MODERN CONCEPTIONS ABOUT ANTI-INFLAMMATORY THERAPY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Abstract
The literature review shows the results of the studies of a great number of authors. They concern the optimization of anti-inflammatory therapy of chronic obstructive pulmonary disease (COPD). COPD is a progressive disease characterized by systemic manifestations and often combined with the concomitant pathology which defines the forecast, the severity course, the treatment tactics and the rehabilitation program. Pulmonary and extrapulmonary manifestations of COPD are associated with the pathologic inflammatory process which is already revealed at the pre-clinical stages and its intensiveness increases alongside with the severity of the disease. The main cells of inflammation are neutrophils, T-lymphocytes and macrophages which are accumulated with the release of huge quantities of biologically active substances and induce a number of inflammatory reactions leading to the restriction of air flow and bronchial obstruction. Taking into account the fact that the chronic inflammation is a major cause of COPD, the treatment should include a powerful anti-inflammatory therapy. A promising trend is the use of a new class of drugs - inhibitors PDE-4, a representative of which is the roflumilast. Inhibitors of PDE-4 slow down the destruction of cAMP; this reduces the emission of biologically active substances involved in the main phases of inflammation by anti-inflammatory cells. Clinical effectiveness of the roflumilast in patients with moderate and severe COPD was studied in a series of large randomized placebo-controlled studies – Record (M2-107), Opus, Ratio (M-112), EOS (M2-107), HELIOS (M2-128), AURA (M-124), HERMES (M-125), the results of which confirm the fact that the roflumilast therapy is accompanied by the improvement of the pulmonary function, the reduction of exacerbations risks and the improvement of the patients’ quality of life.
About the Authors
Ekaterina G. Rybas'
Amur State Medical Academy
Russian Federation
Russian Federation
Svetlana V. Naryshkina
Amur State Medical Academy
Russian Federation
Russian Federation
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Review
For citations:
Rybas' E.G., Naryshkina S.V. MODERN CONCEPTIONS ABOUT ANTI-INFLAMMATORY THERAPY OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Bulletin Physiology and Pathology of Respiration. 2013;(48):90-96. (In Russ.)
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