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

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.