Effects of intravascular laser irradiation of blood on the immune status of patients with bronchial obstructive diseases of the lungs]

Thirty-eight patients with infectious-allergic bronchial asthma and thirty-four ones with chronic obstructive bronchitis were exposed to laser irradiation of blood. Control group given standard chemotherapy, consisted of 30 bronchial asthma and 30 chronic obstructive bronchitis patients. The immunity assessed in both groups exhibited the following changes in the study patients: T-lymphocytes count rose as well as their proliferative ability and concentration of immunoglobulins, the activity of oxygen-dependent metabolism inhibited, neutrophil absorptive capacity reduced. Restoration of normal cell function can serve a criteria of on-going laser therapy efficacy.     

Effectiveness of endobronchial administration of granulocyte concentrate in patients with various forms of chronic bronchitis

The paper concerns the efficacy of endobronchial introduction of fresh donor leukocytic mass which was studied in 56 patients with chronic obstructive bronchitis and compromised immunity in hypoactivity of alveolar macrophages. The above treatment promoted correction of the immunity shifts, activation of alveolar macrophages and eventually better prognosis in relevant patients.     

Immunological disorders in chronic bronchitis

The paper considers changes of cellular and humoral immunity in 181 chronic sufferers with bronchitis. The disease forms and severity were suggested to be evolutionary stages. There was suppression of immunological reactivity most evident in T-cell system and interleukin-1 in progressive chronic bronchitis. Immunological shifts proved more severe in obstructive chronic bronchitis complicated by pulmonary emphysema and chronic cor pulmonale. Alterations in immunological status may contribute to progression of chronic bronchitis.     

The leukotriene B4 content of the bronchoalveolar lavage fluid and the function of the prostacyclin-thromboxane system in patients with variants of chronic bronchitis

A study was made of the content of leukotriene B4, prostacycline and thromboxane A2 in the fluid of bronchoalveolar lavage in 62 patients with chronic bronchitis (CB) in the stage of exacerbation and remission. The time course of changes in the concentration of the eukosanoids was compared with the status of pulmonary local defense factors and cellular immunity. In catarrhal obstructive bronchitis, an important mechanism of a steady maintenance of bronchial obstruction involved a rise of the content of leukotriene B4 whereas in purulent obstructive bronchitis, it was an excess level of thromboxane A2. It is assumed that immunologically dependent activation of the leukotriene B4 and thromboxane synthetase capacity of alveolar macrophages may stipulate the clinical course of CB, modulating the bronchoconstrictor or inflammatory component of the disease. To correct phlogogenous function of alveolar macrophages, the use of immunomodulating therapy with a selective action on the suppressor component of immunity is desirable.     

Blood rheological properties and their interrelation with pulmonary hypertension in patients with chronic dust bronchitis

Nineteen patients with chronic obstructive disease of the lungs and 15 patients with chronic non-obstructive bronchitis of the dust etiology were examined for the purpose of investigating the rheological blood properties and of their interrelation with pulmonary hypertension. The hemorheological properties were evaluated by spontaneous aggregation of erythrocytes and thrombocytes. The control group comprised 8 healthy subjects. The results denoted that the rheological blood properties are to a great extent impaired in patients with dust bronchitis. The rheological blood properties worsened as hypertension of the small blood-circulation circle was increasing; it preceded the development of pulmonary hypertension in patients with chronic obstructive disease of the lungs. The aggregation changes appear to be primarily related with the functional state of thrombocytes in patients with chronic non-obstructive bronchitis; a concurrently higher aggregation of thrombocytes and erythrocytes was observed in patients with chronic obstructive disease of the lungs. The obtained data can be useful for designing a medicamental correction scheme of rheological impairments as a trend within the treatment of affected hemodynamics in the small blood-circulation circle in patients with duct bronchitis.     

