Occupational chronic obstructive pulmonary disease (immunopathogenetic features, diagnostic issues, prognosis)

Introduction. Evaluation of functional characteristics and immunopathogenesis of occupational chronic obstructive pulmonary disease in its isolated and comorbid course opens up new possibilities in assessing the development, predicting the course characteristics and personalized approach to pharmacotherapy of occupational chronic obstructive pulmonary disease (OCPD), as well as in developing an individual strategy for its primary and secondary prevention. The aim of the study was to determine the functional characteristics and immunological markers of the risk of developing OCPD in its isolated course and in combination with arterial hypertension (AH) under conditions of exposure to industrial aerosols of chemical and fibrogenic nature. Materials and methods. The study involved 235 patients: Group 1 (n=60) (control) — healthy volunteers; Group 2 (n=35) — OCPD of the first degree of severity; Group 3 (n=50) — OCPD of the second degree of severity; Group 4 (n=40) — a combination of OCPD of the second degree of severity and (AH); Group 5 (n=50) — isolated course of hypertension. Determination of the levels of cytokines IL-4, IL-6, IL-8, IL-10, MCP-1, FGF 2, TGF-b, vascular endothelial growth factor (VEGF) in the blood serum was carried out by the method of solid-phase enzyme immunoassay. For statistical processing of the data, one-way analysis of variance with intergroup comparisons according to the Dunnett criterion in the form of the mean and standard deviation (M±SD), as well as comparison of the groups as a whole (ANOVA) were used. Results. For the first time, the features of functional and immunological manifestations in COPD were established in its isolated course depending on the severity and in its combined course with hypertension. Limitations of the study. The study has regional (Samara Region) and professional (according to the detailing of working conditions in the studied comparison groups) limitations. Conclusion. The identified functional and immunological features in OCPLD in its isolated course depending on the severity and its combined comorbid course with hypertension can optimize the approach to early diagnosis, prognosis, prevention and pharmacotherapy of OCPLD.