Abstract

Background:Asthma is a heterogeneous disease, usually characterized by chronic
airway inflammation. It is defined by the history of respiratory symptoms such as
wheeze, shortness of breath, chest tightness, and cough that vary over time and in
intensity, together with variable expiratory airflow limitation. AIM: To estimate the pro
inflammatory cytokine (TNFα), anti-inflammatory cytokine (IL-10) and serum IgE
levels during exacerbation and remission of asthma and to compare with normal
controls.
Materials and Methods: Study Design: Prospective comparative study. Study area:
Department of. Pulmonary Medicine and General Medicine, M. V. J Medical College
and Research Hospital, Hoskote, Bengaluru. Study Period: 1st march 2021 to 28th
February 2022. Study population: Patients who had symptomatology of Asthma
attending and admitted in the Dept. of. Pulmonary Medicine and General Medicine.
Sample size: study consisted a total of 50 patients. (25 cases and 25 controls) Sampling
method: Simple Random sampling method. Ethical consideration: Institutional Ethical
committee permission was taken prior to the commencement of the study. Study tools
and Data collection procedure: The study included a total of 50 individuals of which 25
were patients of asthma and 25 normal healthy controls from general population. The
subjects included in the study were explained the purpose of enrolment and informed
consent was taken. Statistical Analysis: Statistical analysis was done using Microsoft
excel sheet and analysed statistically using SPSS (statistical package for social service)
version 22. Since plasma cytokine concentrations were not in a Gaussian distribution,
the Mann–Whitney rank sum test was used to assess the differences.
Results: 8(32%) cases where in the age range of 20-30 years, 9(36%) in 31-40 years
range and 8(32%) were above 40 years. 6(24%) participants of the study group were
males and 19(76%) were females. The serum levels of the pro inflammatory cytokine
TNFα during exacerbation of asthma was 7.38± 5.4 pg/ml and during remission was
5.01±4.1 pg/ml, while the controls had a mean of 2.43± 0.83 pg/ml. The serum levels of
the anti-inflammatory cytokine IL- 10 were 4.36±5.9 pg/ml during exacerbation,
13.72±11.4 pg/ml during remission and 3.42±2.8 pg/ml in controls.
Conclusion: Persistently elevated levels of the pro inflammatory cytokine (TNFα) and
IgE in the remission phase points to the chronic inflammatory nature of asthma and the
exacerbations being acute on chronic type of inflammation. The higher levels of IL-10
point out towards the anti-inflammatory role of IL -10 and its role in inducing a
remission.