Окремі напрямки імунокорекції у пацієнтів з бронхіальною астмою

Abstract

Бронхиальная астма (БА) представляет собой заболевание с четкими клиническими, физиологическими и морфологическими особенностями. По статистическим прогнозам, на фоне устойчивого роста заболеваемости БА до 2025 г. общее количество пациентов увеличится на 100 млн человек, в Европе насчитывается около 30 млн больных БА. Перспективное направление современной медицины — применение бактериальных иммунных препаратов в терапии аллергических заболеваний, обострение которых провоцируется инфекциями. Популярным среди пациентов и врачей является препарат «Бронхомунал». Сейчас на кафедре семейной медицины и общей практики Одесского национального медицинского университета проводятся исследования, имеющие целью улучшить астма-контроль у пациентов с БА. Больным основной группы вместе с базисной терапией было предложено получать лечение бактериальным лизатом в профилактической дозе. Проведенное лечение улучшает астма-контроль и делает течение БА более контролируемым.

Bronchial asthma (BA) is a disease with clear clinical, physiological and morphological features. According to statistical forecasts, against the background of a steady increase in the incidence of asthma until 2025, the total number of patients will increase by 100 million people, in Europe there are about 30 million patients with asthma. Clinical studies that have been devoted to the analysis of the course of asthma with concomitant obesity and overweight have demonstrated a number of typical traits; it has been found that this is usually an older person, with the presence of various concomitant pathologies. Changes in lifestyles in industrialized countries have led to a reduction in the infectious burden, and this is associated with an increase in allergic diseases. Control over asthma can be achieved by using basic therapy that is proven and is the basis of treatment protocols, which include: leukotriene receptor antagonists, inhaled and systemic steroids. However, even with an individual approach when prescribing baseline therapy, it is not always possible to achieve the desired asthma control for each patient. Changing lifestyles in industrialized countries has led to a reduction in the infectious burden and is associated with an increase in allergic diseases. In 1989, D. P. Strachan with authors formed a “hygienic hypothesis”, which suggests that reducing contact with infectious agents reduces the possibility of switching the Th2-cell immune response formed during the antenatal and neonatal periods with predominance of it over the Th1-cell response in the direction of a balanced ratio of T-helper cells 1-Th type and type 2, which promotes persistence of allergic inflammation. Thus, an infection that arose in a certain age, is considered as a protective factor in the development of atopy. The promising direction of modern medicine is the use of bacterial immune drugs in the treatment of allergic diseases, the exacerbation of which is provoked by infections. The drug Bronchomunal is popular among patients and doctors. Now, at the Department of Family Medicine and General Practice of the Odessa National Medical University, research is being carried out to improve asthma control in patients with asthma. Patients in the main group, together with baseline therapy, were asked to receive treatment with bacterial lysate in a prophylactic dose. The proposed treatment improves asthma control and makes the course of asthma more controllable.