MYELOPEROXIDASE ACTIVITY OF NEUTROPHILS AND EOSINOPHILS IN INDUCED SPUTUM OF PATIENTS WITH BRONCHIAL ASTHMA WITH COLD BRONCHIAL HYPERRESPONSIVENESS

In the present work we investigated the cytochemical activity of myeloperoxidase (MPO) of neutrophils and eosinophils in induced sputum (IS) in 49 patients with bronchial asthma (BA) with cold bronchial hyperresponsiveness (cBHR), randomized into two groups. During 12 weeks in the 1^st group (23 patients) the mode of complex therapy of asthma with budesonide/formoterol (Symbikort^®Turbuhaler^®) at a dose of 320/9 mcg + montelukast 10 mg daily was used, in the 2nd group (26 patients) - budesonide/formoterol in the dose of 320/9mcg. The low MPO activity in the cytoplasm of neutrophils and eosinophils, intensive processes of degranulation and cells cytolysis, enzyme-containing granules exocytosis into the extracellular medium in patients of both groups in the introductory period were found. At the end of the study the intracellular MPO activity of eosinophilic and neutrophil leukocytes in IS of patients in both groups increased significantly, accompanied by a decrease in exocytosis of MPO against the reduction of degranulation and destruction of granulocytes. The reduction of MPO exocytosis was associated with the inhibition of destructive potential of granulocytes and accumulation of the enzyme in the bronchial tissue (intracellular) space that influence the inflammation degree. Reduced ejection of MPO from the leukocytes and the increase of its activity in the cytoplasm of leukocytes in IS by the end of the treatment period in both groups of patients were accompanied by improvement of clinical features used to estimate the antiinflammatory therapy effectiveness, and they were significantly higher in 1^st group compared with 2^nd one. Simultaneous increase of intracellular activity of the enzyme studied in patients of the 1^st group, which was significantly higher than in the 2^nd group, suggested a significant decrease in the level of bronchial inflammation. The data obtained allow to consider the MPO activity of neutrophil and eosinophil leukocytes not only as one of the biomarkers of chronic inflammation of the bronchi, but also as an additional criterion for evaluating the effectiveness of various modes of antiinflammatory therapy in asthmatics with cBHR. From the point of application of the criteria of enzyme cytochemical assessment of IS in clinical practice we have demonstrated the advantage of the use of complex pharmacotherapy (budesonide/formoterol + montelukast) to the regime of a fixed combination of budesonide/formoterol only in patients with cBHR.

индуцированная мокрота, эозинофильные лейкоциты, нейтрофильные лейкоциты, макрофаги, миелопероксидаза, фармакотерапия бронхиальной астмы, induced sputum, eosinophils, neutrophils, macrophages, myeloperoxidase, pharmacotherapy of bronchial asthma

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