The aim of this study was to analyze inflammation features and possible causes of asthma-COPD overlap syndrome (ACOS). Methods. Clinical examination was performed for all patients included in the study. Blood levels of alpha-1-antitripsin (AAT), immunoglobulin (Ig) G and E antibodies against four bacterial antigens (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria perflava, and Staphylococcus aureus), and lung function were measured in all the patients. Results. The study involved 175 patients including 78 patients with bronchial asthma, 39 patients with ACOS, 38 patients with COPD, and 20 healthy individuals. AAT blood level was reversely related to lung function and to increased IgG-antibody levels against bacterial antigens. Conclusion. Due to this fact, the authors suppose that the ACOS should be considered as an independent nosology distinct from asthma and COPD, and related to microbial inflammation and AAT level.
175 patients were examined: 78 patients with bronchial asthma (BA), 39 with Asthma-COPD Overlap Syndrome (ACOS), 38 with chronic obstructive pulmonary disease (COPD) and 20 healthy individuals. A general clinical and laboratory examination was conducted, α1-antitrypsin (AAT), IgG and IgA to four bacterial antigens were determined, and pulmonary function test was studied. The clinical and spirometry data (characterizing the ACOS) were received. Negative association of AAT with respiratory function parameters in patients with ACOS, high levels of IgG antibodies to bacterial antigens and the lack of these connections in patients with BA and COPD allows us to consider ACOS to be independent nosological form related with microbial inflammation and marked by the AAT.
Background. The aim of the study was to investigate cellular phenotypes of the spontaneous sputum, estimate possibilities of cytological sputum analysis in evaluation of airways inflammation peculiarities in comparison with the expired nitric oxide level and respiratory function tests. Materials and methods. functional properties of neutrophils were evaluated by respiratory burst intensity. 72 patients were included, 23 - with moderate bronchial asthma course and chronic bronchitis, 18 - with moderate bronchial asthma and COPD, 31 patient had COPD only. All patients were examined in the exacerbation period, all of them had productive cough. Results. Cytological phenotypes were stated as well as the links between different sputum cells presence and between cytological peculiarities, inflammation and functional state of the respiratory system. Functional defects of neutrophils were found in COPD patients.
217 people were examined including BA patients (n=78), patients with COPD (n=38), patients with combined asthma and COPD (n=39), and community-acquired pneumonia patients (n=17). The control group represented patients with essential hypertension and coronary heart disease (n=25) and 20 healthy persons. NE, AAT, phagocytic activity of neutrophils (FGC), oxygen blast, respiratory function and FeNO, serum IgE and IgG antibodies to Strept. pneumoniae, Neisseria perflava, Haemofil. influenzae and Staph. aigai were determined in all patients. The indicators of the functional state of neutrophils reflected the degree and severity of bronchopulmonary inflammation. Patients with bronchial asthma in combination with COPD had bacterial inflammation, manifested by bronchial obstruction with increasing level of AAT. These features were absent in patients with BA and COPD.
The study involved 210 people, of which 32 had mild bronchial asthma, 39 had moderate bronchial asthma, 39 had moderate bronchial asthma combined with chronic obstructive pulmonary disease, 38 had chronic obstructive pulmonary disease, 17 patients suffered from community-acquired pneumonia, 25 patients with essential hypertension and ischemic heart disease (comparison group) and 20 healthy patients. We assessed sIgE to mite allergens, dust allergens, and the mixed grass, trees, weeds and flower pollen allergens , Str. pneumon., Haemofil. influenzae, Neisseria perflava. The levels of interleukin-4, interleukin6, interleukinlO, interleukin-7, gamma-interferon, tumor necrosis factor were investigated. All patients were studied in the acute condition of the disease. We assessed the infectious potential and atopic potential in every patient. Results of the study allow to resume that cytokines levels, their combinations (cytokine profile) testing has not to be advisable for clinical diagnostics, assessement of the severity of the disease and treatment strategy including anti-cytokine therapy.
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