Novikov D.K., Smirnova O.V.
Immunological phenotypes of chronic obstructive pulmonary disease: prospects of immunocorrection
Abstract.
On the basis of the study of the immune status of patients with chronic obstructive pulmonary disease (COPD) for the first time two immunological phenotypes of COPD have been singled out: immunodeficient, which is clinically bronchitis and autoimmune (emphysema). It has been concluded that COPD is a syndrome of obstruction and remodulation of the bronchi that develops in genetically susceptible individuals after prolonged inhalation of toxins damaging their mucosa and causing persistent hyperergic inflammation, leading to the development of immunodeficiency - bronchitic and / or autoimmune - emphysema phenotype of COPD, the early sign of which is recurrent bronchitis. Immunocorrective therapy proper to these phenotypes has been substantiated. We performed a double-blind, placebo-controlled trial of the efficacy of treatment with leyargunal and immugenin. Positive clinical and immunological dynamics has been observed in patients who used immunomodulators. In the groups of patients with COPD treated with lykopid and immugenin a significant decrease in the number of exacerbations and an increase of the life quality, have been noticed which testifies to the effectiveness of COPD immunocorrection.
Key words: chronic obstructive bronchitis, immune status, phenotype.
References
1. Global initiative for chronic obstructive lung disease : global strategy for the diagnosis, management, and prevention of chronic obctructiv pulmonary disease [Electronic resourse]. – 2014. – Mode of access: http://www.goldcopd.org/uploads/users/files/GOLD_Report_2014_Jun11.pdf.
2. Belevskiy AS. Global'naia strategiia diagnostiki, lecheniia i profilaktiki khronicheskoi obstruktivnoi bolezni legkikh (peresmotr 2011 g.) [Global strategy of diagnostics, treatment and prophylaxis of a chronic obstructive pulmonary disease (revision of 2011)]. Moscow, RF: Rossiiskoe respi-ratornoe obshchestvo; 2012. 80 р.
3. Chuchalin AG. Khronicheskie obstruktivnye bolezni legkikh [Chronic obstructive pulmonary diseases]. Moscow, RF: BINOM; 1999. 512 р.
4. Bosse Y. Updates on the COPD gene list. Int J Chron Obstruct Pulmon Dis. 2012;7:607-31.
5. Titova ND. Pattern raspoznaiushchie retseptory i allergiia [Pattern the distinguishing receptors and an allergy]. Rossiiskii allergologicheskii zhurnal. 2011;(1):32-9.
6. Novikov DK, Novikov PD. Klinicheskaia immunopatologiia [Clinical immunopathology]. Moscow, RF: Meditsinskaia literatura; 2009. 464 р.
7. Cosio MG, Saetta M, Agusti A. Immunologic aspects of chronic obstructive pulmonary disease. N Engl J Med. 2009 Jun;360(23):2445-54.
8. Mio T, Romberger DJ, Thompson AB, Robbins RA, Heires A, Rennard SI. Cigarette smoke induces interleukin-8 release from human bronchial epithelial cells. Am J Respir Crit Care Med. 1997 May;155(5):1770-6.
9. Barnes PJ, Shapiro SD, Pauwels RA. Chronic obstructive pulmonary disease: molecular and cellular mechanisms. Eur Respir J. 2003 Oct;22(4):672-88.
10. Lee SH, Goswami S, Grudo A, Song LZ, Bandi V, Goodnight-White S, Green L, Hacken-Bitar J, Huh J, Bakaeen F, Coxson HO, Cogswell S, Storness-Bliss C, Corry DB, Kheradmand F. Antielastin autoimmunity in tobacco smoking-induced emphysema. Nat Med. 2007 May;13(5):567-9.
11. Feghali-Bostwick CA, Gadgil AS, Otterbein LE, Pilewski JM, Stoner MW, Csizmadia E, Zhang Y, Sciurba FC, Duncan SR. Autoantibodies in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2008 Jan;177(2):156-63.
12. Chrysofakis G, Tzanakis N, Kyriakoy D, Tsoumakidou M, Tsiligianni I, Klimathianaki M, Siafakas NM. Perforin expression and cytotoxic activity of sputum CD8+ lymphocytes in patients with COPD. Chest. 2004 Jan;125(1):71-6.
13. Cosio MG. Autoimmunity, T-cells and STAT-4 in the pathogenesis of chronic obstructive pulmonary disease. Eur Respir J. 2004 Jul;24(1):3-5.
14. Wilson RH, Whitehead GS, Nakano H, Free ME, Kolls JK, Cook DN. Allergic sensitization through the airway primes Th 17-dependent neutrophilia and airway hyperresponsiveness. Am J Respir Crit Care Med. 2009 Oct;180(8):720-30.
15. Miravitlles M, Soler-Cataluña JJ, Calle M, Molina J, Almagro P, Quintano JA, Riesco JA, Trigueros JA, Piñera P, Simón A, López-Campos JL, Soriano JB, Ancochea J. Spanish COPD Guidelines (GesEPOC): Pharmacological Treatment of stable COPD. Arch Bronconeumol. 2012 Jul;48(7):247-57.
16. Chuchalin AG, Aisanov ZR, Avdeev SN, Leshchenko IV, Ovcharenko SI, Shmelev EI. Federal'nye klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskoi obstruktivnoi bolezni legkikh [Federal clinical references on diagnostics and treatment of a chronic obstructive pulmonary disease]. Russkii meditsinskii zhurnal. 2014;(5):331-46.
17. Smirnova OV. Narusheniia immunnogo statusa u patsientov s khronicheskoi obstruktivnoi bolezn'iu legkikh [Disturbances of the immune status at patients with a chronic obstructive pulmonary disease]. Immunopatologiia, allergologiia, infektologiia. 2014;(2):43-51.
18. Novikov DK, Smirnova OV. Immunodefitsitnyi i autoimmunnyi fenotipy khronicheskoi obstruktivnoi bolezni legkikh [Immunodeficient and autoimmune phenotypes of a chronic obstructive pulmonary disease]. Immunopatologiia, allergologiia, infektologiia. 2014;(2):74-86.
19. Agusti A, MacNee W, Donaldson K, Cosio M. Hypothesis: does COPD have an autoimmune component? Thorax. 2003 Oct;58(10):832-4.
20. Saetta M, Baraldo S, Corbino L, Turato G, Braccioni F, Rea F, Cavallesco G, Tropeano G, Mapp CE, Maestrelli P, Ciaccia A, Fabbri LM. CD8+ve cells in the lungs of smokers with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1999 Aug;160(2):711-7.
21. Majo J, Ghezzo H, Cosio MG. Lymphocyte population and upoptosis in the lungs of smokers and their relation to emphysema. Eur Respir J. 2001 May;17(5):946-53.
22. Smirnova OV, Novikov DK, Ianchenko VV. Kliniko-immunologicheskaia effek-tivnost' leiargunala pri khronicheskoi bronkho-legochnoi patologii [Kliniko-immunologichesky efficiency leyargunat at chronic bronkho-pulmonary pathology]. Immunopatologiia, allergologiia, infektologiia. 2013;(4):81-90.
23. Ianchenko VV, Aliakhnovich NS, Smirnova OV, Velichinskaia OG, Novikov DK. Otsenka kliniko-immunologicheskoi effektivnosti immugenina pri khronicheskoi obstruktivnoi bolezni legkikh [Assessment of kliniko-immunologic efficiency of an immugenin at a chronic obstructive pulmonary disease]. Immunopatologiia, allergologiia, infektologiia. 2014;(1):15-20.
