DIAGNOSTIC CRITERIA FOR THE PROGRESSION OF THE CHRONIC OBSTRUCTIVE PULMONARY DISEASE UNDER A HIGH TECHNOGENIC LOAD

Abstract

Introduction. The prevalence and gain in the incidence of chronic obstructive pulmonary disease (COPD) is a reason to search for new approaches to the diagnosis of its progression. Air pollution causes an additional burden on COPD patients, contributing to the progression of this pathology. The study of mechanisms of its impact on the inflammatory response in COPD is an urgent task. The aim is to establish the dynamics of expression of interleukin-4 (IL-4), IL-6 and their membrane receptors (IL-4R, IL-6R) in blood T-helpers during COPD progression in patients living in areas with the high technogenic load. Material and methods. Vladivostok was chosen as a region with significant technogenic air pollution - the amount of air pollutants is 59.9 thousand tons per year, with 80% related to vehicle emissions; the surface layer of air is characterized by a predominance of particles less than 10 µm, which are the most pathogenic for the respiratory system. Patients with stable mild (36), moderate (52 ) and severe COPD (24) patients living in Vladivostok for at least 5 years were examined. The control group consisted of healthy volunteers living in the same area (32cases). The levels of IL-4, IL-6 in plasma and the number of T-helper cells expressing IL-4R and IL-6R were determined by flow cytometry. Results. A decline in serum IL-4 concentration and an increase in serum IL-6 level in COPD patients living under constant air pollution has been found. A decrease in IL-4R expression in blood T-helpers at all COPD stages and the gain in IL-6R synthesis in blood T-helpers during the progression of COPD were established. Conclusion. Data on the expression of IL-6R and IL-4R on circulating T-helpers can be used to diagnose the progression of COPD in patients living in urbanized areas.