Vakhnenko A.V., Moiseeva N.V.

APPLICATION OF MODERN IMMUNOMODULATOR DURING EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

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About the author:	Vakhnenko A.V., Moiseeva N.V.
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	Chronic obstructive pulmonary disease (COPD) is a significant problem in modern medicine since the prevalence and mortality from the disease is constantly increasing. Today it’s well known that the basis of the pathogenic action of contaminated air pollutants is oxidative aggression of the airways reactive types of oxygen, nitrogen dioxide and sulfur and other free radicals, which leads to activation of lipid peroxidation and damage to biological membranes, including immune cells. Previously, it was found that the development and progression of COPD accompanied by inhibition of systemic and local immune defense of the bronchial tree against respiratory viruses and bacterias. Today the well-timed prescription of special drugs to patients with exacerbation of COPD is very important, because its provide the activation mechanisms of self-regulation, adequate immune response, improving the barrier function of the bronchial mucosa. The article presents the facts about immunological blood test of 47 patients with exacerbation of chronic obstructive pulmonary disease stage I-II . 20 of them obtain the standard therapy, and 37 - along with standard treatment used Glutoxim within 10 days, which has immunomodulating, bronchodilator, desensitizing, anti-inflammatory and antimicrobial action. The patients of clinical group were divided into two subgroups depending on the initial value of immunoregulatory index and type of T-cell immune disorders. Application of the Glutoxim was effective in the subgroup with low immunoregulatory index, caused mainly T-helper immunodeficiency, which confirmed the statistically significant increase in the total number of lymphocytes, populations of CD3 + - lymphocytes, CD4 + - cells, CD16 + - lymphocytes, lymphocyte proliferative activity in RBTL. Its an indication of a positive effect of this treatment on the immune response. Consequently, the observed decrease of T-cell immunodeficiency, accompanied by a statistically significant normalization of the immunoregulatory index. In the subgroup with high immunoregulatory index, caused mainly T- suppressor immunodeficiency, which confirmed the statistically significant increase in the population of CD3 + - lymphocytes subpopulation of CD8 + - lymphocytes, CD16 + - lymphocytes, accompanied by a statistically significant normalization of the immunoregulatory index. The phagocytic activity of neutrophils is noticeable improve in both clinical subgroups - statistically significant increase in FI and SF. Much less pronounced changes were observed in humoral immunity link patients in both subgroups of clinical group and was noted a downward tendency in the number of B cells : populations of CD22 + - lymphocytes in subgroup A, subgroup B although this figure was statistically significant. In both clinical subgroups was marked statistically significant increase in IgA and reduction of circulating immune complexes was accompanied by a tendency to decrease in IgG and IgM. These changes were quite expected result from the short period of observation. Glutoxim drug-therapy proven to be effective in patients with low immunoregulatory index, which is due mainly T-helper immunodeficiency. Glutoxim proven to be effective in patients with high immunoregulatory index, mainly due to T- suppressor immunodeficiency. That’s why immunomodulatory drug therapy may be considered as Glutoxim pathogenic addition to standard treatments for COPD I-II stages. Which has led to a significant improvement in all parameters of quality of life of patients. All the data was beneficial not only to the quality of life of patients, but also led to compliance adjustment.
