Disorders of the immune status of the patients with chronic obstructive pulmonary disease
Vitebsk State Medical University, Vitebsk, Belarus
The aim of study was to investigate the immune status of patients with frequent exacerbations of chronic obstructive pulmonary disease (COPD).
Material and Methods: We performed open cohort prospective study in the pulmonology and allergy department of the Vitebsk Regional Hospital. We examined 100 patients: 53 patients with COPD, 47 patients with COPD and asthma (BA+COPD), 18 healthy the person. The study examined the immune status of patients: phenotype blood leukocyte and lymphocyte cells (CD3, CD4, CD8, CD13, CD14, CD22, CD25, HLA-DR, CD34, CD38, CD69, CD71), the levels of immunoglobulins (IgG , IgM, IgA, IgE), interferon-a and interferon-³, cytokines (IL-1b, IL-2, IL-4, IL-6, IL-12, TNF-a, TGF-b1).
Results. The patients with COPD, including BA+COPD during exacerbation had signs of immunodeficiency: the reduction in the number of natural killer cells CD16+ in patients with COPD and BA+COPD; decrease of expression CD71+ lymphocytes in both groups, with a strong depression in the COPD group (p = 0.045); decreased expression of CD95+ relative to the reference values in both groups; reducing the number of CD8+ cells in the BA+COPD group (p = 0.001).
The T lymphocytes (CD3) in patients with COPD were increased with respect to the reference values, whereas B lymphocytes (CD22) were increased in the patients with BA+COPD. In the group of patients with significant depression CD16 + lymphocytes (<70%) we observed a marked reduction of the activation markers CD25 +, CD69 + (COPD patients), CD71 +, CD95 + (in both groups), increased expression of HLA-DR + (group BA+COPD), increasing the number CD4 + T helper cells. The serum levels of IL-1b and TGF ²A were significant increased in patients with COPD, including BA+COPD. The IgG1 serum level was decreased and IgA level was increased in patients with COPD compared with a group of BA+COPD. Total IgE in serum in the group of BA+COPD exceed the values of control group more than doubled.
Conclusion. These data indicate the presence of immunodeficiency in patients with COPD with frequent exacerbations.