Prevention Effects Of Bronchiolitis Into Asthma By Bacterial Lysate And Immune Mechanism

Objectives:1. To discuss the high-risk pathogenesis infection factors of bronchial asthma from capillary bronchitis;2. To discuss the impact of early immune interference to prevent and cure capillary bronchitis with bacterial lysates (Broncho-Vaxom) on the incidence of asthma;3. To discuss the impact of bacterial lysates on IL-4, IFN-y, IL-10, IL-17and balance of Thl/Th2and Treg/Th17;4. To analyze the differences of a7nAChR, Th17expression in children between two arms.Methods:The selected children with capillary bronchitis were divided into treatment group and control group based on the regular care. The children in treatment group received bacterial lysates orally once a day for10days and then suspended for20days. The treatment lasted for3months. The long-term follow up period was24months. The times of upper respiratory infection, lower respiratory infection and wheezing onset and the number of days for each onset and the total number of days were analyzed and compared between two groups within12months as well as the change of the number of days with antibiotics and the incidence of bronchial asthma. The relationship between the times of upper or lower respiratory infection and the incidence of bronchial asthma was analyzed.30cases were selected from each group and20cases from healthy children were selected as healthy control group. The changes of cytokines such as IL-4, IFN-y, IL-10and IL-17between capillary bronchitis and healthy children were compared. The changes of cytokines such as IL-4, IFN-y, IL-10and IL-17between pre-treatment and post-treatment in the treatment group and control group were observed respectively. The changes of expression of nuclear transcription factor mRNA between two groups were compared. The changes of expression of a7nAChR between two groups were also analyzed and compared.Results:1. Respiratory tract infection was the high-risk pathogenesis factor of bronchial asthma from capillary bronchitis;2. The times of upper respiratory infection in treatment group and control group were3.5±2.9and5.8±3.6respectively with t-value being5.07and p<0.05; the times of lower respiratory infection in treatment group and control group were1.9±2.3and3.3±2.8respectively with t-value being3.93and p<0.05; the times of wheezing onset was2.1±1.2with t-value being6.33and p<0.05and the number of days for each onset and the total number of days were3.8±2.6and10.3±3.4days with t-value being5.12and11.1respectively and both p values were less than0.05. Asthma was diagnosed in23children in treatment group and the incidence was21.2%while those numbers in control group were33and33.6%. There’s significant difference. Multiple linear regression analysis showed that the primary difference in OM-85BV group compared with control group was the reduced rate of respiratory infection.3. Elisa analysis compared the change of capillary bronchitis group and health groups, before and after the treatment with IL-4, IFN-gamma, IL-10, IL-17.The results showed, bronchiolitis than normal healthy children, IFN-y expression decreased, IL-17level increased, the difference was significant; after OM-85BV treatment than the control group before treatment, IFN-y levels increased, IL-17levels decreased, the difference was significant, there was no significant difference in IL-4, IL-10changes. The RT-PCR the results showed the bronchiolitis than normal healthy children T-bet expression decreased, RORyt increased, the difference was significant, there was no significant difference in GATA-3and FoxP3levels.Compared with the control group, before treatment group,the OM-85BV treatment group, T-bet expression increased, ROR y t decreased, there was significant difference. There had no significant difference expression of FoxP3, GATA-3mRNA.4. The children with bronchiolitis exist increased expression of a7nAChR, IL-17.Compared with the control group, application of OM-85BV in treatment group, the expression of IL-17, a7nAChR decreased, reduce the inflammation of bronchiolitis.Conclusions:1. Repeated respiratory infection was the key factor of wheezing onset in infants and young children. It also was the high-risk factor of asthma from capillary bronchitis;2. Bacterial lysates could reduce the times of respiratory infection and the frequency and number of days of wheezing onset as well as the duration of antibiotics and incidence of asthma from capillary bronchitis;3. The children with capillary bronchitis had disequilibrium of Th1/Th2and Treg/Thl7which can be adjusted by bacterial lysates;4. Application of OM-85BV can reduce the expression of α7nAChR、Th17, down regulating the of inflammatory cytokines cells. The a7nAChR effect of Thl/Th2balance, regulating the balance of Treg/Th17affect the onset of asthma. a7nAChR is the nerve and immune crosslinking evidence.