В исследовании участвовали 163 человека. Целью исследования было проведение сравнительного анализа спонтанной и индуцированной продукции IL-4, IL-10, IL-6, IL-8 в сыворотке крови у больных неаллергической формы бронхиальной астмой (НАБА) и хронической обструктивной болезнью легких (ХОБЛ). Материалом для исследования служил супернатант спонтанной и фитогемагглютинин-индуцированной продукции клеток исследуемых. В основе нейтрофильного воспаления у больных НАБА и ХОБЛ ведущую роль играет как спонтанная, так и индуцированная продукция цитокинов IL-6, IL-8 (р<0,05). Значения IL-8 были выше при ХОБЛ, тогда как при НАБА преобладала продукция IL-6 (р<0,05). Уровень IL-4 и IL-10 были выше у больных НАБА (р<0,05). Изучаемые цитокины играют важную роль в патогенезе астмы и ХОБЛ.

Aim. To study the frequency of polymorphic gene variants encoding proteins of renin-angiotensin system [AGT Thr174Met (rs 4762), AGT Met235Thr (rs699), AGTR1 A1166C (rs5186)], endothelial factors [NOS3 C786T (rs2070744)], and folate cycle enzymes [MTHFR C677T (rs1801133)] in patients with various ischemic stroke severity. Methods. 98 patients with ischemic stroke verified by magnetic resonance imaging and computed tomography scan of the brain, were examined. The severity of stroke was assessed by National Institutes of Health Stroke Scale. The allelic variants of genes were typified by polymerase chain reaction with the detection of amplification products in the «real time» mode. Results. The analysis of genetic polymorphism frequency of renin-angiotensin system did not reveal statistically significant differences in the study groups. The polymorphism of NOSC786T gene in the study was also not associated with the severity of ischemic stroke. Among the studied polymorphic variants, only the C677T polymorphism of MTHFR gene was revealed to be reliably associated with severe course of acute cerebral ischemia. Conclusion. C677T polymorphism of MTHFR gene is reliably associated with severe course of acute cerebral ischemia; carriage of 677T allele of MTHFR gene in the studied category of patients can cause an increased level of homocysteine and have an adverse effect on the course of acute cerebral ischemia.

Chronic polyposis rhinosinusitis (CPRS) is an inflammatory disease of the nose and paranasal sinuses, accompanied by the formation and recurrent growth of polyps. PDRS is an urgent medical problem, because it is difficult to treat and is accompanied by constant exacerbations. The important role of neutrophil granulocytes in the pathogenesis of CPRS has been proved, as they are the first line of defense in response to tissue damage and active participants in the pathological process. There is evidence of successful use of immunocorrectors in the treatment of patients with CPPS, but they are often prescribed without regard to possible pathogenetic mechanisms of the disease. One of the promising immunomodulators of local use is a preparation of human recombinant interferon gamma. It is known that interferon gamma is able to activate neutrophils due to the receptors to this cytokine, which are located on their surface. The aim of the study was to investigate the functional activity of neutrophils in patients with CPPS and the effect of human recombinant interferon gamma on these indicators. Thirty-five patients with CHRS were examined before and after therapy with intranasal interferon gamma. The control group included 30 healthy subjects. Functional activity of neutrophils was studied in whole blood by chemiluminescent method using double stimulation. Patients with CPRS before treatment revealed increased indexes of neutrophils stimulated activity, maximal intensity of cells luminescence, activation coefficient and decreased time of neutrophils output at maximal luminescence. After treatment with intranasal preparation of interferon gamma there was significant decrease of spontaneous and stimulated activity of neutrophils and maximum intensity of cell luminescence. As a result, after the treatment, in patients with CHRS the values of stimulated production of neutrophils and maximum intensity of cell luminescence were reduced to the level of the control group, and the spontaneous activity of neutrophils was even lower than in healthy subjects, while the neutrophils activation factor remained elevated as in patients before therapy. The results obtained testify to normalization of the main indexes of neutrophil functional activity in CHPS patients after treatment with human recombinant interferon gamma.

Chronic obstructive pulmonary disease (COPD) is socially significant disease. COPD is based on chronic inflammatory process of respiratory tract, which determines steady progression of the bronchial obstruction. Studies of the role of cytokines in immune pathogenesis of COPD are of crucial importance. The biological mediators determine local, systemic inflammation, and pathophysiological effects of extra-systemic pathological manifestations. In this work, we studied spontaneous and induced production of IL-4, IL-6, IL-8, IL-10 cytokines by blood leukocytes from the patients with moderate and severe chronic obstructive pulmonary disease, beyond the exacerbation phase. It is shown that the evident role in formation of the inflammatory process in COPD belongs to the IL-6, IL-8. We have found a significant increase in both spontaneous and induced production of IL-6 and IL-8 (p < 0.05) in the patients. Induced production of cytokines strongly suggests the reserve capabilities of immunocompetent cells in response to the pathogenic factor. Neutrophilic type of inflammation, manifesting as activation of granulocytes, mostly, neutrophils, in response to toxic agents (in particular, smoking) and bacterial pathogens, is primarily associated with IL-6 and IL-8. These results reflect the type and intensity of respiratory tract inflammation in patients with chronic obstructive pulmonary disease and its persistent course.High levels of the studied cytokines confirm their role in bronchial remodeling and contribute to irreversibility of bronchial obstruction in this disorder. The relationship between spontaneous and induced production of the studied cytokines and the clinical indices of the disease course has been shown. Statistically significant increase between frequency of COPD recurrences (more than 2 times pro year, p < 0.05), and low FEV1values (p < 0.05) were observed in patients with high values of spontaneous and induced production of IL-6 and IL-8. It may be associated with persistent course of neutrophilic inflammation of respiratory tract and progressive bronchial obstruction. IL-6 and IL-8 significantly contribute to pathogenetic mechanisms, determining the clinical course of COPD and may serve as markers of severity in this disorder. Certainly, the immune mechanisms of pathological inflammation in COPD are complex and multifaceted. Studies of clinical significance of induced cytokine production will help the physician when determining type and duration of treatment. Personalized approach to the therapy of patients with COPD depends on the phenotype of pathology, pattern, severity and intensity of inflammation.

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