Clinical and pathogenetic features and prognosis of the course of occupational bronchial asthma in various phenotypes

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Abstract

Background. Currently, occupational bronchial asthma is considered a phenotypically and genotypically heterogeneous disease. Evaluation of clinical data, functional characteristics and immunopathogenesis opens up new possibilities in assessing the development, predicting the course characteristics and personalized approach to pharmacotherapy of occupational bronchial asthma (OBA), as well as in developing an individual strategy for its prevention.

Objective. Determination of the clinical, immunological markers of the risk of developing OBA under conditions of exposure to sensitizing substances in various phenotypes of this disease.

Methods. The study included 170 patients with various phenotypes (PT) of OBA and 50 people in the control group (CG). The pulmonary function was assessed using a computer spirograph «Care Fusion» by MicroLab UK (Great Britain). Determination of the IL-17, TNF-α, vascular endothelial growth factor (VEGF), MCP-1, IFN-γ, total IgE levels in the blood serum was carried out by the method of solid-phase enzyme immunoassay using kits and reagents (OOO «Protein Contour», «Vector-Best», «Diatex-E», «DIA-plus», «Pharmacia diagnostika»).

Results. For the first time, the features of clinical and immunological manifestations in allergic, non-allergic phenotypes of OBA, as well as phenotypes of a combination of OBA with occupational chronic obstructive pulmonary disease (OCOPD) and metabolic (MT) syndrome were established, the features of formation, immunopathogenesis and prognosis for various phenotypes of OBA were revealed. This allows to recommend determining these immunological parameters during in-depth periodic medical examinations of individuals working under conditions of exposure to sensitizing and irritating substances for differential diagnostics of various phenotypes of occupational asthma in the conditions of specialized inpatient examination.

Conclusion. The identified clinical, immunological and genotypic features of various phenotypes of occupational asthma, the established profiles of the genotypes of occupational asthma can optimize the approach to early diagnostics, prognosis, prevention and pharmacotherapy of this pathology, as well as expand the list of immunological studies used in preliminary and periodic medical examinations, in-depth examination of patients with occupational asthma in clinics for occupational diseases and occupational pathology centers. New reliable criteria can be used to predict the course of this pathology.

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About the authors

S. A. Babanov

Samara State Medical University

Author for correspondence.
Email: s.a.babanov@mail.ru
ORCID iD: 0000-0002-1667-737X

Dr. Sci. (Med.), Professor, Head of the Department of Occupational Diseases and Clinical Pharmacology n.a. Honored Scientist of the Russian Federation

Russian Federation, Samara

L. A. Strizhakov

Izmerov Research Institute of Occupational Medicine

Email: s.a.babanov@mail.ru
ORCID iD: 0000-0002-2291-6453
Russian Federation, Moscow

N. E. Lavrentyeva

Samara State Medical University

Email: s.a.babanov@mail.ru
ORCID iD: 0000-0002-7571-0328
Russian Federation, Samara

A. G. Baykova

Samara City Hospital No. 5

Email: s.a.babanov@mail.ru
ORCID iD: 0000-0003-3438-6602
Russian Federation, Samara

M. S. Artemyeva

Samara State Medical University

Email: s.a.babanov@mail.ru
ORCID iD: 0009-0009-1603-8226
Russian Federation, Samara

A. S. Babanov

Reaviz Medical University

Email: s.a.babanov@mail.ru
ORCID iD: 0009-0000-5053-9790
Russian Federation, Samara

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