway remodeling. Key words: bronchial asthma, transforming growth factor-β1 (TGF-β1), airway remodeling.
Background:During last years we are seeking for new biomarkers of early or even preclinical diseases stages, precise definition of disease activity and accurate prediction of the disease course as well as biomarkers of treatment efficiency. Nailfold capillaroscopy (NFC) considering as a method for early or even preclinical diagnostic tool for systemic scleroderma, at the same time there is enough data that dermatomyositis (DM) characterized with similar NFC changes along with other idiopathic inflammatory myopathies (IIM) due to the peripheral vascular involvement.Objectives:The goal of our research was aimed to analyze possible association between capillaroscopic alterations and angiogenic, tissue remodeling factors in patients with DM.Methods:44 patients with DM were examined and included in the study. NFC we performed usingDino-Lite CapillaryScope with 200 magnification.We assessed nailfold capillary density (NCD), presence of microhemorrhages, giant, dilated and ramified capillaries, scleroderma patterns (defined as an early, active or late pattern) and neovascular pattern (defined as an active and late scleroderma patterns). We use Manual Muscle Testing 8 (MMT8), Health Assessment Questionnaire (HAQ), Myositis Disease Activity Assessment Tool (MDAAT), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), physician’s VAS, patient’s VAS, serum muscle enzymes levels to asses disease activity. The level of transforming growth factor alpha (TGF-α) and vascular endothelial growth factor (VEGF) were assayed by the enzyme immunoassay system in the blood serum. We divided patients into 4 groups: 1stgroup – 17 DM patients with early NFC scleroderma pattern, 2ndgroup included 11 DM patients with active NFC scleroderma pattern, 3rdgroup – 6 DM patients with late NFC scleroderma pattern and 4thgroup included 10 DM patients with no any significant NFC alterations.Results:We didn’t find any significant difference of the VEGF level between examined groups, though the level of VEGF in the 1stgroup was – 473,65±48,24 pg/ml, 2nd– 412,89±106,24 pg/ml, 3rd– 283,0±71,93 pg/ml, 4th– 305,9±45,89 pg/ml (p=0,12, F=2,06), however at the same time we compare the level of VEGF between patients with long disease duration and newly onset disease and VEGF was higher among newly onset active DM patients – 465,32±54,54pg/ml VS 324,96±41,16 pg/ml (p=0,042, F=4,365). The level of TGF-α in the 1stgroup was 100,82±8,98 ng/ml, 2nd– 65,78±9,21 ng/ml, 3rd– 56,9±5,01 ng/ml, 4th– 65,5±10,2 ng/ml, though it was significantly higher in the 1stgroup patients (p=0,002, F=5,88).Conclusion:According to our results we can assume that VEGF and TGF-α could be applied as biomarkers of disease activity and duration, however more data is required.Disclosure of Interests:None declared
Резюме. Бронхіальна астма (БА), асоційована із ожирінням, представляє окремий фенотип, для якого характерний важчий перебіг захворювання та нижча відповідь на базисну терапію. БА та ожиріння визнані як класичні мультифакторіальні захворювання, що виникають в осіб із певним генотипом під дією провокуючих факторів зовнішнього середовища. Дослідження генів-кандидатів БА та ожиріння сприятиме поглибленню наших знань і розумінь загальної генетичної основи даних захворювань. Мета. Огляд літератури, що містить результати досліджень Arg16Gly і Gln27Glu поліморфізмів гена β 2 -адренорецептора (β 2 -АР), які розглядаються, як спільні кандидати щодо виникнення БА та ожиріння, що дозволить зрозуміти та обгрунтувати напрямок подальших досліджень. Матеріали та методи дослідження. Проаналізовано публікації, що містять результати досліджень щодо ролі Arg16Gly і Gln27Glu поліморфізмів гена β 2 -АР у виникненні БА та ожиріння. Результати дослідження. Дані аналізу літератури за досліджуваною проблемою носять суперечливий, а іноді й дискордантний характер. Представлено, що сила взаємодії між Arg16Gly і Gln27Glu поліморфізмами та наявністю БА і ожиріння не завжди достатня, щоб пояснити цей зв'язок. Це підкреслює наявність невирішених запитань, які потребують подальших досліджень. Висновок. Проведений аналіз пошуку спільних генетичних маркерів на прикладі Arg16Gly і Gln27Glu поліморфізмів гена β 2 -АР у хворих на БА і ожиріння вказує на необхідність подальшого вивчення цієї проблеми для удосконалення діагностичних, лікувальних та профілактичних заходів. Ключові слова: бронхіальна астма, ожиріння, Arg16Gly і Gln27Glu поліморфізми гена β 2 -адрено рецептора.
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