An analysis of influence of functional tests (6 or 12 breathings per minute) and inhaled fenoterol on the heart rate variability (HRV) was performed in 64 moderate bronchial asthma (BA) patients with subsiding exacerbation and in 42 healthy individuals. We evaluated FEV 1 , PEF, FEF 50 , FEF 75 and HRV using the frequency analysis. Enhanced sympathetic (in the 6 breathings per minute test) and parasympathetic influences (in the 12 breathings per minute test) on the chronotropic cardiac function were noted. The sympathetic influence on the heart rate after the inhalation of fenoterol was shown in the BA patients. Combination of both the tests allowed to reveal latent disturbances of the sympathetic and parasympathetic components of the heart rate regulation in the BA patients (relative sympathetic and parasympathetic insufficiency). A reliable correlation was found between the parameters of the bronchial passability and HRV, which permitted to assume a united neuro-vegetative regulation of the cardiac-and-respiratory system.
175 patients were examined: 78 patients with bronchial asthma (BA), 39 with Asthma-COPD Overlap Syndrome (ACOS), 38 with chronic obstructive pulmonary disease (COPD) and 20 healthy individuals. A general clinical and laboratory examination was conducted, α1-antitrypsin (AAT), IgG and IgA to four bacterial antigens were determined, and pulmonary function test was studied. The clinical and spirometry data (characterizing the ACOS) were received. Negative association of AAT with respiratory function parameters in patients with ACOS, high levels of IgG antibodies to bacterial antigens and the lack of these connections in patients with BA and COPD allows us to consider ACOS to be independent nosological form related with microbial inflammation and marked by the AAT.
The article deals with bacterial lung microbiota in patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD), bacterial inflammation of the bronchopulmonary system which can be manifested by sensitization and allergy. Also they can be a trigger with the development of bacterial inflammation. Bacteria can colonize the lungs without severe clinical, laboratory and instrumental changes. High levels of IgG to Str. pneumoniae, Neisseria perflava, Haemophilus influenza in ACOS patients can be evidence of their etiological significance. Taking into account the etiological significance of microbiota, methods of treatment of patients with COPD and BA with the use of antibiotics, vaccines and probiotics have been developed.
The aim of this study was to analyze inflammation features and possible causes of asthma-COPD overlap syndrome (ACOS). Methods. Clinical examination was performed for all patients included in the study. Blood levels of alpha-1-antitripsin (AAT), immunoglobulin (Ig) G and E antibodies against four bacterial antigens (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria perflava, and Staphylococcus aureus), and lung function were measured in all the patients. Results. The study involved 175 patients including 78 patients with bronchial asthma, 39 patients with ACOS, 38 patients with COPD, and 20 healthy individuals. AAT blood level was reversely related to lung function and to increased IgG-antibody levels against bacterial antigens. Conclusion. Due to this fact, the authors suppose that the ACOS should be considered as an independent nosology distinct from asthma and COPD, and related to microbial inflammation and AAT level.
The study involved 210 people, of which 32 had mild bronchial asthma, 39 had moderate bronchial asthma, 39 had moderate bronchial asthma combined with chronic obstructive pulmonary disease, 38 had chronic obstructive pulmonary disease, 17 patients suffered from community-acquired pneumonia, 25 patients with essential hypertension and ischemic heart disease (comparison group) and 20 healthy patients. We assessed sIgE to mite allergens, dust allergens, and the mixed grass, trees, weeds and flower pollen allergens , Str. pneumon., Haemofil. influenzae, Neisseria perflava. The levels of interleukin-4, interleukin6, interleukinlO, interleukin-7, gamma-interferon, tumor necrosis factor were investigated. All patients were studied in the acute condition of the disease. We assessed the infectious potential and atopic potential in every patient. Results of the study allow to resume that cytokines levels, their combinations (cytokine profile) testing has not to be advisable for clinical diagnostics, assessement of the severity of the disease and treatment strategy including anti-cytokine therapy.
Authors of this article have been studying clinical and pathogenic features of bronchial asthma for about 40 years. As a result, 10 clinicopathological variants of asthma have been described. This classification is based on a type of the airway inflammation, age at the disease onset, triggers and risk factors, presence of upper airway disease, endocrine and immune pathology, psychological characteristics of the patients, clinical features and course of asthma. An algorithm of diagnosis has been developed for each clinicopathological variant. Recently, according to a tendency to describe different asthma phenotypes the authors propose the term “clinicopathological phenotypes of asthma” in order to bring Russian terminology in line with international consensuses.
Authors of this article have been studying clinical and pathogenic features of bronchial asthma for about 40 years. As a result, 10 clinicopathological variants of asthma have been described. This classification is based on a type of the airway inflammation, age at the disease onset, triggers and risk factors, presence of upper airway disease, endocrine and immune pathology, psychological characteristics of the patients, clinical features and course of asthma. An algorithm of diagnosis has been developed for each clinicopathological variant. Recently, according to a tendency to describe different asthma phenotypes the authors propose the term “clinicopathological phenotypes of asthma” in order to bring Russian terminology in line with international consensuses.
