Combined immunodeficiency in elderly persons with COPD as a manifestation of immune aging

The study of immune system (IS) functions in chronic respiratory pathology is especially relevant in elderly and senile persons, since frequent prolonged exacerbations of chronic obstructive pulmonary disease (COPD) significantly affect the condition of patients, leading to decompensation of diseases. The objective of this study was to perform expanded evaluation of IS state, and to specify the variants of disorders in elderly and senile patients with COPD. 10 patients aged 60-80 years with COPD comprised the study group (SG) l; the comparison group (CG) included 30 conditionally healthy individuals. The general and local clinical status was determined. Before treatment, the following immune parameters were studied: T lymphocytes (CD3+CD19-, CD3+CD4+, CD3+CD8+), B lymphocytes (CD3-CD19+), NK cells (CD3-CD16+CD56+), two subsets of neutrophilic granulocytes (NG) CD64-CD32+CD16+CD11b+ and CD64+CD32+CD16+CD11b+ using an FC-500 Beckman Coulter device, with calculation of the CING index reflecting the ratio between the two NG subpopulations. Phagocytic function of NG was evaluated, i.e., engulfment (%PAN, PN, PI), killing and digestion (%D, ID) of microbial particles (S. aureus, strain 209), as well as NADPH oxidase activity by the NBT test. The SG patients showed combined immunodeficiency of varying severity: quantitative deficiency of T lymphocytes due to a decrease of T helper cells (p 0.05), altered effector function of NG (deficiency of actively phagocyting NG, impaired capture, digestion and killing, p1-3 0.05). A decrease in the CD64-CD32+CD16+CD11b+NG subset, and an 8.9-fold increase in “immature” subset (negatively transformed CD64+CD32+CD16+CD11b+) were shown, suggesting an inferior NG response to bacterial infection. When calculating the CING, bacterial infections were detected: Mild, moderate and severe conditions were diagnosed, respectively, in 60%, 10% and 30% of SG patients. The evidence of immunodeficiency in elderly and senile COPD patients has been obtained, thus requiring development of immunotherapeutic approaches aimed at recovery of IS defects, in order to increase the efficiency of COPD therapy and improve the quality of life in patients.