Magnetophore therapy in the combined treatment of patients with obstructive bronchial diseases and its effect on immunological reactivity

Follow up of 93 patients with chronic obstructive bronchitis and bronchial asthma enabled the authors to trace the effect of magnetophorotherapy combined with pathogenetic treatment on the disease progress, external respiration function, cardiovascular system, and immune responsiveness. It was shown that magnetophorotherapy is an effective therapy for bronchial obstruction, favouring the recovery and improvement of respiratory function, characteristics of the flow-volume curve. It also exerts a beneficial effect on different components of immunity.     

Comparative immunologic characteristics of patients with acute and chronic bronchitis

Twenty patients with acute, 24 with chronic nonobstructive and 16 with chronic obstructive bronchitis were examined over time. The activity of the inflammatory process was taken into account while analyzing the data obtained in the course of immunologic studies. The patients with chronic bronchitis demonstrated a noticeable decrease in the immune response as compared to those with acute bronchitis. Application of multidimensional statistic analysis made it possible to reveal the most informative characteristics of immune responsiveness in acute and chronic bronchitis depending on the intensity of obstruction and the phase of the inflammatory process.     

Seasonal fluctuations of the indicators of cellular and humoral immunity in persons with prenosological and nosological manifestations of chronic bronchitis

A study was made of the tissue and humoral immunity in 276 persons with prenosological and nosological signs of chronic bronchitis among the indigenous population as well as in newcomers living under the conditions of ultracontinental climate. Seasonal fluctuations of indices of the cellular and humoral immunity were more noticeable in the former than in the latter. Persons with prenosological signs of bronchitis were characterized by less pronounced tension of the cellular immunity in autumn than healthy people whereas considerable inhibition of the cellular immunity and change in the rhythm of its seasonal fluctuations were noted in patients with chronic bronchitis.     

Immediate and late results of rehabilitation at the climatic health resorts on the southern coast of the Crimea with sunlight- and meteorolabile patients with chronic bronchitis

A study of the social, socioeconomic and economic indices of rehabilitation of patients with chronic obstructive and nonobstructive bronchitis has shown that one should take account of a degree of expression of heliometeolability when selecting patients with chronic bronchitis residing in West Siberia for climatic treatment in the Crimean South Coast. It has been shown that rehabilitation in the Crimean South Coast health resort area is advisable for heliometeostable patients and patients with mild and marked degrees of heliometeolability. Patients with chronic bronchitis should not be sent to the Crimea in winter and late autumn as the rehabilitation effect in this period is lowered.     

Use of nebulizer in berodual treatment of patients with chronic obstructive bronchitis in exacerbation

AIM: To study efficiency and safety of berodual in solution for inhalations delivered with the help of nebulizer in patients with exacerbation of chronic bronchitis (CB). MATERIALS AND METHODS: 12 patients with chronic bronchitis who had not responded to oral methylxantines in combination with expectorants received berodual for 10 days (1 ml 3 times a day). RESULTS: In the course of berodual treatment all the CB symptoms relieved and external respiration function improved. CONCLUSION: Berodual is effective as monotherapy of chronic obstructive bronchitis.     

Effect of ketotifen on the eicosanoid system, immunoreactivity and bronchial patency in patients with obstructive pulmonary diseases]

A study was made of the effect of ketotifen on the concentration of leukotriene B4, prostacyclin and thromboxane A2 in the liquid of bronchoalveolar lavage and on external respiration and cellular immunity during 4 weeks of the treatment of patients with infection-dependent bronchial asthma and chronic obstructive bronchitis. Inclusion of ketotifen into the treatment of patients with bronchial obstruction exerts a stimulating action on the suppressor component of T-cell immunity, leads to a decrease of the content of leukotriene B4 and thromboxane A2 in the lavage liquid, which is accompanied by positive shifts in the clinical course of the broncho-obstructive syndrome. Ketotifen turned out most effective in patients with an initially low content of the subpopulation of T suppressors and with high concentrations of leukotriene B4 and thromboxane A2 in the liquid of bronchoalveolar lavage.     

