Immune Status of Patients With Chronic Obstructive Pulmonary Disease, Accompanied With Chronic Kidney Disease and Metabolic Disturbances

Abstract

The chronic kidney disease (CKD) is often accompanied to the chronic pulmonary disease (COPD) III stage and metabolic syndrome, (MS) which is because to the persistence of arterial hypertension and disturbances in hydrocarbon metabolism.
 Materials and methods. There were examined the 52 patients with III stage COPD, combined with MS, aged 51,3±4,2 years old, among them 23 with COPD, combined with MS and CKD I-IIstage (the main group). The compared group was included the 29 patients with COPD, combined with MS, without signs CKD. The all persons were examined by immunology investigation with the detection of cell and humoral immunity indexes and cytokine level.
 Results and discussion. The breath function data’s, the arterial hypertention stage and level did not have the significant differences. All the patients had the creatinine clearance not less than 60 ml/min/1,73m2.
 The detection of immune status shows the decrease of T-cell amount, especially the T-cytotoxical lymphocytes/ supressors, the significantly increase level ofactivated Tcells with early activated markers, those, which expressed adhesion molecule ICAM-1 and FAS- receptor, autoimmune and inflammatory changes in blood serum.
 Conclusions. The available ofСKD in patients COPD, combined with MS, initiated the more high activity of system immune inflammation in atherosclerosis manifestation as the morphological substrate of MS.

Diagnostic Value of Leptin in Chronic Obstructive Pulmonary Disease of the Iii Degree in Patients with Excessive Body Weight

“…The results of experimental and clinical scientific studies intensively performed during the last decade, revealed a new phenomenon: excessive body weight is accompanied by inflammation of adipose tissue, which occurs with its infiltration by immune cells. Moreover, the severity of this inflammation clearly correlates with the degree of obesity [1,2,11,13]. Since the inflammatory reaction occurs in tissue that is well-vascularized and inner-vated, the proportion of which can be up to 50% or more of the total body weight, therefore systemic manifestations should be expected [3,4,10].…”

“…They function both locally and systematically [9,15]. Leptin is one of the adipokines synthesized by the adipose tissue; it activates inflammation, promotes angiosteosis, initiates oxidative stress, increases the tone of sympathetic nervous system, changes cytokine regulation, which plays an important role in the pathogenesis of inflammatory damage [1,12,22].…”

“…However, during these studies (Krommidas G., 2010), patients were not classified accord- ing to the level of body overweight as compared to the respiratory function, but were evaluated in the general cohort. This issue was also studied in patients with bronchial asthma, which proved the increase of leptin level that is associated with the decrease in pulmonary capacity (PC), forced vital lung capacity (FVLC) and peak expiratory flow rate (PEFR) [1,10,23]; however, the role of leptin in the process of generalization of the inflammatory response with FEV1 index below 50% in COPD patients with excessive body weight still remains uncertain.…”