COMBINED IMMUNODEFICIENCY IN THE ELDERLY WITH COPD AS A MANIFESTATION OF THE AGING OF THE IMMUNE SYSTEM

Abstract

Introduction. The study of the functioning of the immune system (IS) in chronic respiratory pathology is especially relevant in the elderly and senile, since frequent prolonged exacerbations of chronic obstructive pulmonary disease (COPD) significantly affect the condition of patients, leading to decompensation of diseases.

Objective: To conduct an expanded study of the state of IS, to clarify the variants of disorders in elderly and senile patients with COPD.

Materials and methods. 10 patients aged 60-80 years with COPD were studied – the study group (SG), the comparison group (CG) - 30 conditionally healthy individuals. The general and local status was clinically determined. Before treatment, IS was studied: T-lymphocytes (CD3⁺CD19^-, CD3⁺CD4⁺, CD3⁺CD8⁺), B-lymphocytes (CD3^-CD19⁺), NK cells (CD3^-CD16⁺CD56⁺), two subsets of neutrophilic granulocytes (NG) CD64^-CD32⁺CD16⁺CD11b⁺ and CD64⁺CD32⁺CD16⁺CD11b⁺ (FC-500 "Beckman Coulter") with the calculation of the CING index reflecting the ratio between the two subpopulations of NG. The phagocytic function of NG was evaluated: the processes of capture (%PAN, PN, PI), killing and digestion (%D, ID) in relation to S. aureus (strain No. 209), NADPH oxidase activity in the NBT test. Results. Patients of SG showed combined immunodeficiency of varying severity: quantitative deficiency of T-lymphocytes due to a deficiency of T-helper cells (p<0.05), impaired effector function of NG (deficiency of actively phagocyting NG, impaired capture, digestion and killing, p_1-3<0.05). A decrease in the CD64^-CD32⁺CD16⁺CD11b⁺NG subset and an 8.9-fold increase in the "immature" negatively transformed CD64⁺CD32⁺CD16⁺CD11b⁺ subset were shown, indicating an inferior NG response to bacterial infection. During the calculation of the CING, bacterial infections were detected: 60% of SG patients - mild, 10% - moderate, and 30% - severe.

Conclusion. Data on the presence of immunodeficiency in elderly and senile COPD patients have been obtained, which requires the creation of immunotherapeutic approaches aimed at restoring IS defects in order to increase the effectiveness of COPD therapy and improve the quality of life of patients.