PATHOLOGICAL IMMUNITY CHANGES IN COMORBID PATIENTS WITH EXACERBATION OF BRONCHIAL ASTHMA

Abstract

The aim of the study – to investigate immunological changes in patients with exacerbation of bronchial asthma with different severity and controllability depending on the presence of comorbid pathology. Materials and methods of research. The work is based on the analysis of data from a comprehensive clinical and laboratory examination of 190 patients with exacerbation of asthma. The relative content of T–lymphocytes and their main subpopulations was determined on a flow cytofluorimeter FACS Calibur (Canada) by phenotyping lymphocytes with monoclonal antibodies (BECKMAN COULTER, USA) to surface membrane differentiation antigens (CD): CD3+19– (pan T-cells), CD4+–8+– (T−helpers/inducers), CD4–8+ (cytotoxic T lymphocytes), CD3–16+ (natural killers). To identify the imbalance of immunoregulatory subpopulations of T cells, the immunoregulatory index was calculated – the ratio of the number of CD4+8– Lf and CD4-8+ Lf. To calculate the absolute content in the peripheral blood of individual populations of Lf, leukogram indicators determined on the hematological analyzer ABH-miscros60, France were used. The proliferative activity of lymphocytes was evaluated in cultures of whole blood in the reaction of blast transformation of these cells with morphological accounting of the results. Statistical processing of the obtained data was carried out using licensed software products included in the Microsoft Office Professional 2007 package, license Russian Academic OPEN No Level № 43437596 in Excel. Conclusions. In moderate asthma, the frequency of pathological changes in the T-system of immunity did not depend on the presence of comorbid pathology, as a rule. In severe asthma, an increase in the content of pan–T cells occurred 1.2 times more often than in moderate asthma, but this was not observed in people with concomitant pathology. In this group, the frequency of increasing the content of T–helpers and decreasing the content of cytotoxic T – cells in patients with severe asthma without concomitant diseases was 1.3 times more frequent than in patients with comorbid pathology. No pathological changes in the T–system were detected in patients with controlled asthma. In partially controlled asthma, these changes were registered 1.5 times more often than in controlled asthma, and in its uncontrolled course, the prevalence of pathological changes in the T–system of immunity was much higher than in the two previous groups. In patients with concomitant diseases, these changes, as a rule, had a higher frequency than in patients without comorbid pathology.