The Cellular Reactions in Bronchopulmonary System in Patients with Chronic Obstructive Pulmonary Disease

Abstract

severe edema ( n = 21, 44.6 %) with elements of dislocation of the brain structures ( n = 14, 29.7 %) in the form of secondary stem syndrome and hemorrhagic transformation of the heart attack ( n = 8, 17.02 %), which has been associated with the highest average volume of ischemic heart disease and severe initial neurological deficiency. Conclusions. The received information allows to individualize the therapeutic approach to the correction of ischemic stroke complications and to predict the risk of their occurrence, depending on the period of cerebral ischemia onset. The cellular reactions in the bronchoalveolar complex have been studied on the basics of broncho-pulmonary fluid in 60 patients with chronic obstructive pulmonary disease (COPD). At the beginning of the examinations of the patients they have been divided into two groups, represented by age, sex and severity of disease. The first clinical group has included 33 (55 %) patients with COPD II; the second group - 27 (45.0 %) patients with COPD III. The control group has consisted of 18 practically healthy persons without any signs of the respiratory tract diseases and other pathology of internal organs. The study of the condition of local immunity has been carried out by cytological study of the received bronchopulmonary fluid (BPF) during the fibrobronchoscopy according to standard method. A great number of neutrophilic granulocytes (NG) has been studied using a peripheral blood smear, followed by a determination of their phagocytic and bactericidal activity. The bactericidal activity of NG has been investigated using a spontaneous and induced NTB-test (Nitroblue tetrazolium blood test) using the methodology of the Lviv Research Institute of Hematology and Blood Transfusion. The phagocytic activity of NG has been studied using the culture of S. aureus, with the determination of the phagocytic index (FI) and the phagocytic number (FF). The functional state of AM and NG have been determined by their adhesion and absorption capacity and oxygen dependent metabolism. The adhesive ability of AM has been evaluated using the method of BM Novikova, YK Novikov (1984) in the modification of KF Chernushenko et al. (1986). The absorption capacity of alveolar macrophages (AM) has been estimated using method of TI Ivchik (1980): Incubation of attached to the cladding glass AM has been carried out with polystyrene latex particles for 60 minutes. FI has been calculated - the percentage of AM that has absorbed latex particles from their total number, as well as the FF - the average number of latex particles in a 1 phagocyte cell. During the study the quantitative composition of cellular elements in BPF, phagocytic and biocidal activity of AM and NG in peripheral blood has been determined. The immune disorders developing in patients with COPD in the exacerbations have been also established. The obtained data on the study of cellular composition and their functional activity in the bronchoalveolar space of patients with exacerbation of COPD with high reliability indicate an absolute increase in the total number of cells, a relative decrease in alveolar macrophages, a percentage increase in the number of neutrophilic leukocytes, lymphocytes and eosinophils have been compared to practically healthy individuals. The causative factors of prolonged activation of AM can act as an infectious factor, as well as other triggers of inflammation of airways. They correlate with both changes in the cellular content of the immune defense and in the functional stage. The relapses of the exacerbations cause the increase of neutrophils in the bronchopulmonary fluid and peripheral blood, the decrease of their functional activity (according to NBT tests and phagocytosis indexes) in the peripheral blood and in BPF indi-cating the processes, which take place in a system of local BPF defense. The peculiarities of cellular structure of the local immunity in bronchoalveolar complex of patients with COPD depend on many factors including inflammatory processes and stages of the disease