Occupational chronic obstructive pulmonary disease and comorbidity: diagnostic issues, prognostic criteria

Introduction. Evaluation of clinical data, functional characteristics and immunopathogenesis of occupational chronic obstructive pulmonary disease (OCPD) in its isolated and comorbid course opens up new possibilities in assessing the development, predicting the course features and a personalized approach to pharmacotherapy of OCPD, as well as in developing an individual strategy for its primary and secondary prevention. The aim of the study was to determine the clinical and functional characteristics and immunological markers of the risk of developing COPD in its isolated course and in combination with arterial hypertension (AH). Materials and methods. The study involved 235 patients: Group 1 (n=60) (control) — healthy volunteers; Group 2 (n=35) — COPD of the first degree of severity; Group 3 (n=50) — COPD of the second degree of severity; Group 4 (n=40) — a combination of COPD of the second degree of severity and (AH); Group 5 (n=50) — isolated course of AH. The function of external respiration was assessed using a computer spirograph «Care Fusion» by MicroLab UK (Great Britain). Determination of the levels of cytokines IL-4, IL-6, IL-8, IL-10, IL-17, MCP-1, FGF 2, TGF-b in the blood serum was carried out by the method of solid-phase enzyme immunoassay using kits and reagents (OOO «Proteinovy Kontur», «Vektor-Best», «Diateks-E», «DIA-plus», «Pharmacia diagnostika»). To study the content of vascular endothelial growth factor (VEGF) in the blood serum, the method of solid-phase enzyme immunoassay of the «sandwich» type was used using a reagent kit from the company «eBioscience». Calculation of the optical density results was performed using a multichannel spectrophotometer «Dynatech MR 5000» (USA), wavelength — 450 nanometers. Spirometry and immunological data of the groups were assessed using one-way analysis of variance with intergroup comparisons using Dunnett's test in the form of mean and standard deviation (M±SD). Results. For the first time, the features of clinical, functional and immunological manifestations of OCPLD of varying severity were established in its isolated course and in combination with arterial hypertension. Study limitations. The study has regional (Samara region) and professional (according to the details of working conditions in the studied comparison groups) limitations. Conclusion. The revealed clinical, functional and immunological features of OCPLD in its isolated course depending on the severity and in combined comorbid course with arterial hypertension can optimize the approach to early diagnosis, prognosis, prevention and pharmacotherapy of OCPLD.

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