Клеточный профиль мокроты и активность миелопероксидазы у больных бронхиальной астмой с холодовой гиперреактивностью дыхательных путей

Abstract

Th e aim of the research. To study the infl ammation pattern, myeloperoxidase activity and the content of the epithelium in the bronchi of patients with bronchial asthma (BA) with diff erent forms of airway hyperresponsiveness to physical stimuli. Material and methods. Th e degree of asthma control, pulmonary function, and cellular composition of induced sputum were studied in 142 BA patients with various forms of airway hyperresponsiveness to indirect provoking triggers. In cytological smears, the number of neutrophils, eosinophils, bronchial epithelial cells was counted. A cytochemical study of myeloperoxidase activity in sputum neutrophils was carried out. Results. It has been established that BA patients with combined airway hyperresponsiveness to various physical stimuli have lower asthma control, a higher number of eosinophils in sputum, a higher level of myeloperoxidase in neutrophils, and a lower percentage of intact bronchial epithelium compared to patients with isolated cold airway hyperresponsiveness. A close relationship was found between the level of eosinophils and the number of intact epitheliocytes (Rs=-0.52, p<0.001). In patients with combined airway hyperresponsiveness, a relationship was found between the activity of myeloperoxidase in neutrophils and the severity of the bronchial response to isocapnic hyperventilation with cold air (R=-0.33; p<0.05). Conclusion. Activation of the peroxidase function of neutrophils and stimulation of the eosinophil activity, which leads to destruction of the epithelium and a decrease in the content of normal epitheliocytes, are associated with a greater severity of airway hyperresponsiveness to cold and the addition of reactions to other stimuli