Immune system deficiency in chronic obstructive pulmonary disease

Ishchenko O.V., Sukalo A.V.

Vitebsk State Medical University, Vitebsk, Belarus
Belarusian State Medical University, National Academy of Sciences of Belarus, Minsk, Belarus

Objective. Aim was research and analysis of the immune status of patients with moderate and severe COPD and COPD in combination with asthma (COPD+A) with frequent
exacerbations.
Material and methods. The study was performed according to the protocol of the open study with COPD, 47 patients with COPD+A and 18 healthy persons. The leukocytes and
lymphocytes (CD3, CD4, CD8, CD25, CD34, CD38, CD69, CD71, HLA-DR), phagocytosis, levels of immunoglobulins and serum cytokines (INF-α, INF-γ, IL-1, IL-2, IL-4, IL-6,
IL-12, TNF-α, TGF-β1), CRP were studied. Blood was taken during an exacerbation, after 2 weeks, 2 and 3 months.
Results. Patients with COPD and COPD+ were signs of dysfunction of the immune system and immunodeficiency: a persistent decrease the number of natural killers CD16+ CD56+; reduction of expression on CD71+ lymphocytes for transferrin, (p = 0.045); decrease expression of CD95+ -Fas receptor. A significant increase the serum levels of IL-1β and
TGFβ patients with COPD, including COPD+A, was revealed. At the same time, decrease lymphocytes with activation markers (CD25+, CD69+ (COPD), CD71+, CD95+ (in both
groups), an increase in HLA-DR+ expression was observed simultaneously in the group of patients with a significant decrease in the level of NK lymphocytes (<70% (group BA +
COPD) and an increase in the number of T helper CD4 + in the same group.
In patients with COPD+A the level of CD8+ cells was decreased by 21.6 (12.5, 24.3)% compared with COPD 31 (23.9, 36.2)%(p = 0.001) and control group, increased the number of B cells CD22+ 18.5 (10.1, 24.7)% compared with COPD 9.8 (2.7, 22.2)% p = 0.033; increased levels of IgG1 8.6 (7.7; 9, 7) mg / ml and an average increase in the total IgE level of 250 (154, 549) МЕ/мл, as well as a higher percentage of patients with a low NK cells CD16 + CD56+ than in the COPD group (p = 0.008).
The conclusion. Analysis of clinical and immunological data in patients with bronchial phenotype COPD and COPD+A allowed us to characterize the "bronchial" phenotype as a phenotype with immune deficiency, which it is clinically manifested by exacerbation with bronchopulmonary infections. The immunological phenotypes of patients with COPD+A were significantly different from COPD. Thus, the inadequacy of the immunity system in COPD patients, induced by toxicants, leads to the development of persistent inflammation in the airways, colonization by microorganisms, and, repetition and exacerbations.