Pharmacogenetic aspects of resistant bronchial asthma.

По материалам: Farrero E., Antуn A., Egea C.J. et al. Guidelines for the management of respiratory complications in patients with neuromuscular disease. Arch. Bronconeumol. 2013; 49 (7): 306–313.

Summary. Four clinical phenotypes of respiratory syndrome have been identified in patients with connective tissue dysplasia using the mathematical modeling method. All phenotypes were characterized by different clinical manifestations and functional disorders and had different independent predictors. The most common chronic bronchitis phenotype was related to tobacco smoking and included early obstructive disorders. Bullous phenotype also predominantly occurred in smokers and comprised apical subpleural bullae or blebs. A probable genetic basis of the bullous phenotype is mutations in alleles of the matrix metalloproteinases MMP1 and MMP9. Thoracodiaphragmatic phenotype was typical for patients with the chest and the spine deformities and was characterized by restrictive disorders. Hyperventilation phenotype was closely related to autonomic dysfunction and increased anxiety, predominantly in females.

Summary. A definitive role of tobacco smoking as a risk factor for development of chronic obstructive pulmonary diseases (COPD) is of no doubt today. We performed in vivo experimental modeling of COPD in mice of different genetic strains (С57 and Balb/c). We studied phenotypes of main cells of the innate immunity that are alveolar macrophages, and revealed genetic and age susceptibility to COPD in experimental animals. We showed that 1) there is a certain genetic susceptibility to hazardous exposition of tobacco smoke, probably, associated with proinflammatory М1 macrophage phenotype; 2) aging promotes transformation of macrophage phenotypes towards antiinflammatory М2 which is more expressed in mice macro-phages with baseline genetically determined М1 phenotype (mice strain С57), and 3) long-time exposition to tobacco smoke enhances age-dependent macrophage transformation aside М2 phenotype, that is also more expressed in mice macrophages with genetically determined М1 phenotype (С57).

Summary. Since November, 2012, patients with chronic lung disease, chronic heart failure (CHF) or a history of myocardial infarction have being actively vaccinated using 13-valent conjugated pneumococcal vaccine, in Chelyabinsk pulmonological centre. To December, 2013, 103 patients have been vaccinated. Safety of 13-valent conjugated pneumococcal vaccine was evaluated in all vaccinated patients. Efficacy was evaluated in 61 patients (21 with chronic obstructive pulmonary disease (COPD), 10 with bronchiectasis, 26 with COPD and asthma, and 4 with CHF. The vaccine efficacy was evaluated in a year after the vaccination. We found 4.8-fold reduction in exacerbation number in COPD patients, 4.1-fold reduction in bronchiectasis patients and 2.3-fold reduction in patients with COPD and asthma. Number of hospitalisations decreased in 9, 8 и 2.2 times, respectively; number of pneumonias decreased in 6; 4.1 and 2.3 times, respectively.

Summary. We examined a role of respiratory viruses in occurrence of asthma exacerbation associated with ARVI. Viruses were suggested as a cause of asthma exacerbations in 51.7 % of cases. In patients with confirmed viral infection, rhinovirus dominated (in 55 % of cases). Other respiratory viruses were found less frequently: boсavirus in 10.0 % of cases; metapneumovirus 8.3 %; respiratory syncytial virus in 6.7 %; influenza A and influenza B viruses in 5.0 % each; coronavirus in 3.4 %; adenovirus and parainfluenza virus in 3.3 % each. Administration of Ingavirin in patients with asthma exacerbation associated with ARVI increased the treatment effectiveness: fever period reduced, systemic manifestations decreased, number of bacterial complications decreased by 15 %. The drug was well tolerated and safe.

Summary. In penitentiary hospitals, patients with infiltrative pulmonary tuberculosis and cavitation not having HIV infection were treated with combined antituberculosis therapy including Lomekomb. After 3 months of treatment, sputum culture conversion was observed in 73.5 % of patients and cavity closure in 32.4 %. Adverse events were seen in 97.1 % of cases, all of them were reversible. The most frequent adverse events were combined toxic and allergic reactions (67.6 % of patients) followed by toxic reactions (20.6 %) and allergic reactions (8.8 %) alone. Urticaria was observed in 17.6 % of patients, blood eosinophilia in 73.5 %, and elevated transaminases in 82.4 %.

Relationships between allergic disease and autoimmunity.

Current opportunities to improve dyspnea in patients with chronic obstructive pulmonary disease

Drug therapy to prevent and diminish radiation injury of the lungs.

Early and long-term pulmonary complications of radiotherapy of Hodgkin's lymphoma.

Pulmonary rehabilitation: novel programmes and perspectives.

About enlargement of the lungs.

Therapy of idiopathic pulmonary hypertension with combination of inhaled iloprost and bosentan.

Thoracoscopic lobectomy in intrapulmonary lung sequestration.

Real-life PET / CT abilities to assess activity and extension of sarcoidosis.

Yuly M. Perelman. To the 60th birthday.