ОСОБЕННОСТИ СТРУКТУРНОЙ ОРГАНИЗАЦИИ БОКАЛОВИДНОГО ЭПИТЕЛИЯ БРОНХОВ У БОЛЬНЫХ БРОНХИАЛЬНОЙ АСТМОЙ С ХОЛОДОВОЙ ГИПЕРРЕАКТИВНОСТЬЮ ДЫХАТЕЛЬНЫХ ПУТЕЙ

Abstract

In 46 patients with mild persistent asthma the collection and cytological study of the induced sputum (IS) was done to assess the inflammatory pattern of bronchi, structural organization of bronchial epithelium and secretory goblet cells; the level of the disease control by the data of the validated questionnaire Asthma Control Test was found out; the base lung function (FEV1) was determined; the response of airways to standard 3-minute isocapnic hyperventilation by cold (-20ºC) air (IHCA) was studied. By the results of IHCA test the patients were divided into 2 groups: with cold airway hyperresponsiveness (1st group) and without any response to IHCA test (2nd group). The patients of the 1st group in comparison with the ones of the 2nd group had a lower level of spirometric parameters and control over the disease. In the 1st group there were found more significant changes in the structural organization and destructive-cytological activity of goblet cells against the decrease of a number of epithelial cells of IM and activation of a neutrophilic pool under eosinophilic pattern of inflammation. The patients with cold airway hyperresponsiveness were found to have a close correlation between identified disorders in the structural organization of the goblet epithelium, the number of neutrophils of IS and severity of the bronchial response to IHCA test. The association of disorganization of the goblet epithelium and bronchial response to cold stimulus against the features of inflammatory pattern can be considered a risk factor of escalation of mucociliary insufficiency and worsening of clinical course of a disease and the level of asthma control.