Evaluation of the influence and correction of pneumocystis infection on clinical and laboratory characteristics of chronic obstructive pulmonary disease

Introduction. Chronic obstructive pulmonary disease (COPD) is an actual problem of modern medicine due to the appearance of exacerbations and inevitable progression, but currently known clinical factors cannot fully explain the course of the disease.
Aim. To assess the relationship between the presence of Pneumocystis (PC) infection and the clinical characteristics of COPD, as well as the effect of correcting the activity of PC on the course of COPD.
Materials and methods. 90 patients with COPD of II, III, IV degrees of severity were examined. Against the background of standard therapy for COPD exacerbation and therapy with trimethoprim/sulfamethoxazole, laboratory and functional research methods were performed, the current of COPD was evaluated by validated questionnaires (CAT, mMRC), the titer of IgM and IgG antibodies to PC in the blood serum was determined, and the number of COPD exacerbations was tracked throughout the year.
Results. Markers of active PC infection were detected in 62.2% of patients. PC infection with COPD exacerbation significantly increased the frequency of COPD exacerbations (2.68±0.08 vs. 2.45±0.15; р˂0.05). PC infection was statistically (р˂0.05) more common in individuals with grade II COPD. In the group with PC infection, a significantly higher number of eosinophils was observed than in the group without PC infection in COPD exacerbation of 360.46±15.39 vs. 277.82±13.63 cells/µL (р˂0.01) and remission of 398.87±19.49 vs. 324.21±26.68 cells/µL (р˂0.05). After treatment with trimethoprim /sulfamethoxazole, there was a disappearance of IgM to PC and a decrease in IgG titer, a significant decrease in the level of blood leukocytes (6.08±0.13 vs. 6.91±0.19×10⁹ /L; p<0.01), an improvement in the values of FEV₁ (63.59±1.30 vs. 61.06±1.29% pred.; р˂0.01) and FEV₁ /FVC 54.53±1.0 vs. 52.29±1.03%; р˂0.01). There was a significant decrease in COPD activity according to the CAT test, mMRC, and a decrease in the number of exacerbations during the year.
Conclusion. Active PC infection in COPD is associated with a high number of eosinophils in the blood and an increased risk of frequent exacerbations of COPD during the year. Treatment of PC infection in COPD with a combination of trimethoprim/sulfamethoxazole leads to a significant improvement in clinical and laboratory parameters and a decrease in the frequency of exacerbations of the disease over the next year

chronic obstructive pulmonary disease, Pneumocystis infection, exacerbations of chronic obstructive pulmonary disease, eosinophilia

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