ПОТЕНЦИАЛЬНАЯ РОЛЬ СЫВОРОТОЧНОГО ПЕРИОСТИНА В РАННЕЙ ДИАГНОСТИКЕ БРОНХИАЛЬНОЙ АСТМЫ У ДЕТЕЙ

Респираторные вирусные инфекции у детей раннего и дошкольного возраста часто сопровождаются повторными эпизодами свистящего дыхания и с ними связывают повышенный риск развития бронхиальной астмы. Механизмы связи вирусной инфекции с последующим развитием аллергического воспаления в респираторном тракте изучены недостаточно. К сожалению несмотря на наличие такой связи на основе клинических симптомов проблематично прогнозировать реализацию риска. В качестве предикторов аллергического воспаления в дыхательных путях было предложено определение оксида азота в выдыхаемом воздухе числа эозинофилов в периферической крови и бронхоальвеолярной лаважной жидкости а также IgE но эти суррогатные маркеры у пациентов в т. ч. у детей с бронхиальной астмой имеют умеренную диагностическую точность. Их использование в качестве маркера эозинофилии дыхательных путей может обусловить значительное количество ложноположительных и ложноотрицательных результатов. Исследования последних лет показали что определение уровня сывороточногопериостина с большей точностью подтверждает эозинофильное воспаление дыхательных путей. Обсуждается возможность исследования этого маркера при различных вариантах свистящего дыхания у детей как возможного предиктора развития бронхиальной астмы с учетом его надежности стабильности и небольшой вариативности в определении эозинофильного воспаления в дыхательных путях при симптомах бронхиальной обструкции.

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