Clinical and immunological effectiveness of the immune physiotherapy in patients with features of both asthma and chronic obstructive pulmonary disease
Vitebsk State Medical University
The aim of our study was to investigate clinical and immunological effectiveness of the immune physiotherapy in patients with features of both asthma and chronic obstructive pulmonary disease (COPD).
Material and Methods. We performed blind, randomized, controlled clinical prospective comparative study in parallel group. 80 patients 40-65 years with clinical, laboratory and functional spirometric features of both asthma and COPD were included in the study. The patients with basic therapy were randomized on groups. There are patients with ultrasound (US) on the supraclavicular fossa in the thymus area, patients with extremely high frequency (EHF) therapy, patients with combined two-color laser therapy and patients without therapy. We assessed the clinical and functional characteristics, the level of asthma control, as well as the expression of the activation markers CD25, CD38, CD69, CD71, HLA-DR lymphocytes, levels of peripheral hematopoietic stem cells - CD34+ 117 + and level A Disintegrin And Metalloproteinase -33 (ADAM-33) in the serum.
Results. In groups of patients with physiotherapy the number of days without asthma symptoms increased and number of β2 agonists decreased in compared with the group without physiotherapy. 70% this patients were without exacerbations for 3 months. Well or partly control of asthma symptoms was achieved in the majority of patients: 80% (16/4) in patients with ultrasound therapy, 65% (13/7) patients with EHF therapy, 70% (14/6) patients with combined laser therapy, 40% (8/12) in patients without physiotherapy. The ratio of bronchial obstruction increased, FEV1/ FVC ratio increased. Physiotherapy led to changes in the expression of activation markers, levels of ADAM-33 and CD34 + 117 + cells.
Conclusion. It was established that immuno physiotherapy increases asthma control and reduces the number exacerbation, decreases of bronchial obstruction, improves the quality of life of patients. Ultrasonic increases the number of activated CD25 + and CD71 + blood cells, reduces of the number of mature T lymphocytes CD3 + HLA-DR +, of lymphocytes with activation marker CD38 +, of hematopoietic stem cells CD34 + 117 +. EHF-therapy increases level metalloproteinase ADAM-33 on short time, and then decreases. Laser therapy increases the number of cells with the early activation marker CD69. Our data indicated that each physiotherapy method has its own point of application in the immune system with a similar clinical efficacy.