STUDY OF ACTIVATING EFFECT OF SURFACTANT DRUGS ON PULMONARY MACROPHAGES IN VITRO IN PATIENTS WITH BRONCHIECTASIS

Abstract

The state of surfactant system of lungs in chronic inflammation is known to disrupt their structural organization, causes shifts in the system itself, the severity of which depends on alveolar parenchyma injury rate. The cell destruction of aerohematical barrier is accompanied by changes in pulmonary surfactant system, its deficiency, development of dis− and atelectases, which increases the severity of lung injury and promotes the progression of bronchiectasis. Exogenously introduced surfactant restores local immunity and serves as a substrate for synthesis of its own surfactant. To determine the stimulatory effect of natural surfactant on receptors of the lung macrophages and its influence on activation of phagocytosis a comparative study of direct effect of infasurf on cell surface and formation of phagocytic vacuoles in macrophage elements of individuals with bronchodectic disease at an acute stage was performed . In bronchoalveolar lavage of patients the percentage and viability of pulmonary macrophages were determined. Other lavage material was investigated both as a baseline control and with infasurf. The electron microscopic examination of bronchoalveolar lavage macrophage elements in patients show that after incubation of cells with infasurf, there is a pronounced cell surface activation, formation of phagocytic vacuoles containing membranes of exogenous surfactant. Its small and large clusters were often observed lying freely between pulmonary macrophages, whereas in the control group (without infasurf) small fragments of tubular myelin or osmiophilous lamellar bodies were noted. Thus, the specific pharmacological action of surfactant drugs directly contributes to differentiation and maturation of pulmonary macrophages, their phagocytic function activation. Key words: bronchiectasis, surfactant, pulmonary macrophages.