Lviv clinical bulletin 2014, 3(7): 39-44

https://doi.org/10.25040/lkv2014.03.039

Immunological Criteria of Verification of Chronic Obstructive Pulmonary Disease and Asthma in Patients with Bronchial Obstructive Syndrome after Treatment of Tuberculosis or Pneumonia

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H. Volnytska, I. Ilnytskyj, O. Kostyk, L. Bilozir

Danylo Halytsky Lviv National Medical University

Introduction. Bronchial obstruction that persists in patients after primary treatment of tuberculosis or pneumonia is an important immunodependent link for their pathogenesis, defining the main manifestations of the disease, the rate of increase of the severity and probability of various complications, can be a major clinical syndrome of both chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA), which greatly complicates the diagnostic process and the appointment of an adequate treatment. The clinical signs of the course of COPD and BA, including after the completion of the main course of treatment for tuberculosis or pneumonia, are largely influenced by bronchoobstructive syndrome (BOS) – an important immune-dependent linkage of their pathogenesis, which determines the main manifestations of the disease, the rate of increase in its severity and the probability of occurrence of various complications.

Aim. To find out the diagnostic value of the parameters characterizing the state of the immune system in patients with COPD and asthma with BOS, after the completion of the main course of treatment for tuberculosis or pneumonia.

Materials and methods. To study the immunological criteria for verification of the COPD and asthma with bronchial obstructive syndrome (BOS) in patients, who took tuberculosis or pneumonia treatment, were examined 129 (100 %) patients with uncomplicated TB without destructive changes in the lungs (first or third clinical category of registered patients) and community acquired pneumonia with BOS who were treated at the therapeutic and pulmonology departments of the Lviv Regional Pulmonology Center.

Results. The changes found in the subpopulation lymphocytes in the peripheral blood in patients with COPD and asthma indicate more expressed manifestations of depression in the immunity of T-area in patients with COPD, which is a consequence of more severe inflammation in patients with COPD than in ones with asthma. The quantitative deficiency of T lymphocytes in patients was also established and accompanied by the inhibition of their proliferative activity, and in patients with COPD, this inhibition was more pronounced. The activation of B-system of immunity in patients with COPD compared with patients with asthma, was characterized by a more pronounced increase in the relative number of B-lymphocytes, increased levels of circulated immune complexes (CIC) and dysimmune globulinemia, manifested in an increased level of Ig G, Ig A in patients with the COPD and growth of Ig E in patients with asthma.

Conclusions. These research findings have made it possible to affirm that of the diagnostic value for verification of the COPD   in tuberculosis or pneumonia patients with BOS were indicators  of blast transfection reaction of lymphocytes with phytohemagglutinin, CD3+-, CD4+-, CD4+/CD8+-, CD16+-lymphocytes, CIC, Ig G, and for the verification of BA – indicators of CD22+-lymphocytes, CIC, Ig E.

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