The Role of Immunological Mechanisms in the Pathogenesis of Asthmatic Bronchitis in Children: doi: 10.7417/CT.2026.2147

This article investigates the impact of high-altitude conditions on the development of asthmatic bronchitis in children, aiming to improve therapeutic strategies for the disease. The aim of the study was to assess the impact of altitude-related factors on the immunological mechanisms underlying the pathogenesis of asthmatic bronchitis in children. A total of 120 children residing in low-altitude (880 m), mid-altitude (1400 m), and high-altitude (2468-3000 m) regions of southern Kyrgyzstan were examined to evaluate pro-inflammatory and anti-inflammatory cytokines, lymphocyte subpopulations, oxidative stress markers, and antioxidant capacity. Serum cytokine levels were determined using enzyme-linked immunosorbent assay (ELISA) with commercial Thermo Fisher Scientific kits. The results revealed significant differences in immune and respiratory parameters depending on altitude. High-altitude regions exhibited the most pronounced inflammatory response: IL-4 and IL-6 levels reached 18.2±2.3 pg/mL and 34.1±4.7 pg/mL, respectively, while IL-10 decreased to 10.8±1.2 pg/mL. The pro-inflammatory cytokine TNF-α was highest (25.6±3.5 pg/mL), indicating chronic inflammation. In low-altitude zones, pro-inflammatory activity was minimal. Analysis of ventilatory parameters showed a reduction in forced vital capacity (75.8±5.5%) and forced expiratory volume in the first second (70.2±4.9%) among high-altitude children, correlating with pro-inflammatory cytokine (r=-0.61, p<0.05) and malondialdehyde levels (r=-0.52, p<0.05). Diminished antioxidant defence (14.2±1.8 mmol/L), combined with hypoxic stress, exacerbated lung tissue damage. These findings highlight the importance of considering altitude and environmental factors when developing therapeutic strategies. Personalised treatment approaches are proposed, focusing on cytokine response modulation and oxidative stress reduction for children from high-altitude regions.