DYNAMICS OF IMMUNOLOGICAL AND FUNCTIONAL INDICATORS IN THE COURSE OF TREATING EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

2021 ◽  
pp. 1-8
Author(s):  
Evgenia P. Alekseeva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Adaptive Immunity ◽  
Interferon Γ ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Immunological Parameters ◽  
Obstructive Pulmonary Disease ◽  
Functional Parameters ◽  
Ifn Γ

Repeated exacerbations of chronic obstructive pulmonary disease cause progression of this disease and result in its unfavorable outcome. Prevention of the first exacerbation of chronic obstructive pulmonary disease and alleviation of exacerbations are key goals in the treatment of the disease. Due to the fact that immune mechanisms occupy the central place in the pathogenesis of chronic obstructive pulmonary disease, the aim of the study was to study immunological parameters in patients with chronic obstructive pulmonary disease at the beginning of exacerbation and in the period of exacerbation termination, as well as the way how changes in immunological indicators affect the dynamics of pulmonary functional parameters in the process of treating patients with exacerbation of chronic obstructive pulmonary disease. The study included 116 patients hospitalized in the pulmonology department due to the first exacerbation of chronic obstructive pulmonary disease. In addition to the standard set of studies, patients underwent lymphocyte phenotyping using CD3, CD4, CD8, CD20 monoclonal antibodies, evaluation of neutrophils' phagocytic activity in a latex test, determination of immunoglobulins – IgG, IgA, IgM concentrations, circulating immune complexes and cytokines (interleukin (IL)-1β, IL-4, IL-8, interferon-γ (IFN-γ) in the serum. The above-described range of studies was carried out on the 2nd day of inpatient treatment and on the 10th–12th days of treatment. The results of the study showed that COPD exacerbation is associated with quantitative insufficiency of the cellular link in adaptive immunity against the background of activation of its humoral link. The features of the cytokine profile in patients with chronic obstructive pulmonary disease in exacerbation stage testified to the activated production of proinflammatory cytokines (IL-1ß, IL-8) and the main cytokines associated with the activation of humoral (IL-4) and cellular (IFN-γ) components of adaptive immunity. At this, the function of the cellular link was activated to a greater extent, as indicated by an increase in the ratio of IFN-γ/ IL-4. Analysis of indicators of external respiration function enabled us to establish that all speed indicators in patients were lower than in healthy ones. The functional parameters of the lungs, as well as immunological parameters, did not undergo significant changes as a result of treatment, which determines further progression of the disease.

Possibilities of cardiovascular events in patients with chronic obstructive pulmonary disease and newly diagnosed tuberculosis, including those associated with HIV infection, when prescribing long-acting β2-agonists

MedAlliance ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 32-39
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Tb Treatment ◽  
Long Acting ◽  
Β2 Agonists

Chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis (TB) are a common pathology among respiratory diseases. Both conditions may have common risk factors, aggravating each other, accom-panied by the development of bronchial obstructive syndrome, requiring mandatory medical correction to increase the effectiveness of therapy for both the main and concomitant pathologies. The aim of the study was to study the effectiveness of treatment of TB in patients with COPD first diagnosed with tuberculosis, including those associated with HIV when prescribing long-acting β2-agonists. Materials and methods. A simple com-parative study included 60 patients of a TB dispensary aged 30–65 years. Patients were divided into 2 groups of 30 people (TB+COPD and TB+COPD+HIV), each of whom for 2 months received a long-acting β-agonist (indacaterol) as an accompanying therapy for the cor-rection of bronchial obstructive syndrome (BOS), with subsequent assessment of the effectiveness of therapy. Results. Subjectively, patients of both groups noted the rapid development of positive dynamics (short-ness of breath decreased from 1–3 days of taking the drug, coughing — within a week, tolerance to physical exertion improved), which was confirmed by indica-tors of the function of external respiration (FEV1). The state of the cardiovascular system was assessed by the results of daily monitoring of blood pressure (BPM). In the COPD+TB group, there is a certain average daily systolic blood pressure (SBP) with a tendency to nor-malize indicators, which is possibly associated with a decrease in the severity of hypoxia during bronchodi-lator therapy. In the COPD+TB+HIV group, the average daily level of SBP increased by 1 mm Hg, but given the very low starting rates, the increase in blood pressure had a positive effect on the patients' condition. The average heart rate (HR) during bronchodilator thera-py did not tend to increase. The best TB treatment re-sults were obtained in the TB+COPD group. In terms of the closure rate of TB+COPD decay cavities — 26.6%, TB+COPD+HIV — 20.0%), the TB+COPD+HIV group had longer periods of abacillation and closure of decay cav-ities, which is associa ted with the severity of the under-lying and associated diseases. The drug was well toler-ated in both groups. Conclusion. The use of 300 mcg long-acting β-adrenomimetics in the complex therapy of β2-adrenergic agonists for patients with TB+COPD and TB+ COPD+HIV can reduce the severity of bronchial obstruction syndrome, improve quality of life, increase adherence to TB treatment, thereby shortening hospi-talization and reduce the likelihood of disability of pa-tients, without the development of side effects from other organs and systems.

