The effect of a systemic inflammatory response on adaptive mechanisms and the state of homeostasis in patients with respiratory tuberculosis in combination with chronic obstructive pulmonary disease

2020 ◽  
Vol 22 (4) ◽  
pp. 23-27
Author(s):  
A. V. Кaticheva ◽  
N. A. Brazhenko ◽  
O. N. Brazhenko ◽  
A. G. Chuikova ◽  
A. V. Nikolay ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Endothelial Dysfunction ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Systemic Inflammatory Response ◽  
The State ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Adaptive Mechanisms

The influence of the systemic inflammatory response on the adaptive mechanisms and the state of homeostasis of the body in patients with respiratory tuberculosis against the background of chronic obstructive pulmonary disease is considered. It has been established that respiratory tuberculosis and chronic obstructive pulmonary disease are widespread among the population and are important causes of bronchopulmonary morbidity and mortality. Chronic obstructive pulmonary disease is determined in one third of newly diagnosed patients with respiratory tuberculosis. The combined course of respiratory tuberculosis and chronic obstructive pulmonary disease is a mutually aggravating condition. Comorbid pathology is much more difficult, accompanied by severe intoxication, disintegration of lung tissue and bacterial excretion. Biomarkers and the severity of the systemic inflammatory response are of great clinical and diagnostic value in chronic obstructive pulmonary disease. It was determined that the systemic inflammatory response in chronic obstructive pulmonary disease is characterized by endothelial dysfunction of the vascular wall, significant changes in white blood cells, changes in the protein spectrum of the blood, and lipid metabolism disorders. The manifestations of systemic inflammation and endothelial dysfunction, characteristic of chronic obstructive pulmonary disease, in patients with respiratory tuberculosis, aggravate the course of both diseases. The comorbid state is also characterized by a change in the lipid profile of patients, an increase in the content of total cholesterol and atherogenic fractions. These changes are interrelated with the state of adaptive mechanisms, homeostasis and reactivity of the organism. The state of homeostasis largely determines the development, course and outcome of pathological processes characteristic of tuberculous inflammation and inflammation in chronic obstructive pulmonary disease, and the increase in the effectiveness of the treatment is closely related to the restoration of homeostatic balance and reactivity of the body. The availability of methods for determining the homeostatic balance of the body in clinical practice, with their high information content, allows a personalized approach to the management of patients with comorbidity.

scholarly journals Pneumonic versus Nonpneumonic Exacerbations of Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 41 (06) ◽  
pp. 817-829
Author(s):  
Ernesto Crisafulli ◽  
Alessandra Manco ◽  
Miquel Ferrer ◽  
Arturo Huerta ◽  
Claudio Micheletto ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Defense Mechanisms ◽  
Community Acquired Pneumonia ◽  
Systemic Inflammatory Response ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Reactive Protein ◽  
The Impact

AbstractPatients with chronic obstructive pulmonary disease (COPD) often suffer acute exacerbations (AECOPD) and community-acquired pneumonia (CAP), named nonpneumonic and pneumonic exacerbations of COPD, respectively. Abnormal host defense mechanisms may play a role in the specificity of the systemic inflammatory response. Given the association of this aspect to some biomarkers at admission (e.g., C-reactive protein), it can be used to help to discriminate AECOPD and CAP, especially in cases with doubtful infiltrates and advanced lung impairment. Fever, sputum purulence, chills, and pleuritic pain are typical clinical features of CAP in a patient with COPD, whereas isolated dyspnea at admission has been reported to predict AECOPD. Although CAP may have a worse outcome in terms of mortality (in hospital and short term), length of hospitalization, and early readmission rates, this has only been confirmed in a few prospective studies. There is a lack of methodologically sound research confirming the impact of severe AECOPD and COPD + CAP. Here, we review studies reporting head-to-head comparisons between AECOPD and CAP + COPD in hospitalized patients. We focus on the epidemiology, risk factors, systemic inflammatory response, clinical and microbiological characteristics, outcomes, and treatment approaches. Finally, we briefly discuss some proposals on how we should orient research in the future.

scholarly journals Features of the course of chronic obstructive pulmonary disease in patients with respiratory tuberculosis in modern conditions

2020 ◽  
Vol 22 (2) ◽  
pp. 106-109
Author(s):  
A. V. Katicheva ◽  
N. A. Brazhenko ◽  
O. N. Brazhenko ◽  
A. G. Chuikova ◽  
S. G. Zheleznyak ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Disease ◽  
The Body ◽  
Chronic Obstructive ◽  
Initial State ◽  
Obstructive Pulmonary Disease ◽  
Adaptive Mechanisms ◽  
Symptom Complex

Abstrаct. The features of the course of chronic obstructive pulmonary disease are considered. It was established that this pathology is widespread in patients with tuberculosis and is determined in one third of patients. Moreover, the combination of respiratory tuberculosis and chronic obstructive pulmonary disease have a mutual aggravating effect, and the patients serious condition can be caused by both exacerbation of chronic obstructive pulmonary disease and progression of the tuberculosis process. The severity of the comorbid state is associated with a decrease in adaptive-adaptive mechanisms and a violation of the state of the homeostasis of the body. Patients with a combination of pulmonary tuberculosis and chronic obstructive pulmonary disease are characterized by intense types of adaptive reactions, with their extreme manifestations, a deep and pronounced disturbance in homeostatic balance and a decrease in the reactivity of the body. Such changes are combined with functional disorders of the respiratory system (changes in spirometric indicators, impaired airway, impaired ventilation function and diffusion capacity of lung tissue). The combined course of pulmonary tuberculosis and chronic obstructive pulmonary disease affects the effectiveness of the treatment and its outcome. In patients with comorbid pathology, there is a decrease in the frequency of abacillation and closure of decay cavities, the formation of pronounced residual tuberculous changes in the lungs. At the same time, in patients with pulmonary tuberculosis, chronic obstructive disease has a more severe course, with a pronounced symptom complex and a high probability of frequent exacerbations. In more than half of cases, chronic obstructive pulmonary disease is characterized by an unfavorable course with a high risk of exacerbations, more than twice a year, which is an extremely unfavorable factor for predicting the course of chronic obstructive pulmonary disease and the development of complications. Identified violations impair the quality of life of patients suffering from comorbidity. Therefore, it is diagnostically important to assess the initial state of chronic obstructive pulmonary disease in patients with tuberculosis, to predict its course and the risks of exacerbations.

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