Tags	chronic obstructive pulmonary disease, immune status, immunomodulatory therapy, Glutoxim
Bibliography	Гембицкая Т.Е. Клинические особенности, діагностика и лечение некоторых наследственно обусловленных заболеваний органов дыхания у взрослых: автореф. дис. на соискание ученой степени докт. мед. наук: спец. 14.00.43 «Пульмонологыя» / Т.Е. Гембицкая //– Л., 1987. – 158 с. Дворецкий Л.И. Инфекция и хроническая обструктивная болезнь легких / Л.И. Дворецкий // Consilium Medicum. – 2001. - №3(12). – С. 587-595. Дзюблик А.Я. Обострение ХОЗЛ: современное состояние проблемы / А.Я. Дзюблик, Т.А. Перцева // Укр. пульмонол журн. – 2009. - №2. – 10c. Ільницький Р.І. Особливості імунологічної реактивності у хворих на хронічне обструктивне захворювання легень / Р.І. Ільницький // Укр. пульмонол. журн. – 2007. - №2(56). – С. 21-25. Ільницький Р.І. Значення диференційованої антигомотоксичної терапії для відновлення слизової оболонки бронхів у хворих із загостренням хронічного обструктивного захворювання легень / Р.І. Ільницький // Укр. Терапевт. журн. – 2007. - №4. – С. 31-40. Копелян И.И. Разработка микромодификации культивирования клеток крови / И.И. Копелян, М.П. Григорьева // Бюлл. эксп. биол. и мед. – 1972. - №9. – С 119-122. Лещенко И.В. Основные направления лечения хронической обструктивной болезни легких / И.В. Лещенко // Тер. Архив. – 2007. - №5. – С. 75-84. Молодцова А.В. Оценка эффективности иммуномодулятора Глутоксима в лечении больных хроническими обструктивними заболеваниями легких: автореф дис. на соискание ученой степени канд. мед. наук: спец. 14.00.43 «Пульмонология» / А.В. Молодцова // – СПб., 2005. – 23 с. Островський М.М. Оптимізація корекції бронхіальної обструкції при загостренні хронічного обструктивного захворювання легень / М.М. Островський // Здоров’я України. – Тематичний номер. – 2011. - №4(16). – С. 12-14. Передерий В.Г. Иммунный статус, принципы его оценки и коррекции иммунных нарушений / В.Г. Передерий, А.М Земсков, Н.Г. Бычков [и др.] - К.: Здоров'я, - 1995. – 211 с. Соодаева С.К. Оксидантная и антиоксидантная системы при хронических обструктивних заболеваниях легких. Хронические обструктивне болезни легких / С.К. Соодаева // – СПб.: Невский діалект, 1998. – С. 92-111. Фещенко Ю.И. Обструктивные заболевания легких / Ю.И. Фещенко, Л.А. Яшина, А.М. Полянская // – К., 2004. – 287 с. Фещенко Ю.И. Новая редакция руководства Глобальной инициативы по обструктивному заболеванию легких (GOLD) / Ю.И. Фещенко // Здоров’я України. – Тематичний номер. – 2012. - №2(18). – С. 10-11. Шмелев Е.И. Комбинированная бронходилатирующая терапия болезней органов дыхания, протекающих с БО / Е.И. Шмелев // Тер. Арх. – 2005. - №3. – С. 17-21. Global initiative for chronic obstructive lung gisease. WHO, updated 2011. Haskova V. Simpl method of circulating immune complex defection in human sera be polyethylenglycol precipitation / V. Haskova // Immunol. Forsch. – 1977. - №4. – Р. 399-486. Herper-Owen R. Virus and chlamidia isolation in COPD exacerbation / R. Herper-Owen // Eur. Resp. J.: abstracts. ERS. Annal. Congress. - Madrid, Spain, - 1999. – 392 p. Mancini G. Immunochemical quantitation of antigens by single radial immunodiffusion / G. Mancini, A.O. Carbonara, J.F. Heremans // Immunochemistry. – 1965. – Vol. 2. – P. 235-254. Ozaras R. Changes in malondialdehyde levels in bronchoalveolar fluid and serum by  the treatmentof asthma with inhaled steroid and beta 2 agonist / R. Ozaras, V. Tahan, F. Talay [et al.] // Respiratory – 2000. – Vol. 5, №3. – Р. 289-292. Tager M. Evidense of a defective thiol status of alveolar macrophages from COPD patients and smokers. COPD / M. Tager, A. Biecyk, T. Kohnelin [et al.] // Free Radic. Biol. Med. – 2000. – Vol. 29, №11. – Р. 1160-1165. Webb Dr. Selective immunoglobulin A deficiency and chronic obstructive lung disease / Webb Dr., J. Condemt. // Ann. Іntern. Med. – 1974. – Vol.80. – P. 618-621.
Publication of the article	«World of Medicine and Biology» №4(41) 1 part 2013 year, 014-019 pages, index UDK 616.24-002.2:615.37