Cytokine profile in anemic children with respiratory allergies from Trans-Aral region depends on the level of physical development

The ecologically unfavorable Trans-Aral region is characterized by high prevalence of chronic respiratory allergies in children, often combined with anemias. These disorders significantly impact children’s health and require comprehensive study of immune and physiological features. Our objective was to assess the characteristics of cytokine profile in children from different age groups with respiratory allergies accomplished by anemia, depending on the presence of concomitant dermatoses, and level of physical development. The study included 284 children aged 3 to 17 years, divided into three groups: 121 children with respiratory allergies (RA), 126 children with respiratory allergies and concomitant dermatoses (RA + D), and 37 practically healthy children (control group). Concentrations of key cytokines (IL-4, IL-6, IL-10, IL-18, TNFα), and total IgE in blood serum samples were determined by enzyme-linked immunosorbent assay (ELISA). Physical development was assessed using the standardized WHO AnthroPlus methodology. Children with respiratory allergies, regardless of the presence of dermatoses, showed significantly increased levels of IL-4 and IgE compared to controls (p < 0.01), thus suggesting emergence of a dominant Th2 response. The highest level of anti-inflammatory cytokine IL-10 was found in the RA + D group (p < 0.01), likely reflecting a compensatory mechanism aimed at limiting inflammation. Meanwhile, pro-inflammatory cytokines IL-6 and TNFα were significantly decreased in patients compared to healthy children (p = 0.001 and p < 0.001, respectively), thus suggesting probable hyporesponsiveness of the pro-inflammatory pathway in chronic allergic conditions. The levels of IL-4 and IL-10 proved to be lower in children with delayed physical development, while IL-18 was relatively increased, being consistent with literature data and suggesting possible mechanisms of immune dysregulation associated with impaired general health status. The data obtained suggest a predominance of Th2 immune response in children from Trans-Aral Region with respiratory allergies as reflected by increased IL-4, IL-10, and IgE levels. The decreased IL-6 and TNFα levels warrant further study to understand inflammatory processes in chronic allergies under the conditions of ecological stress. Accounting for cytokine profiles and physical development is important for development of personalized therapeutic approaches and improving the disease prognosis.

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