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Immunological changes associated with clinical improvement of asthmatic children subjected to psychosocial
M Castés1, I Hagel, M Palenque
1Department of Immunology, Laboratory of Psychoneuroimmunology, Institute of Biomedicine, Central University of Venezuela, Caracas, Venezuela. mcaste@telcel.net.ve
Insights
Psychosocial intervention (PSI) significantly improved asthma management in children by reducing episodes and medication use. The program also enhanced immune markers, suggesting a link between psychological well-being and physical health in pediatric asthma.
Area of Science:
- Pediatric Allergy and Immunology
- Psychoneuroimmunology
- Clinical Medicine
Background:
- Asthma is a chronic respiratory condition affecting children worldwide.
- Asthma management often involves conventional treatments, but psychosocial factors can influence disease severity.
- Understanding the interplay between psychosocial factors and immune responses is crucial for comprehensive pediatric asthma care.
Purpose of the Study:
- To evaluate the impact of a psychosocial intervention (PSI) program on the immunological status and clinical outcomes of asthmatic children.
- To assess changes in clinical asthma indicators, such as episodes and medication use, following PSI.
- To investigate alterations in specific immune markers, including IgE responses and immune cell populations, in response to PSI.
Main Methods:
- A study involving 35 asthmatic children, divided into a PSI group (19) and a control group (16).
- The PSI group received a 6-month program including relaxation, guided imagery, and self-esteem workshops, alongside conventional treatment.
- Immunological status was assessed through specific IgE, NK cells, T-cell receptor expression, and IgE receptor expression, alongside clinical data collection.
Main Results:
- The PSI group showed a significant reduction in asthma episodes and bronchodilator use, with improved pulmonary function.
- Significant decreases in specific IgE against Ascaris lumbricoides were observed in the PSI group.
- PSI led to increased NK cells, augmented T-cell receptor for IL-2 expression, and decreased leukocytes with low-affinity IgE receptors, normalizing these markers.
Conclusions:
- Psychosocial intervention can lead to significant clinical improvements in pediatric asthma.
- PSI appears to modulate the immune system, normalizing specific IgE responses and immune cell surface markers.
- These findings suggest that PSI is a valuable adjunctive therapy for managing childhood asthma, potentially through immunomodulatory mechanisms.
Abstract:
In the present study we evaluated the impact of a program of psychosocial intervention (PSI) on the immunological status and the clinical management of a group of asthmatic children of an island population in Venezuela. We studied a total of 35 asthmatic children who belonged to either a PSI group (19 patients) or a control group (16 patients), both of which received conventional antiasthmatic treatment. The PSI group received, in addition, a 6-month psychosocial intervention program which included relaxation, guided imagery, and self-esteem workshops. During the PSI period, the number of asthmatic episodes and the use of bronchodilator medication were significantly reduced, and pulmonary function was significantly improved, compared to the 6 months before intervention. There was also a significant reduction in the specific IgE responses against the most important allergen in these children, the intestinal parasite Ascaris lumbricoides. PSI resulted in a significant increase of NK cells, an augmented expression of the T-cell receptor for IL-2, and a significant decrease of leukocytes with low affinity receptors for IgE. In fact, these surface markers became similar to those of nonasthmatic children from both Coche Island and the mainland. None of these clinical or immunological changes were seen in the control group of asthmatics who did not undergo PSI. These results are consistent with the possibility that PSI induces immunological alterations that are responsible for the clinical and physiological improvements observed in the study group.