Possibilities of treatment of patients with chronic obstructive pulmonary disease: long-term follow-up results after the use of beta-glucans

Abstract

Objective — to study long-term follow-up results after the use of beta-glucans in сhronic obstructive pulmonary disease (COPD) patients with frequent exacerbations. Materials and methods. 42 patients with COPD (group C according to the GOLD classification) were under our supervision for 2 years. Patients had 2 to 4 clinical exacerbations during the previous year. They have been randomized into 2 groups with beta-glucans treatment and without it. Results and discussion. In the patients with COPD a significant decrease in the indicators of cellular immunity was observed, which was manifested primarily by a decrease in the number of cells with natural killer activity and cells of the monocyte-macrophage series, as well as a significant decrease in the immunoregulatory ratio CD4+/CD8+. As a result, after 1 year of observation 2 patients progressed to a more severe COPD stage (from the second to the third due to repeated infectious exacerbations), and after 2 years — another 3 (15.0 %). The prescription of beta-glucans leads to the increasing of cells with the activity of natural killers (p < 0.05) and cells of the monocyte-macrophage pull (CD14+, p < 0.05), and to the normalization of the CD4+/CD8+ index (p < 0.05). These changes were largely leveled off by the end of the second year of observation. The use of Immunsil D3 (Nutrimed, Ukraine) for 1 month reduced the number of exacerbations of COPD (p > 0.05) and significantly reduced the need for antibiotics prescription in patients with COPD (p < 0.05) within 1 year after treatment. During the next year of observation, the difference between the groups was significantly less pronounced. Conclusions. Prescription of beta-glucans can be recommended for patients with COPD with frequent clinical exacerbations (groups C and D). It is needful to repeat the course of treatment with beta-glucans annually in patients with frequent clinical exacerbations of COPD.