Grygola O. Activity-induced bronchial asthma in school age children (factors of disposition, clinical-paraclinical features of the state of bronchial asthma, diagnostic and treatment reasoning)

Object - asthma physical exertion in children of school age; purpose - to study the diagnostic value indicators integrated clinical-paraclinical examination and justify individualized therapeutic and prophylactic measures in acute period and attack free intervals to enhance the effectiveness of the treatment of asthma physical exertion; methods - general clinical, molecular-genetic, method of sputum induction, cytomorphological, immunological, allergological, biochemical, spirometric, statistical; results - created the diagnostic constellation table that allows to verify the phenotype of activity-induced bronchial asthma; obtained new evidences regarding activity-induced bronchial asthma interrelation of processes oxygen dependent metabolism of blood neutrophils with the level of monitoring activity-induced bronchial asthma of pupils under criteria proposed by GINA-2008, indicators of bronchial hyperreactivity and enzymatic fibrinolytic activity in the condensate of expiratory air and blood level of CD8+-lymphocytes with the severity of activity-induced bronchial asthma attacks and high concentration in expiratory air metabolites of nitrogen monoxide; using cluster analysis, it was broaden imagination of verifying value of activity-induced bronchospasm in the formation of phenotype activity-induced bronchial asthma; there were proved the individualized approaches to easier treatment of asthma attacks and basic treatment in attack free intervals considering speed of acetylatory processes and deletion polymorphism of GSTM1 gene; demonstrated that significant variations are being occurred in the individual indicators of bronchospasm, index of bronchospasm exceeds normal values by 1.5-2.0 times, but these values are not being significantly correlated with the severity of the indicator.