The state of the cardiovascular system in occupational bronchitis and chronic obstructive pulmonary disease, not associated with the impact of harmful industrial factors

2021 ◽  
pp. 55-68
Author(s):  
Vyacheslav S. Lotkov ◽  
Anton Vladimirovich Glazistov ◽  
Antonina G. Baykova ◽  
Marina Yuryevna Vostroknutova ◽  
Natalia E. Lavrentieva
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Cardiovascular System ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Occupational Lung Diseases ◽  
The Right ◽  
The Impact

The formation and progression of chronic dust bronchitis and chronic bronchitis of toxic-chemical etiology, chronic obstructive pulmonary disease is accompanied by an increase in the degree of ventilation disorders, echocardiographic signs of hypertrophy and dilatation of the right ventricle are formed, typical for chronic pulmonary heart disease. The progression of disturbances in the function of external respiration in dusty lung diseases leads to a decrease in myocardial contractility. The detection of hemodynamic disturbances at the early stages of the development of occupational lung diseases indicates the need for individual monitoring of the functional state of the cardiovascular system in the process of contact with industrial aerosols, especially in groups of workers with long-term exposure.

Using laser therapy in the treatment of patients with occupational chronic obstructive pulmonary disease

2021 ◽  
pp. 51-56
Author(s):  
Elvira F. Kabirova ◽  
Alla I. Borisova ◽  
Ferdaus A. Urmantseva ◽  
Denis O. Karimov ◽  
Elmira R. Shaykhlislamova ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Laser Therapy ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Laser Device ◽  
Treatment Standards ◽  
Clinical Indicators ◽  
Obstructive Pulmonary Disease ◽  
Severe Degree

The purpose of the study was to determine the effect of laser therapy in combination with basic pharmacotherapy in 72 patients with occupational chronic obstructive pulmonary disease of moderate and severe degree during the exacerbation period. For the treatment of patients in the comparison group, traditional therapy was used in accordance with the treatment standards. The course of laser therapy was conducted by a semiconductor laser device Mustang 2000 with a radiating head KLOZ-2000. Analyzing the obtained data, it can be suggested that this method allows accelerating the normalization of clinical indicators, improving external respiration indicators and extending the remission period.

scholarly journals Changes in Th1/Th2-producing cytokines during acute exacerbation chronic obstructive pulmonary disease

2018 ◽  
Vol 46 (9) ◽  
pp. 3890-3902 ◽  
Author(s):  
Bing Wei ◽  
Chun Sheng Li
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive Lung Disease ◽  
Serum Levels ◽  
T Cell Subsets ◽  
Th2 Cells ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Ifn Γ

Objective This study aimed to explore cytokine serum levels and the ratio of type 1 T helper (Th1)/Th2 cells in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total 245 patients diagnosed with AECOPD and 193 patients who progressed to stable COPD after the initiation of treatment in hospital were selected, while a further 50 healthy individuals served as controls. All patients with COPD were diagnosed using Global Initiative for Chronic Obstructive Lung Disease criteria. Serum concentrations of interleukin (IL)-2, interferon (IFN)-γ, IL-4, IL-10, IL-17, and immunoglobulin (Ig)E were measured using enzyme-linked immunosorbent assays. Results AECOPD patients had higher levels of IL-2, IFN-γ, IL-4, IL-10, IL-17, and IgE than those with stable COPD or controls. Intriguingly, the ratios of Th1/Th2 and IL-17/IgE were lower in AECOPD patients compared with the other two groups. These data suggest that AECOPD patients produce more IgE and have more differentiated Th2 cells than other groups. Conclusion Our findings suggest that an imbalance of circulating CD4+ T cell subsets correlates with AECOPD, and that a shift of Th1/Th2 and IL-17/IgE ratios may be caused by increased Th2 cell production.

scholarly journals Secretory Leucocyte Protease Inhibitor Inhibits Interferon-γ-induced Cathepsin S Expression

