Rubtsov R. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Chronic obstructive pulmonary disease (COPD) of occupational etiology is the most prevalent disease in the structure of occupational diseases. The necessity of studying the indicators of humoral immunity and activity of immune complexes in workers of mining industry with COPD of occupational etiology in the post-exposure period led to the relevance and scientific novelty of the research. The object and methods of research. There were examined 69 employees of mining industry, patients with COPD of occupational etiology in the post-exposure period. The humoral immunity link was determined after the content of serum immunoglobulin A, M, G (IgA, IgM, IgG), total immunoglobulin E (IgE), the amount of B-lymphocytes (CD3 – , CD19 + ). Functional activity of immune cells was measured by the number of circulating immune complexes (CIC) (large, medium, small), by their spontaneous and induced activity, phagocytes index, complement (C3 content), proliferative activity of lymphocytes in the reaction of blast leukocytes transformation (RBTL) with Myogen ConA. Results of the research and their discussion. The conducted researches have shown an increased content of IgA and IgM in blood serum of patients with COPD of occupational etiology in the post-exposure period, that indicate the activation of protective mechanisms of respiratory organs and the effectiveness of local and general immunity. At the same time, the IgE content increases as a marker for atopy formation, and the content of IgG decreased, increasing individual sensitivity to bacterial infection. With the increase of the post-exposure period, a decrease in the content of IgG and IgM, an increase in IgE content, especially in the early (up to 5 years) post-exposure period were detected. The number of B-lymphocytes (CD3 – , CD19 + ) in patients with COPD of occupational etiology compared to the control group was lower and tended to increase along with of the post-contact period increasing. The authors associate these processes to the change in the synthesis of IgG and IgM as a primary response of the immune system to the action of industrial pollutants. This confirms the suggestion about so-called “exhaustion” of the humoral link of general immunity in this category of workers. It has been determined that an increase of time period after termination of contact with industrial pollutants is characterized by an increase of the amount of medium and small subpopulations of the CIC, especially in patients with a post-exposure period more than 10 years. The spontaneous and induced activity of the CIC is the highest in patients with a post-exposure period of 5-10 years, a tendency towards its reduction has been observed in the group with a post-exposure period more than 10 years. At the same time, the content of the complement (C3 and C4-2 component) increases. The obtained data demonstrate the correlation of the detected changes in systemic immunity with the strain and exhaustion of humoral link, increasing the number and activity of immune cells, which is a predictor of chronic and progression of the systemic inflammatory process, increasing the risk of tendency to infectious complications, the formation of its allergic component in this category of patients. Conclusions. Decrease of the IgM and IgG content while increasing the IgE content and the number of B-lymphocytes (CD3 – , CD19 + ), steady decline to increasing the number of all subpopulations of the CIC, primarily large and medium, with increasing and subsequent decreasing in their spontaneous and induced functional activity, as well as increasing of the content of the complement (C3 and C4-2 component), the preservation of the revealed trend with an increase in the term after termination of work in harmful conditions are the predictors of progression and transition to chronic state of the systemic inflammatory process, higher risk for infectious complications, the formation of its allergic component in patients with COPD of occupational etiology in the post-exposure period. Perspectives for further investigations. The data obtained on mechanisms of pathogenesis of COPD of occupational etiology in the post-exposure period on after studying the state of humoral immunity determine the necessity and perspectivity of further research aimed at the development, implementation and assessment of the efficacy of methods of treatment and prevention of the disease in this category of patients.

chronic obstructive pulmonary disease, humoral immunity, immune cells, employees, post-exposure period

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«Bulletin of problems biology and medicine» Issue 2 Part 1 (150), 2019 year, 191-196 pages, index UDK 616.24-057+612.017 (622)

10.29254/2077-4214-2019-2-1-150-191-196