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.

Background. The aim of the study was to investigate cellular phenotypes of the spontaneous sputum, estimate possibilities of cytological sputum analysis in evaluation of airways inflammation peculiarities in comparison with the expired nitric oxide level and respiratory function tests. Materials and methods. functional properties of neutrophils were evaluated by respiratory burst intensity. 72 patients were included, 23 - with moderate bronchial asthma course and chronic bronchitis, 18 - with moderate bronchial asthma and COPD, 31 patient had COPD only. All patients were examined in the exacerbation period, all of them had productive cough. Results. Cytological phenotypes were stated as well as the links between different sputum cells presence and between cytological peculiarities, inflammation and functional state of the respiratory system. Functional defects of neutrophils were found in COPD patients.

The investigation concerned the diagnostic value of following inflammation markers in patients with mild or moderate bronchial asthma (BA), chronic obstructive pulmonary disease (COPD), chronic bronchitis and pneumonia: expired air nitric oxide (Feno) and serum levels of α 1-antitripsin and neutrophilic elastase. 93 patients were included: 6 with mild BA, 11 - with moderate BA, 17 - with mild BA and chronic bronchitis, 25 - with moderate BA and COPD, 25 - with COPD, 9 - with pneumonia. The control group consisted of 21 healthy donors. We revealed that Feno, α 1-antitripsin and neutrophilic elasthase indicate the presence of the inflammation: Feno elevation mostly related to allelrgic one, α 1-antitripsin and neutrophilic elasthase - to infection-dependent inflammation. Treatmentinduced remission of the disease leads to the decrease of α 1-antitripsin and neutrophilic elasthase, but levels are not reaching the normal values. This confirms the presence of airways inflammation during clinical remission of the disease. Elevated levels of α 1-antitripsin and neutrophilic elasthase are associated with the decreased forced expiratory volume during the first second (FEV 1 - % to the predicted values).