2007 ◽  
Vol 282 (46) ◽  
pp. 33389-33395 ◽  
Author(s):  
Patrick Geraghty ◽  
Catherine M. Greene ◽  
Michael O'Mahony ◽  
Shane J. O'Neill ◽  
Clifford C. Taggart ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Protease Inhibitor ◽  
Pulmonary Disease ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Interferon Γ ◽  
Secretory Leukocyte Protease Inhibitor ◽  
Cathepsin S ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

We have demonstrated that bronchoalveolar lavage fluid from chronic obstructive pulmonary disease patients contains higher levels of interferon-γ compared with controls. Interferon-γ is a potent inducer of various cathepsins and matrix metalloproteases. Therefore, we postulated that interferon-γ could induce protease expression by macrophages in acute and chronic lung disease. Chronic obstructive pulmonary disease patients had greater levels of cathepsin S and matrix metalloprotease-12 in their bronchoalveolar lavage fluid. Macrophages incubated with chronic obstructive pulmonary disease bronchoalveolar lavage fluid exhibited increased expression of cathepsin S and matrix metalloprotease-12, which was inhibited by the addition of interferon-γ-neutralizing immunoglobulin. Human secretory leukocyte protease inhibitor is an 11.7-kDa cationic non-glycosylated antiprotease synthesized and secreted by cells at the site of inflammation. We have demonstrated that secretory leukocyte protease inhibitor can inhibit interferon-γ-induced cathepsin S production by macrophages. Pretreatment of macrophages with secretory leukocyte protease inhibitor inhibited interferon-γ-induced inhibitor κB β degradation and activation of nuclear factor κB. Secretory leukocyte protease inhibitor may prove to be therapeutically important as a potential inhibitor of protease expression in chronic obstructive pulmonary disease.

scholarly journals Clinical Characteristics of the Combined Course of Chronic Obstructive Pulmonary Disease and Gastroesophagal Reflux Disease

2021 ◽  
Vol 6 (4) ◽  
pp. 91-98
Author(s):  
O. I. Lіakh ◽  
◽  
M. I. Tovt-Korshуnska ◽  
M. A. Derbak
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Pulmonary Disease ◽  
Reflux Disease ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Outpatient Basis ◽  
Obstructive Pulmonary Disease ◽  
Respiration Function

The comorbid diseases can occur at any stage of bronchial obstruction, and, regardless of the severity or phase of chronic obstructive pulmonary disease, significantly affect disability, increase the frequency of hospitalizations, and increase the cost of medical care. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease is an independent aggravating risk factor for exacerbations and is associated with health deterioration of this group of patients. The purpose of the study was to study the features of the clinical course of chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease. Materials and methods. Retrospective analysis of 138 patients who were treated in the pulmonology department for exacerbation of the disease and outpatient treatment by a gastroenterologist was carried out. 3 groups of patients were formed: 1 group (n=60) – patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease, 2 group (n=42) – patients with chronic obstructive pulmonary disease without signs of gastroesophageal reflux disease, who were treated in the pulmonology department for exacerbation of the disease and 3 group (n=36) – patients with gastroesophageal reflux disease who were treated on an outpatient basis. The patients were similar in age, stage of disease and duration of illness. The average age of the patients was 55±1.64. It should be noted, regarding the gender characteristics of the groups, that among the examined patients by gender, men predominated – 78.4% (80 out of 102). Results and discussion. The main clinical and anamnestic features of the combined pathology were studied. The significance of the assessment of functional changes in spirometry indexes in this category of patients is described. A significant decrease in external respiration function was revealed in the indicators of the external respiration function in patients of all groups. In the patients with chronic obstructive pulmonary disease in combination with gastroesophageal reflux disease the frequency of exacerbations increases. These exacerbations were associated with the presence and severity of gastrointestinal symptoms, namely increased heartburn, acid regurgitation causes worsening of respiratory symptoms, until the exacerbation of the disease with subsequent hospitalization. Also the length of stay in the hospital of the patients in this group increased by 1.5±0.4 days, which is associated with a severe exacerbation of chronic obstructive pulmonary disease and the need to use a double dose of glucocorticoids to control the symptoms of respiratory failure. Among the complaints of patients with combined pathology, extraesophageal manifestations of gastroesophageal reflux disease prevailed. Conclusion. The presence of concomitant gastroesophageal reflux disease in patients with chronic obstructive pulmonary disease expands and aggravates the clinical manifestations of the underlying disease

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