The character of changes of inflammatory-cellular pattern of bronchial secretion in patients with asthma in association with cold airway hyperresponsiveness (CAHR) under the influence of standard therapy has been studied little. The aim of the present work is to study dynamics of cellular profile, neutrophilic component of bronchial inflammation under the combination therapy of asthmatics with CAHR. 12 asthma patients with CAHR were studied upon the number of cells of the induced sputum (IS), peroxidase, cytolytic and destructive activity of eosinophils and neutrophils in the sputum, lung function and asthma control with the help of questionnaire Asthma Control Test (АСТ) before and after the therapy with the combination of budesonide/formoterol. Before the therapy the patients had a low level of asthma control (14.4±1.2 points of ACT), FEV1 was 87.4±3.3% from predicted values; in IS neutrophils prevailed (26.4±1.7%) over eosinophils (18.5±2.6%); the level of myeloperoxidase (mean cytochemical coefficient) was 65.9±5.4 pixels. After 48 weeks of the observation only in 58% of patients the criteria of good control of asthma and the improvement of lung function were achieved. In IS there was a decrease of eosinophils (11.4±3.2%; p=0.045); the intensiveness of eosinophils and neutrophils cytolysis dropped; intracellular concentration of myeloperoxidase grew (98.2±14.1 pixels; p=0.0637); destructive changes in granulocytes were registered but the number of neutrophils remained high (34.0±8.2%, р=0.34), which was considered as the factor of stable initiation of inflammation and oxidative stress. Thus, the use of anti-inflammatory treatment regime lasting 48 weeks with combination of budesonide/formoterol oriented to achieve clinical criteria of asthma control in patients with CAHR does not allow to achieve correction of the level of neutrophilic inflammatory component. Quantitative index of neutrophils in IS in these patients has prognostic value for the possible loss of achieved asthma control.
inflammation, asthma, cold airway hyperresponsiveness, treatment, control, neutrophilic component of bronchial inflammation, budesonide/formoterol.
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