Pro and anti-fibrotic proteins and asthma: is there a correlation betwween their levels with inflammation and airway resistance?

• Grant number: 20/03994-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): October 01, 2020
• Effective date (End): June 30, 2021
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Rodolfo de Paula Vieira
• Grantee: Victor Hugo Souza Palmeira
• Host Institution: Instituto de Ciência e Tecnologia (ICT). Universidade Federal de São Paulo (UNIFESP). Campus São José dos Campos. São José dos Campos , SP, Brazil

Abstract

Asthma is chronic inflammatory airway disease, in which beyond the inflammatory alterations, structural alterations called remodeling also occurs. The airway remodeling has an important role in the physiopathology and in the clinical symptoms of asthma, since it is directly associated to airway hyperresponsiveness and obstruction, and consequently to wheezing, chest tightness, cough and exercise intolerance. From clinical view, the degree of the remodeling is associated to the degree of airway obstruction, which can be evaluated not only through spirometry (normally evaluated through the FEV1 and the relation FEV1/FVC), but also through the impulse oscilometry. In this view, the impulse oscilometry is particularly useful since the exam does not need efforts and almost none patient collaboration. Beyond that, the impulse oscilometry derives important information, such as the resistance of respiratory system and of the airways, which can reflect more directly the alterations caused by the remodeling. From the immunological point of view, several pro-fibrotic proteins called growth factors have been associated to the development and degree of the remodeling in asthma. On the other side, the role of different anti-fibrotic proteins on airway remodeling in asthma is still not understood, which can be denoted by the scarce number of studies that have evaluated, for instance, the role of relaxins and klotho in asthma. Therefore, the present study aims to investigate if there is some correlation between the degree of airway obstruction and resistance between themselves, as well as to investigate if there is some correlation between the levels of pro and anti-fibrotic proteins with the degree of airway obstruction and resistance. To that, 30 non-asthmatic individuals will be recruited to compose the control group (Group 1), 30 individuals with intermittent asthma to compose the Group 2 and 30 individuals with moderate persistent asthma to compose the Group 3. The pulmonary function by using spirometry, lung mechanics by using impulse oscilometry, pulmonary inflammation by using the measurements of pro and anti-inflammatory mediators in the breath condensate and the levels of exhaled nitric oxide will be evaluated. Additionally, the levels of pro and anti-inflammatory cytokines and pro and anti-fibrotic proteins will be evaluated in the breath condensate and in the serum. Thus, the present study will permit for the first time, establish or not, a correlation between the levels of pro and anti-fibrotic proteins with the degree of airway obstruction and resistance of asthmatic patients with different severities.