318 Immunological Characteristics of Patients with Bronchial Asthma and Obesity

BACKGROUND: The problem of obesity-related diseases is current and worldwide increasing. We aimed to estimate the relationship between obesity, it's biomarkers and immunological features of bronchial asthma (BA) in obese patients as compared to healthy people with different BMI. METHODS: Body mass index (BMI) was evaluated in 57 adult patients with atopic BA, 23 patients with allergic rhinitis (AR) and 25 healthy people. Spontaneous production of TNF-α and IL-4 from blood lymphocytes and levels of C reactive protein (CRP), total IgE and leptine were detected in serum samples using ELISA kits. Levels of IgE- autoAbs to keratin, III and VI collagen types and elastin that showed association with BA severity in our previous data were also measured by ELISA. RESULTS: Atopic patients with BMI > 30 kg/m(2) in groups with AR and with BA had elevated levels of C-reactive protein (744 ± 28 ng/mL) and high spontaneous production of TNF-α (45 ± 4 ng/mL) and IL-4 (9.5 ± 2.8 ng/mL) in comparison with normal-weight patients and healthy (7.3 ± 2.7 ng/mL, 3 ± 0.6 ng/mL and 1.7 ± 0.3 ng/mL accordingly). BMI was considerably associated with BA severity (R = 0.4) and IgE-autoreactivity only in obese asthmatics (R = 0.58; P = 0.01), which showed raised IgE-autoAbs to keratin (11.6 ± 2 IU/mL) and collagen III (1.03 ± 0.3 IU/mL) in comparison with preobese (6.7 ± 1.5 IU/mL, 0.3 ± 0.01 IU/mL) and nonobese patients. The levels of total IgE in all groups showed no association with BMI and serum leptine concentration. Leptine level correlated with CRP (R = 0.59) and BMI (R = 0.4) and appeared to be overproduced in obese (57 ± 7.1 ng/mL) via non-obese (23 ± 6 ng/mL) asthmatics, as compared with AR patients and healthy subjects independently from BMI (6.1 ± 0.3 ng/mL) and therefore was associated with BA but not atopy in overweight patients. CONCLUSIONS: In obese patients with atopy the adipose mass represents an important source of inflammatory cytokines whereas it's mediators, such as leptine appears to impact especially in pathogenesis of BA in comparison with AR. Obesity is attended with higher generation of autoIgE-Abs, which elevated levels can indicate the disturbance of normal immune regulation. So asthmatics with higher BMI, show a special phenotype of disease which needs to be managed and treated distinctly.