scholarly journals Clinical and Pathophysiological Phenotyping of Chronic Obstructive Pulmonary Disease

2021 ◽  
Vol 6 (4) ◽  
pp. 105-110
Author(s):  
O. M. Radchenko ◽  
◽  
O. V. Fedуk
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Fasting Blood Glucose ◽  
Practical Importance ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Chronic Anemia ◽  
Endogenous Intoxication ◽  
Inflammatory Phenotypes

The purpose of the study was to determine the clinical and laboratory features of inflammatory phenotypes among patients with chronic obstructive pulmonary disease, moderate respiratory failure and anemia of chronic disease. Materials and methods. The study included 150 patients with exacerbation of chronic obstructive pulmonary disease and chronic anemia, in which inflammatory phenotypes were identified, among which the largest share was neutrophilic (66/44.0±4.0%), less lymphocytic (35/23.3±3.4%) and eosinophilic (16/10.7±2.5%). In 33/22.0% of patients, the inflammatory phenotype was mixed and patients were excluded from the study. Among 117 patients included in the study, 67.5% were men and 32.5% were middle-aged (25.6%), elderly (42.7%) and senile (24.8%). The results were processed by the methods of variation statistics, the materiality threshold p <0.05. Results and discussion. It was established, that peripheral blood analysis and biochemical parameters, regardless of the pathophysiological nature of inflammation in all groups showed moderate dysfunction of external respiration, normochromic normocytic nature of mild chronic anemia with activation of all components of the external coagulation mechanism and increased prothrombin time and inflammation activation (by C-reactive protein and seromucoids). The neutrophilic phenotype of inflammation, in comparison with lymphocytic and eosinophilic, was the most common and was accompanied by the most pronounced anemic syndrome, the highest activity of systemic inflammation and the most pronounced syndrome of endogenous intoxication with deterioration of liver function. The lymphocytic phenotype of inflammation was the second widespread and was characterized by the most pronounced normochromic anemic syndrome with the most pronounced predisposition to hypercoagulation (the highest prothrombin index) with high activity of the inflammatory syndrome. The eosinophilic phenotype of inflammation was significantly less common than the neutrophilic and lymphocytic with the favorable characteristics of the anemic syndrome and with low inflammatory activity and the small activity of endogenous intoxication but the highest fasting blood glucose level as normo-hyperglycemia. Conclusion. Clinical and pathophysiological phenotyping of chronic obstructive pulmonary disease makes it possible to determine not only the activity of inflammation, but also the severity of anemic syndrome, endogenous intoxication, liver status and carbohydrate metabolism, which is of practical importance for both physicians and scientists

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 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

scholarly journals Pharmacoeconomic Analysis of Drug Therapy of Chronic Obstructive Pulmonary Disease: Umeclidinium Bromide/Vilanterol Compared with other Combinations of Long-Acting β-Antagonists and Anticholinergics

2018 ◽  
pp. 75-88
Author(s):  
Aleksandr Tolkushin ◽  
Natalia Pogudina
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pharmacoeconomic Analysis ◽  
Pharmacoeconomic Study ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Forced Expiration ◽  
Obstructive Pulmonary Disease ◽  
Glycopyrronium Bromide ◽  
Long Acting

The article presents the results of pharmacoeconomic study of umeclidinium bromide/vilanterol compared with tiotropium bromide/olodaterol and glycopyrronium bromide/vilanterol for the treatment of patients with chronic obstructive pulmonary disease (COPD). It was found that the use of umeclidinium bromide/vilanterol reduces the cost of therapy (26 and 29% respectively) and direct medical costs (23 and 25% respectively), and also increases the effectiveness in respect of the criteria that characterise external respiration in patients with obstructive pulmonary diseases based on the measurement of volume that has been exhaled at the end of the first second of forced expiration (FEV1). It is also the most convenient and simple in use and maintenance.

scholarly journals Adenosine-related mechanisms in the pathogenesis of chronic obstructive pulmonary disease in patients with pulmonary tuberculosis

2019 ◽  
pp. 47-56
Author(s):  
М.Е. Дьякова ◽  
Н.Б. Серебряная ◽  
Л.Д. Кирюхина ◽  
Д.С. Эсмедляева ◽  
П.К. Яблонский
Keyword(s):  
Nitric Oxide ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Tuberculosis ◽  
Pulmonary Disease ◽  
Oxidative Burst ◽  
Chronic Obstructive ◽  
External Respiration ◽  
Obstructive Pulmonary Disease ◽  
Nitrite Production ◽  
Nbt Test

