The purpose of our research was to study local immunity in patients with infection-allergic and atopic bronchial asthma (BA) and efficiency of a new treatment method. 30 BA patients were examined clinically and immunological. Also levels of antibodies to surface bacterial antigens and contents of IgA, IgG, IgM, IgD, IgE, slgA in bronchial secret and saliva were investigated. Along with low IgA content and absence of IgM and IgD compensatory function, hyperproduction of antibodies to gram-negative bacteria is registered. This form of BA is also characterized by significant decrease in slgA content and increase in IgE level. BA patients were treated by a complex of immunomodulators and local antihistaminic drugs. This method proved to be more efficient as compared to the basic therapy alone. Immunomodulators and antihistaminic drugs promote better and longer remission of BA patients.
BA patients suffering from respiratory airway inflammatory processes for a long time have serious morphofunctional disturbances in their bronchial mucous membrane. By immunohistochemical methods a marked rise of Type 3 collagen content in the mucous membrane basal layer was revealed; Type 4 and 5 collagen activity round the vessels as well as its content in basal membrane and in spaces between the epithelial cells increases. Against the background of the lipid peroxide oxidation rise the activity of ciliated epithelium reduce. Due to the complex anti-inflammatory therapy of BA patients (laser therapy, anti-inflammatory corticosteroids and cytokins) we succeeded to reduce bronchial airway obstruction by 30%; to abolish asphyxia attacks; to restore mucous membrane epithelium, ciliated epithelium activity.
Some revealed defects of humoral (decrease in IgA level) and cell immunity (decrease in the general amount of the T-lymphocytes and T-suppressors) in children with BA, together with hyperproduction of IgE and immune complexes made us search for new methods of directed therapeutic action on various sections of immunity. Immunal was used in 25 children suffering from BA at the age from 3 to 5 years. Immune status normalization was registered in 16 patients (64%). In the rest 36% the total number of lymphocytes increased significantly. In all patients IgE content and immune complexes level decreased. No increase in their contents was registered after 7 months observation.
Allergen-specific therapy is of pathogenic value in the treatment of BA in children. One year after the treatment, pronounced immunological effect was registered in 60 children (71.4%), while after two years it increased up to 86% children. Specific immunotherapy resulted in normalization of T-lymphocyte functional activity, IgA, IgG and slgA serum levels in nasal secret. Prolonged therapeutic effect was registered in all clinical immunological data after the specific immunotherapy course.
We studied the functional state of central nervous and immune systems in patients with BA and effect of acupuncture on it. Positive result of acupuncture was obtained in 88.6% patients.
Along with objective clinical effect, i. e. ceasing of asphyxia attacks, patients´ quality of life became much better: they gained optimism, eagerness to work, decrease of irritation and tearfulness, improvement of appetite and sleep. Immunological parameters also improved. Our results demonstrate high clinical and immunologic effect of acupuncture in BA patients with initial changes in central nervous system.
The work was submitted to international scientific conference «Present-day problems of experimental and clinical medicine», Thailand, February 18-28, 2008, came to the editorial office on 15.01.2009.