Influence of intestinal permeability and endotoxinemia on the course of asthma in obese patients
- Authors: Grakhova M.A.1,2, Troshina I.A.1, Golubeva T.I.1, Pavlova A.M.1, Pluzhnikova A.P.2
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Affiliations:
- Tyumen State Medical University
- Regional Clinical Hospital No. 1, Tyumen
- Issue: Vol 41, No 5 (2024)
- Pages: 35-44
- Section: Original studies
- URL: https://bakhtiniada.ru/PMJ/article/view/271977
- DOI: https://doi.org/10.17816/pmj41535-44
- ID: 271977
Cite item
Abstract
Objective. To study the characteristics of asthma with a severe course in obese patients and to evaluate the relationship of the level of intestinal endotoxin (ET) and fecal zonulin with clinical, laboratory and instrumental indicators in such patients.
Materials and methods. The study included 98 patients with asthma combined with obesity (group 1 – mild asthma (n = 47), group 2 – severe asthma (n = 51)) and 45 obese patients without asthma composed the comparison group. A complete standard examination and tests were conducted in all the patients. Intestinal ET, fecal zonulin, TNF-a, IFN-g, IL-4, 6, 10, 17, total IgE levels were assessed as well. The IBM SPSS Statistics 26.0 application software package was used for statistical calculations. The results were considered as statistically significant at the level of p <0,05.
Results. In patients of both groups, the average age of onset was 43 years. The median duration of BA characteristics was higher in patients of group 2: 14 [10; 19] years (p = 0.013). In all groups, CRPhs values increased significantly and the highest ones were in patients with severe asthma (p < 0.001). Significantly lower levels of FVC, FEV1, FEV1/FVC, IL-10 (p<0.001) with uncontrolled course of asthma (p = 0.008) and rare control (p = 0.009) occurred in patients of group 2. Higher levels of TNF-a, IFN-g, IL-6,17, intestinal ET, fecal zonulin were revealed in patients of group 2 (p≤0.001). The level of fecal zonulin positively correlated with the level of intestinal ET in patients of group 2 (p<0.001, rs=0.813). In patients of group 2 direct correlations of the fecal zonulin and intestinal ET with BMI, WC, HC, WC/HC, lack of BA control, CRPhs, TNF-a, IL-6,17, IFN-g, LDL were established and inverse correlations were with IL-10, HDL, FEV1, AST; a negative correlation of fecal zonulin levels with FVC was also revealed.
Conclusions. The obtained results allow us to speak about the existence of a clinical complex “severe asthma – obesity – intestinal endotoxemia and increased intestinal permeability” which is characterized by the predominance of pro-inflammatory markers, increased levels of intestinal ET and fecal zonulin, reduced function of external breathing.
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##article.viewOnOriginalSite##About the authors
Maria A. Grakhova
Tyumen State Medical University; Regional Clinical Hospital No. 1, Tyumen
Author for correspondence.
Email: mari.grahova@yandex.ru
ORCID iD: 0000-0002-1657-0695
SPIN-code: 3567-8379
Scopus Author ID: 57204454570
Allergist-Immunologist, Assistant of the Department of Hospital Therapy with the Course of Endocrinology
Russian Federation, Tyumen; TyumenIrina A. Troshina
Tyumen State Medical University
Email: iritro@inbox.ru
ORCID iD: 0000-0002-7772-8302
SPIN-code: 4821-2155
DSc (Medicine), Associate Professor, Head of the Department of Hospital Therapy with the Course of Endocrinology
Russian Federation, TyumenT. I. Golubeva
Tyumen State Medical University
Email: golubeva@mail.ru
ORCID iD: 0000-0002-3909-5364
PhD (Medicine), Associate Professor of the Department of Hospital Therapy with the Course of Endocrinology, Gastroenterologist
Russian Federation, TyumenA. M. Pavlova
Tyumen State Medical University
Email: alsusabitova200591@gmail.com
ORCID iD: 0000-0002-2172-111X
Assistant of the Department of Hospital Therapy with the Course of Endocrinology, Endocrinologist
Russian Federation, TyumenAnna P. Pluzhnikova
Regional Clinical Hospital No. 1, Tyumen
Email: anya.pluzhnikova@gmail.com
ORCID iD: 0009-0000-3450-2816
Pulmonologist
TyumenReferences
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