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Introduction. The role of neutrophil inflammation of the bronchi in patients with asthma in the development and manifestation of cold airway hyperresponsiveness (CAHR) has not been sufficiently studied.Aim. To assess the level of neutrophils and the activity of myeloperoxidase (MPO) in the bronchi of asthma patients with cold-induced bronchospasm.Materials and methods. In 138 patients with mild-to-moderate asthma with CAHR, the level of asthma control (ACT), lung function (FEV1), cellular composition of sputum was examined before and after the bronchoprovocation test by isocapnic hyperventilation with cold air (IHCA). In sputum samples, the percentage of neutrophils, eosinophils, and bronchial epithelial cells (structurally intact cylindrical ciliated and goblet cells) was assessed; the concentration and activity of MPO in neutrophils were studied by the cytochemical method.Results. The patients were divided into three groups: group 1 (n=94) - patients with mild cold-induced bronchospasm, group 2 (n=28) - with moderate bronchospasm, group 3 (n=16) - with severe bronchospasm (AFEV1=- 13.5±0.3, -24.6±0.5, -36.9±1.5%, respectively). Patients did not differ in the level of asthma control (16 [12; 21]; 16 [13; 20] and 16 [12; 21] ACT points, respectively). Patients of the third group had lower values of bronchial patency in comparison with the first and second groups: FEV1 79.4±3.2; 92.4±1.7 (p25-75 46.4±4.3; 66.1±2.5 (pConclusion. The mobilization of neutrophils in a mixed pattern of airway inflammation in asthma patients is associated with worsening of cold-induced bronchospasm. An increase in the content of MPO in neutrophil granules in response to the action of cold air is aimed at enhancing the secretion of the enzyme in the interstitium, activating its oxidative activity in the respiratory tract, and escalating the oxidative/halogenating stress that accompanies bronchospasm. |
