Rubtsov R. V

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

As it is known the progression of COPD of occupational etiology occurs mostly after the termination of work under harmful conditions. Thus, the studying of the cellular immunity state and its role in the processes of sanogenesis and pathogenesis of the disease within different terms after termination of work under harmful working conditions in this category of patients is relevant. The object and methods of research. There were examined 69 employees of mining industry with COPD of occupational etiology. The average age of workers was 56.2 ± 2.1 years, their work record under harmful conditions was about 18.4 ± 0.6 years. Group I consisted of 27 workers with a post-exposure period of up to 5 years, Group II therefore – 20 workers with a post-exposure period of 5-10 years, Group III – 22 workers with a post-exposure period of more than 10 years. The control group comprised 21 (for hemogram indicators) and 10 (for systemic cellular immunity indicators) virtually healthy employees of mining industry. Results of the research and their discussion. The dynamics of cellular element indicators of general immunity was studied for objective assessing the features of the pathogenesis of COPD of occupational etiology among employees of mining industry in the post-exposure period. It has been defined that in some hemogram indices in the post-exposure period, there is a tendency to increasing the number of leukocytes, lymphocytes, relative number of bacillonuclear neutrophils, whose indices have a maximum value in patients with a post-exposure period of more than 10 years, and in relation to lymphocytes – in the early post-contact period (under 5 years). At the same time, direction towards a decrease in the relative number of monocytes and segmented neutrophils is observed primarily in the group with a post-exposure period of 5-10 years. Also according to the indices of cellular immunity the main subpopulations of T-lymphocytes are tended to decreasing with the increased time of post-exposure period. Thus, the lowest indices of CD3 + , CD19 and CD3 + , CD56 + were detected in patients with the highest post-exposure period (more than 10 years), respectively 72.3 ± 2.6% and 5.9 ± 0.7%, and indices CD14 and CD3 – , CD56 + were the smallest in the group with a post-exposure period of 5-10 years, respectively 5.9 ± 0.6% and 10.5 ± 1.8%. On the contrary, an increase of the post-exposure period led in this group to an increase in other T-cell indices – the general immunity link – CD4 + , CD8 – and CD4 -, CD8 + , respectively, up to 44.8 ± 2.1% and up to 24.6 ± 2.6%, and CD4 +, CD8 – \ CD4 -, CD8 + up to 2.2 ± 0.3. The revealed changes should be assessed as signs of chronic inflammation in the bronchial mucosa with symptoms of a slight activation of the T-helper subpopulation of lymphocytes, which indicates more “strong” immune response in patients with a post-exposure period of 5-10 years, with a tendency to “decrease” its activity in patients with a post-exposure period over 10 years and the formation of the normoergic state of the cellular link of general immunity in this category of patients. The content of CD3 + , CD56 + tended to increase, reaching maximum values in patients with a post-exposure period of 5-10 years (to 7.2 ± 2.0%) with a subsequent decrease in employees with post-contact period over 10 years (to 5.9 ± 0.7%) and, on the contrary, CD3 – , CD56 + (up to 14.1 ± 2.4%) had the maximum values in the group of employees with a post-exposure period over 10 years. The content of CD14 after termination of work under harmful conditions decreased to 5.9 ± 0.6% (in the group of 5-10 years), and the level of total leukocyte antigen did not change significantly. Conclusions. The revealed changes in the cellular link of the general immunity indicate that in the post-exposure period in patients with COPD of occupational etiology the processes of its activation occur, a tendency to decreasing in the content of monocytes / macrophages indicates the prolongation of the chronic inflammatory bronchopulmonary process. At the same time, the constant content of the total leukocyte antigen indicates the activation of differentiation of hematopoietic cells from immature to mature forms. The obtained results require the further developing effective methods for the treatment and prevention of COPD of occupational etiology in mining employees in the post-exposure period. Perspectives for further investigations. The data obtained require the further research aimed on development of effective therapy methods and prevention of COPD of occupational etiology among mining employees in postexposure period.

chronic obstructive pulmonary disease, employees, post-exposure period, cellular immunity

1. Bilyk LI, Kovalʹchuk TA, Levina OV, Grín’ AV, Bílous SS, Bondarenko AV. Suchasni pidkhody laboratornoyi diahnostyky khvoroblyvykh orhaniv dytyny profesiynoyi etiolohiyi v profesiynykh hirnychodobuvnykh haluzyakh: posibnyk dlya likariv. Kryvyy Rih; 2015. 34 s. [in Ukrainian].
2. Makarov IA, Potapova IA, Mokeyeva NV. Osobennosti dinamiki professional’noy khronicheskoy obstruktivnoy bolezni legkikh u rabochikh pylevykh professiy. Pulʹmonolohyya. 2017;27(1):37-40. [in Russian].
3. Shpagina LA, Poteryayeva YeL, Kotova OS, Shpagín ÍS, Smirnova ÍL. Aktual’nyye problemy pul’monologii v sovremennoy profpatologicheskoy praktike. Meditsina truda i promyshlennaya ekologiya. 2015;9:11-4. [in Russian].
4. Dolgikh OV, Zaytseva NV, Krivtsov AV, Gorshkova KG, Lanin DV, Bubnova OA, i dr. Obosnovaniye geneticheskikh i immunnykh markerov chuvstvitel’nosti i effekta v usloviyakh kombinirovannogo vozdeystviya faktorov riska na rabotnikov gornorudnoy promyshlennosti. Meditsina truda i promyshlennaya ekologiya. 2014;12:19-23. [in Russian].
5. Dolgikh OV, Zaytseva NV, Alikina IN, Otavina EA, Lanin DV. Osobennosti imunnogo statusa i kharakteristika indikatornykh pokazateley narusheniy immunologicheskoy rezistentnosti u rabotnikov, zanyatykh na proizvodstve po dobyche khromovykh rud. Meditsina truda i promyshlennaya ekologiya. 2018;10:20-3. [in Russian].
6. Kosarev VV, Zhestkov AV, Babanov SA, Averina OM, Vasyukov PA. Immunopatogeneticheskiye osobennosti professional’nogo bronkhita. Meditsina truda i promyshlennaya ekologiya. 2012;9:22-7. [in Russian].
7. Kozitskaya AS, Mikhaylova NN, Zhukova AG, Gorokhova LG. Immunologicheskiye mekhanizmy formirovaniya professional’noy pylevoy patologii bronkholegochnoy sistemy. Meditsina truda i promyshlennaya ekologiya. 2018;6:33-7. [in Russian].
8. Pertseva TO, Sanina NA. Vyrazhennost’ sistemnykh vospalitel’nykh reaktsiy u bol’nykh khronicheskoy obstruktivnoy bolezn’yu legkikh. Pulʹmonolohyya. 2013;1:38-41. [in Russian].
9. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Poket guide to COPD diagnosis, management and prevention 2019. Available from: https://goldcopd.org. (Last accessed 02.03. 2019).
10. Nakaz MOZ Ukrayiny vid 27 chervnya 2013 № 555. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnolohichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomohy pry khronichnomu obstruktyvnomu zakhvoryuvanni lehenʹ: Dostupno: http://document.ua/pro-zatverdzhennja-ta-vprovadzhennja-mediko-tehnologichnih-d-doc166218.html [in Ukrainian].

«Bulletin of problems biology and medicine» Issue 4 Part 1 (153), 2019 year, 153-158 pages, index UDK 616.24-057+612-083(622)

10.29254/2077-4214-2019-4-1-153-153-158