The metabolic effects of glucocorticosteroids in patients with chronic obstructive bronchitis]

The purpose of the study was to examine the effect of glucocorticosteroids on metabolic processes that occur in alveolar macrophages and bronchoalveolar liquid in patients with chronic obstructive bronchitis, in particular the activity of the antioxidant defense system, processes of hydrogen peroxide generation, and the content of phospholipids. It has been discovered that in patients suffering from chronic obstructive bronchitis, glucocorticosteroids suppress hydrogen peroxide production and exert a negligible effect on the antioxidant system of alveolar macrophages as well as stimulate the synthesis of phospholipids in pulmonary tissue and suppress phospholipase A2 activity. To prevent unfavourable metabolic effects of glucocorticosteroids, antioxidants and stimulants of phagocytosis can be applied.     

Evaluation of external respiratory function in patients with chronic obstructive bronchitis using radionuclide methods

A trial was designed to study shifts in various mechanisms of external respiration (ER) distress in chronic obstructive bronchitis by type of respiration insufficiency (RI). Combined clinicoroentgenological, spirographic, endoscopic and radionuclide (133Xe radiopneumography and 99Tc scintigraphy) examinations were conducted in 66 patients (41 males and 25 females aged 20-60 with 2-17-year history of chronic obstructive bronchitis) versus 30 healthy controls. ER parameters assessed in 4 groups of patients (with-out resting RI, with obstructive and mixed RI variants) by+radiopneugraphy and scintigraphy were found abnormal for either lung and both lungs as a whole. The abnormalities recorded correlated with RI variant. The following parameters appeared most informative in studying ER in the bronchitis patients with radionuclide techniques: the volume of ventilated alveoli, respiratory capacity, total and functional residual lung capacity, index ventilation/blood flow, capillary blood flow, time of half elimination of Xe from the alveoli and vascular bed. The above parameters change for the worse with progressive deterioration of external respiration.     

Diagnostic significance of various symptoms of right-ventricular insufficiency in patients with chronic obstructive bronchitis

The paper is concerned with the results of echocardiography, Doppler cardiography, radionuclide investigation and direct pressure measurement in the peripheral vein in 22 patients with chronic obstructive bronchitis and 7 persons with normal bronchial permeability. It was shown that the diameter of the peripheral veins, the pressure and rate of the blood flow in them and liver enlargement in patients with chronic obstructive bronchitis depended, to a large extent, on respiratory fluctuations of intrathoracic pressure. A conclusion was made that peripheral vein swelling and liver enlargement which were considered to be common symptoms of the development of right ventricular insufficiency, resulted from an increase in intrathoracic pressure during exhalation making difficult blood venous return to the heart in patients with dramatic disorders of bronchial permeability.     

Serotonin receptors blocker ketanserin in the combined therapy of patients with chronic obstructive bronchitis]

The addition of ketanserin (a blocker of serotonin S2-receptors) to treatment of bronchial obstruction is shown to lower plasma and platelet concentrations of serotonin, leukotriene B4 level in the lavage fluid, to shift prostacyclin-thromboxane balance to the side of prostacyclin. In 40 patients with chronic obstructive bronchitis treated, the above changes were associated with persistent clinical response, a decrease of bronchial obstruction, being the most profound in a group of patients with chronic catarrhal bronchitis.     

The activity of lipid peroxidation and proteolysis in assessing the stability of the course and the prognosis of ischemic heart disease in patients with chronic bronchitis]

In combination of coronary heart disease with chronic obstructive bronchitis observed in 57 patients there appeared hyperactivity of lipid peroxidation and suppression of lipid antioxidant abilities. In aggravated chronic bronchitis, lipid peroxidation intensified still more, starting the chain of biochemical reactions which entailed further imbalance and inhibition of the antioxidant and proteolysis systems. This suggests the conclusion on the validity of introduction of antioxidants and proteolytic inhibitors into complex therapy of such patients.     

