Indications for the administration of inhaled glucocorticosteroids in patients with chronic obstructive pulmonary disease


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Abstract

Background. Respiratory tract inflammation in chronic obstructive pulmonary disease (COPD) is heterogeneous with a different response to therapy. To date, there are no exact criteria for the administration of inhaled glucocorticosteroids (IGCS). Objective. Optimization of the therapy with IGCS in COPD patients taking into account immunological inflammatory markers. Methods. 50 COPD patients, 47patients with moderate to severe allergic bronchial asthma not in exacerbation, and 17 healthy donors were examined. The number of eosinophils and neutrophils in the blood and induced sputum (IM), the blood serum eosinophilic cationic protein (ECP) and neutrophilic elastase (NE) were determined in patients. ROC analysis was carried out to determine the threshold values of the studied indicators in groups. Results. Eosinophilia in the blood was detected in 16% (n=8), in IM- in 10% (n=5) of COPD patients. An increased ESR level was detected in 12% (n=6), and an increased NE level - in 82% (n=41) of COPD patients. The ROC analysis allowed to clarify the critical values of the markers for different types of inflammation. Markers of eosinophilic airway inflammation in COPD include the number of eosinophils in IM >3.5%, ESR >19.92 ng/ml, NE <,135 ng/ml and absolute blood neutrophils <5.38x109/1. Conclusion. Markers of eosinophilic airway inflammation should be determined and taking into account for the administration of IGCS in COPD patients.

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About the authors

E. Yu Trushina

Penza Institute for Advanced Medical Education

Email: tiushina.lena@mail.ru
Teaching Assistant at the Department of Pulmonology and Phthisiology 8A, Stasova str., Penza 440060, Russian Federation

E. M Kostina

Penza Institute for Advanced Medical Education

Penza, Russia

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