Актуальность. Учитывая важность пуриновой регуляции воспалительного процесса, раскрытие её участия в патогенезе хронической обструктивной болезни лёгких (ХОБЛ) может дать дополнительную информацию о патофизиологических механизмах воспаления и компенсации, приводящих к развитию ХОБЛ на фоне хронического воспаления, поддерживаемого туберкулёзной инфекцией. Цель настоящего исследования - выявить связь параметров аденозинового метаболизма с характеристиками окислительного взрыва, генерацией оксида азота и функциональными показателями внешнего дыхания у больных туберкулёзом лёгких в сочетании с ХОБЛ. Материалы и методы. В исследование включены мужчины активные курильщики с верифицированным диагнозом туберкулёз лёгких (ТЛ) и ТЛ в сочетании с ХОБЛ (ТЛ+ХОБЛ). Пуриновый метаболизм оценивали по активности аденозиндезаминазы (АДА-1 и АДА-2) в сыворотке крови (экто-АДА), мононуклеарах (мн) и нейтрофилах (нф), уровню экто-5’-нуклеотидазы (экто-5’-НК) в сыворотке крови, CD26 (дипептидилпептидазы-4, ДПП-4) в сыворотке и мононуклеарах. Окислительный взрыв фагоцитов оценивали по тесту восстановления нитросинего тетразолия (НСТ-тесту). Генерацию оксида азота - по концентрации метаболитов NO в сыворотке крови, мононуклеарах и нейтрофилах. Результаты. У больных ТЛ и ТЛ+ХОБЛ получены разнонаправленные изменения концентрации внеклеточного аденозина (рост активности экто-АДА-2, уровня экто-5’-НТ, снижение активности экто-АДА-1), в то время как внутриклеточные концентрации этого медиатора могут быть повышены (снижение активности АДА-1 и CD26 (ДПП-4) мононуклеаров). У больных ТЛ+ХОБЛ выявлено усиление респираторного взрыва мононуклеаров и нейтрофилов. У больных ТЛ регистрировали усиление продукции реактивных радикалов кислорода только в индуцированном НСТ-тесте нейтрофилов. В обеих группах отмечено значимое снижение продукции нитритов и нитратов как в моноцитах, так и нейтрофилах. У больных ТЛ параметры функции внешнего дыхания (ФВД) были связаны с активностью экто-5’-НТ и неспецифической пептидазы CD26 (ДПП-4), с продукцией нитритов нейтрофилами и моноцитами. В то время как у больных ТЛ+ХОБЛ показатели ФВД были ассоциированы с активностью экто-АДА-1 и АДА-1 в моноцитах, с сывороточной продукцией нитратов и продукцией нитритов нейтрофилами. Выводы. У больных ТЛ нарушение ФВД связано с избыточным образованием аденозина при чрезмерной активации формирующих его ферментов, а также с продукцией нитритов нейтрофилами и моноцитами, активных участников бактерицидных реакций, направленных против микобактерии туберкулеза (МБТ). Тогда как при ТЛ+ХОБЛ ведущим является нарушение деградации аденозина при снижении активности АДА-1, развитие эндотелиальной дисфункции и изменение функционального состояния нейтрофилов. Таким образом, разработка целенаправленных воздействий, приводящие к нормализации пуринергического обмена у больных ТЛ, в частности, к увеличению активности изоформы АДА-1, сможет обеспечить либо превенцию с ХОБЛ, либо, у лиц с уже развывшейся патологией, привести к стабилизации процесса. Background: Purine regulation plays an important role in inflammation. Therefore, disclosing the role of purine regulation in the pathogenesis of chronic obstructive pulmonary disease (COPD) may provide additional information about inflammation pathophysiology and compensation, which lead to COPD in chronic inflammation supported by tuberculosis infection. The aim of this study was to identify the relationship of adenosine metabolic indexes with characteristics of an oxidative burst, nitric oxide generation and functional parameters of external respiration (ER) in patients with pulmonary tuberculosis in combination with COPD. Materials and methods. The study included male active smokers with a verified diagnosis of pulmonary tuberculosis (PT) and PT in combination with COPD (PT+COPD). Purine metabolism was evaluated by adenosine deaminase (ADA-1 and ADA-2) activity in serum (ecto-ADA), mononuclear cells (mnc), and neutrophils (nph); serum concentration of ecto-5’-nucleotidase (ecto-5’-NT); and serum and mnc concentrations of CD26 (dipeptidyl peptidase-4, DPP-4). Oxidative burst in phagocytes was evaluated by the nitroblue tetrazolium conversion test (NBT-test). Nitric oxide generation - by concentrations of NO metabolites in blood serum, mnc, and nph. Results. Patients with PT and PT+COPD had multidirectional changes in extracellular adenosine concentration (increased activity of ecto-ADA-2, level of ecto-5’-NT, decreased activity of ecto-ADA-1). At the same time, intracellular adenosine concentrations could be increased (decreased mnc activities of ADA-1 and CD26 (DPP-4)). In patients with PT+COPD, the respiratory burst was observed only in mnc and nph. In patients with PT, increased production of reactive oxygen species was observed only in nph in the inductive NBT-test. In both groups, the nitrite and nitrate production significantly decreased both in monocytes and nph. In patients with PT, parameters of external respiration (ER) were linked to ecto-5’-NT and nonspecific peptidase CD26 (DPP-4) activities and to nitrite production by nph and monocytes. At the same time, in patients with PT+COPD, ER indexes were linked to monocyte activities of ecto-ADA-1 and ADA-1 and to serum nitrate and nph nitrite. Conclusion. In PT patients, impaired ER was associated with excessive formation of adenosine and excessive activation of adenosine-forming enzymes, as well as with nitrite production by nph and monocytes, which are active participants in bactericidal reactions directed against mycobacterium tuberculosis (MBT). However, in PT+COPD, the leading factor is impaired adenosine degradation with decreased ADA-1 activity, development of endothelial dysfunction, and changed nph functionality. Therefore, development of targeted means for normalizing the purinergic metabolism in patients with PT, specifically, by increasing the ADA-1 isoform activity, may provide either prevention in COPD or stabilization of the process in patients with already developed pathology.

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