Experience in treating patients with chronic obstructive bronchitis with fenspirid

AIM: To study a clinical effect of fenspirid and its impact on external respiration function in patients with chronic obstructive bronchitis (COB) in the exacerbation phase. MATERIAL AND METHODS: 30 COB patients participated in the trial (20 males, 10 females, age 39-80 years). The severity of clinical symptoms (cough, sputum, dyspnea) was studied using special scales. External respiration function was examined by a spirometric system "Tamrac system spiro sense Y2 14". Fenspirid treatment was conducted in a dose 80 mg twice a day for 3 months. Control examinations were made 2 weeks, 1 and 3 months after the treatment start. RESULTS: A 3-month treatment with fenspirid resulted in regression of COB symptoms: cough and sputum ceased, dyspnea decreased. This led to improvement in external respiration function, especially in patients with mixed ventilatory disorders with prevailing restriction. CONCLUSION: Fenspirid is an effective and well tolerated treatment of chronic obstructive bronchitis.     

New aspects of studying the morphofunctional insufficiency of bronchial epithelium in chronic bronchitis

The paper is concerned with some data on the state of the epithelium in chronic bronchitis from a view-point of its quantitative assessment with plotting models of the epithelium--morphograms reflecting its morphofunctional insufficiency. A total of 137 patients with chronic bronchitis were investigated. Morphofunctional epithelial insufficiency was shown to be an obligatory symptom of chronic bronchitis. Biopsy of the central, lobar bronchi was sufficient for the detection of morphological (quantitative) signs of chronic bronchitis. Results of morphometric investigations can be applied to differential diagnosis of chronic nonobstructive and obstructive bronchitis as well as chronic bronchitis and other types of pulmonary pathology. Morphometry of biopsy specimens is an indispensable and adequate method of therapeutic control.     

Characteristics of viral infections in patients with chronic obstructive bronchitis

Virological and immunological studies on 53 patients with chronic obstructive bronchitis at the clinical stage of fading exacerbation were conducted. A high percentage of active viral infection (43%), persistence of viruses (25%) and virus-specific components (ribonucleoprotein in influenza) in the cells of brush biopsy bronchial mucosa specimens was characteristic for these patients. The respiratory-syncytial virus was the most common persisting virus (11%). A high percentage of association (72%) of respiratory viruses (influenza, adenoviruses) and pneumonia Mycoplasma contributed to an increase in a period of an infective process. The utmost decrease in indices of cellular immunity (natural killer cell activity, T-cell and phagocytosis function) was detected in a group of patients with a prolonged (over 4 months) virus persistence.     

Respiratory arterial pH and PCO2 oscillations in patients with chronic obstructive airways disease

1. Arterial pH oscillations have been monitored in vivo in patients with well defined chronic obstructive bronchitis, asthma and clinical emphysema. 2. The patients with clinical emphysema were shown to differ from those with chronic obstructive bronchitis on the basis of a number of clinical and physiological criteria. 3. Patients with asthma showed least attenuation of their pH oscillations as a group, in contrast to emphysematous patients who showed most attenuation. In patients with clinical emphysema the attenuation was relatively homogeneous. The patients with chronic obstructive bronchitis showed the full range from normal oscillations (zero attenuation) to zero (complete attenuation). 4. The amplitude and approximate rate of change of upslope of the PaCO2 oscillations in vivo were calculated, from measured pH oscillation amplitudes, using buffer slope values in vitro from Siggaard Anderson [(1962, 1963) Scandinavian Journal of Clinical and Laboratory Investigation, 14, 598-604; 15, 211-217], then dividing the PaCO2 amplitude by half the respiratory period. 5. Mean arterial PCO2 in vitro showed a very strong correlation with the downslope of the pH oscillation in vivo (calculated as for PaCO2 upslope) in patients without clinical emphysema. This correlation would be expected to some extent, owing to the logarithmic relationship of PaCO2 oscillations to pH oscillations. However, the mean arterial PCO2 also showed a very strong correlation with the upslope of the calculated PaCO2 oscillations, again excluding patients with clinical emphysema.