Association between Immune System Response, Inflammatory Cytokines and Obesity among Asthmatic Saudi Patients

Research Article

Austin J Allergy. 2017; 4(2): 1031.

Association between Immune System Response, Inflammatory Cytokines and Obesity among Asthmatic Saudi Patients

Al-Sharif FM*

Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia

*Correspoing author: Fadwa M. Al-Sharif, Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Saudi Arabia

Received: August 14, 2017; Accepted: September 19, Published: September 26, 2017

Abstract

Background: Currently, the global prevalence of asthma and obesity is progressively rising. However, obesity is linked with systemic inflammation and altered immune system parameters. There is limited studies investigated the immuno-competence among asthmatic obese patients.

Objective: This study designed to detect the association between immune system response, inflammatory cytokines and body mass index among asthmatic Saudi patients.

Subjects and Methods: One hundred asthmatic obese Saudi patients of both sex; their age mean was 42.63 ± 9.15 year and their body mass index (BMI) mean was 32.42 ± 2.96 Kg/m² known as group (A), in addition to one hundred non-obese asthmatic, who were gender, age and BMI matched with study group, were enrolled in the study. Results: There was higher levels of high-sensitivity C-reactive protein (hsCRP), Interleukin-6 (IL-6), Tumor necrotic factor-alpha (TNF-a), serum IgE, white blood cells count, Total leukocytes count, Neutrophils count, Monocytes, lymphocytes count, T lymphocytes (CD3) count and B lymphocytes (CD19) count among obese asthmatics(group A) than lean asthmatic (group (B), in addition to a strong association between these parameters and body mass index in both groups.

Conclusion: There is a strong association between inflammatory cytokines, immune system response and BMI among obese asthmatic patients; therefore future studies are essential to explore impact of life style modification intervention on immune system and systemic inflammation modulation.

Keywords: Immune system; Systemic inflammation; Obesity; Bronchial asthma; Body mass index

Introduction

Asthma is a common medical problem as there is about 300 million patients with bronchial asthma all over the world [1,2]. However, asthma is more common among obese than no-obese individuals [3-5]. In addition, severity of asthma positively correlated with body mass index [6], where obesity reduces the effects of asthma medications [7-9]. There is association asthma and obesity [10-11].

Obesity is a pro-inflammatory state [18-20]. Systemic lowgrade inflammatory status that is associated with obesity adversely affect immune system performance [21] and worsen the airway inflammation among patients with bronchial asthma [22,23]. Impaired immune system performance led to increased rate and severity of infections among obese subjects [24,25].

The purpose of this study was to determine the relationship between Body Mass Index (BMI), immune system and inflammatory cytokines in asthmatic Saudi patients.

Subjects and Methods

One hundred asthmatic obese Saudi patients; their age mean was 42.63 ± 9.15year and their BMI mean was 32.42 ± 2.96 Kg/m² known as group (A), in addition to one hundred non-obese asthmatic, who were gender, age and BMI matched with study group, were enrolled in the study upon referral to Internal Medicine Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia Known as group (B). Exclusion criteria included diabetes, liver, kidney, neurological and other respiratory disorders rather than bronchial asthma. All participants signed the consent and the Scientific Research Ethical Committee, Faculty of Applied Medical Sciences at King Abdulaziz University approved this study.

Methods

Evaluated Parameters: Blood samples were collected in two different vacutainer tubes (BD vacutainer). One tube was a red top for hsCRP level, IL-6, TNF-a and for the total IgE measurement. The second tube contains EDTA K2, EDTA K3 for measuring Complete Blood Count (CBC) and flow cytometry. Whole blood Samples were centrifuged (at 3500 rpm for five minutes), to separate the serum and plasma. Samples were stored at -80°C until time of processing.

A. Biochemical Parameters: Biochemical parameters including serum hsCRP, total IgE and CBC were measured at the same time after collection. Serum for hsCRP was quantified by enzymaticcolorimetric methods using commercially available kits (Roche Diagnostics, Mannheim, Germany). Beckman Coulter Ac.T 5diff hematology analyzer at king Abdul-Aziz University Hospital used for peripheral blood cells analysis.

B. Measurement of Biomarkers of Inflammatory Cytokines: Biomarkers of inflammatory cytokines including tumor necrosis factor-alpha (TNF-a), and Interleukin-6 (IL-6) levels were measured from frozen plasma samples stored at -80°C. Enzyme-linked Immunosorbent Assays Kits (ELISAs) used to measure soluble levels of (TNF-a), and IL-6 (GE Healthcare Amersham, Biotrak Easy ELISA), which utilized the quantitative sandwich enzyme immunoassay technique.

C. Flow cytometric analysis: The human leukocyte differentiation antigens CD3, and CD19 (Beckman Coulter, Marseille, France) were analyzed by flow cytometry using Cytomics FC500 and CXP software (Beckman Coulter).

D. Analysis of serum IgE: Blood was collected into red top tubes (BD vacutainer, USA) and UniCAP Total IgE fluoro enzyme immunoassay was used to determine serum IgE levels (Pharmacia and Upjohn Diagnostics, Freiburg, Germany).

E. Body Mass Index (BMI): Body weight of participants in both groups was measured (HC4211, South Korea) while wearing hospital gowns and undergarments. Where the height was measured using digital stadiometer (JENIX DS 102, Dongsang). Body Mass Index (BMI) was computed as BMI= Body weight/Height.

Statistical analysis

Independent t-test was used to compare mean differences between measured parameters between both groups. Statistical analysis of data was performed using SPSS (Chicago, IL, USA) version 23. The degree of correlation between immune system & inflammatory cytokines and BMI was detected by Pearson’s product moment correlation coefficients (r) (P> 0.05).

Results

The demographic and clinical characteristics of the subjects shown in (Table 1). There was no significant age and hemoglobin difference between the obese asthmatics (group A) and lean asthmatic (group (B). However BMI, hip circumference, waist hip ratio, waist circumference, Erythrocyte sedimentation rate, forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), ratio between forced expiratory volume in the first second and forced vital capacity (FEV1/FVC) and forced expiratory flow during the middle half of the FVC maneuver (FEF25-75%) were significantly different between obese asthmatics (group A) and lean asthmatic (group (B).