ETIOPATHOGENESIS OF MUCOCILIARY INSUFFICIENCY IN BRONCHIAL ASTHMA

Abstract

The analysis of the causes of mucociliary clearance decrease in 140 patients with bronchial asthma was done. All the patients had clinical-functional examination, biopsy of bronchi mucosa with the study of morphological structure of mucous and functional activity of respiratory cilia, the study of viscoelastic properties of bronchi secretion and biochemical composition of glycosaminoglycans in the bronchial secretion. It was found out that the more severe the disease was, the more intensive morphofunctional changes, especially in the low parts of the bronchial tree, there were in the patients with bronchial asthma. Against the chronic inflammatory process the growth of the conjunctive tissue increases in bronchi mucosa, which leads to the decrease of the number of tiny blood vessels and to the formation of tissue liquid. In the mucosa epithelium there is the alteration of the epithelium layer: the number of beaker cells secreting the liquid secretion decreases. In bronchi lumen in the patients with severe bronchial asthma the number of chondroitin sulfate grows and the contents of hyaluronic acid and heparin decreases, which increases the viscosity of bronchial secretion. The rest ciliary cells lose cilia and die in 50% of cases. In the bronchial lumen the situation of low activity of secretion escalation into the outside is created.