RESUMEN
The aim of the study was to compare the clinical characteristics and the inflammatory process activity in the airway of patients with severe therapy-sensitive and therapy-resistant bronchial asthma (TSBA; TRBA). The subjects were 171 patients with severe bronchial asthma (BA) aged 18 to 60; the diagnosis was established prior to the study according to GINA 2002 criteria. There were 50 TSBA patients, 121 TRBA, and 50 controls. According to a range of criteria, BA in TRBA was more severe than that in TSBA. TRBA patients displayed significantly higher indices of inflammatory process activity, such as absolute and relative number of eosinophiles and neutrophiles in induced sputum (IS), and IS level of IL-5. Evaluation of IS inflammatory markers in patients with severe BA allowed substantiation of the central role of persistent inflammation as a risk factor of TRBA development.
Asunto(s)
Asma/tratamiento farmacológico , Adolescente , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Agonistas Adrenérgicos beta/administración & dosificación , Agonistas Adrenérgicos beta/uso terapéutico , Adulto , Albuterol/administración & dosificación , Albuterol/uso terapéutico , Antiasmáticos/administración & dosificación , Antiasmáticos/uso terapéutico , Asma/clasificación , Asma/diagnóstico , Asma/genética , Beclometasona/administración & dosificación , Beclometasona/uso terapéutico , Broncodilatadores/administración & dosificación , Broncodilatadores/uso terapéutico , Interpretación Estadística de Datos , Resistencia a Medicamentos , Eosinófilos , Humanos , Persona de Mediana Edad , Neutrófilos , Fenotipo , Esputo/citología , Factores de TiempoRESUMEN
AIM: To study quality of monitoring, features of a course and therapy of severe bronchial asthma (BA) in Russia. MATERIALS AND METHODS: The trial recruited 378 patients with severe bronchial asthma (SBA) in 7 cities of Russia. Each center participating in the study filled in individual case sheets recording demographic, clinical, monitoring, pharmacotherapeutic data. A special focus was on factors influencing the disease course. The chi-square and Mann-Witney criteria were used. RESULTS: It was found that current recommendations of BA patients' management are not used in full. Most of the patients do not receive adequate therapy. Phenotypes of uncontrolled course of severe BA are prevalent. The key role of adequate management of severe BA patients in control of the disease is shown. CONCLUSION: Wider use of updated recommendations on therapy and monitoring of BA with special focus on patients with uncontrolled course of the disease is urgent. Fulfilment of all the components of management of a patient with bronchial asthma recommended by GINA including the patient education and control over the disease triggers contribute much to effective treatment and control over BA.
Asunto(s)
Asma/diagnóstico , Asma/tratamiento farmacológico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Federación de RusiaRESUMEN
Expression of IL-5 mRNA and the content of IL-5 in the sputum of patients with asthma of different severity were studied before and after treatment. The expression of IL-5 mRNA in mild asthma differed from that in severe and moderate asthma before and after treatment. The level of IL-5 before therapy was different in patients with mild and severe disease. In patients with severe asthma the level of IL-5 differed before and after treatment.
