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THE IMPORTANCE OF SOME LABORATORY INDICATORS
IN LUNG DISEASES
1 2 3
Kudratova Z.E. , Kuvandikov G.B. , Yulaeva I.A. Email: [email protected]
1Kudratova Zebo Erkinovna - Assistant; 2Kuvandicov Golib Berdirasulovich - Assistant; 3Yulayeva Irina Andreevna - Assistant, DEPARTMENT OF CLINICAL LABORATORY DIAGNOSIS, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: respiratory diseases are the most pressing problem of modern health care. Around the world, there is an increase in acute and chronic respiratory diseases (CRD). The World Health Organization (WHO) pays considerable attention to this problem. In many countries, deficiencies in the diagnosis of most CRDs result in inadequate treatment for these conditions, and in some cases there is a shortage of essential drugs. The main risk factors for the development of the diseases are tobacco smoking, outdoor and indoor air pollution, various allergens, and occupational risk factors. In clinical practice, primary care physicians and pulmonologists are faced with both isolated forms of these diseases and their combined course. Laboratory research methods are of great importance in the diagnosis of CRD. They acquire special weight in differential diagnosis, since most pulmonary diseases have similar respiratory manifestations [1].
Keywords: chronic lung diseases, eosinophil, C-reactive protein, fibrinogen.
ЗНАЧЕНИЕ НЕКОТОРЫХ ЛАБОРАТОРНЫХ ПОКАЗАТЕЛЕЙ ПРИ ЗАБОЛЕВАНИЯХ ЛЕГКИХ Кудратова З.Э.1, Кувандиков Г.Б.2, Юлаева И.А.3
1Кудратова Зебо Эркиновна - ассистент; 2Кувандиков Голиб Бердирасулович - ассистент;
3Юлаева Ирина Андреевна - ассистент, кафедра клинической лабораторной диагностики, Самаркандский государственный медицинский институт, г. Самарканд, Республика Узбекистан
Аннотация: в последние годы во всех странах мира наблюдается неустанный рост количества воспалительных заболеваний верхнего и нижнего дыхательного тракта, которые во многом предопределены вирированием спектра существенных возбудителей и повышением этиологической важности. Всемирная организация здравоохранения (ВОЗ) уделяет большое внимание этой проблеме. По мнению ВОЗ, необходимо приложить усилия для улучшения диагностики и медицинского обслуживания населения. Большое значение в диагностике ХБЛ имеют лабораторные методы исследования. Особое значение они приобретают при дифференциальной диагностике, поскольку большинство заболеваний легких имеют сходные респираторные проявления [1].
Ключевые слова: хронические заболевания легких, эозинофил, С-реактивный белок, фибриноген.
Acute-phase proteins. Acute phase proteins are coagulation proteins, transport proteins that are also mediators of the immune system. These proteins are directly involved in the processes of elimination of damaging factors, contribute to the localization of the focus of damage and the restoration of the damaged structure of cells and organs, as well as their
functions. Fibrinogen is more related to vascular reactions during inflammation, while other markers, being multifunctional, are involved in the implementation of numerous immune processes [2, 4].
C-reactive protein (CRP) is a stimulator of immune responses, including phagocytosis, takes part in T- and B-immune responses, activates the classical complement system. CRP synthesis occurs mainly in hepatocytes, initiated by antigens, immune complexes, bacteria, fungi, and trauma. As a rule, CRP is absent in the serum of a healthy person, with the exception of some physiological processes. The CRP test has a direct correlation with ESR. Both indicators increase sharply at the onset of the disease, but CRP reacts earlier than the ESR changes. In laboratory diagnostics, this test is used to monitor the course of the disease and monitor the effectiveness of the therapy. In addition, the concentration of CRP in the blood is associated with the activity of the disease and the stage of the process [7, 8].
The level of fibrinogen tends to increase with various inflammatory reactions, it is a sensitive marker of inflammation and tissue necrosis, the main plasma protein that directly affects the erythrocyte sedimentation rate. With an increase in the concentration of fibrinogen, ESR also increases. An increase in the concentration of fibrinogen in plasma, including at normal values, correlates with an increase in the risk of complications of cardiovascular diseases [4, 7].
Procalcitonin (PCT) is a more specific marker of bacterial infection than CRP. It is a precursor of the hormone calcitonin and is produced by several types of cells in various organs under the influence of pro-inflammatory agents, primarily bacteria. The PCT level above 2 ng/ml is highly likely to indicate the infectious nature of inflammation [5, 6]. Controlling the dynamics of the PCT level can serve as an additional highly informative method for assessing the effectiveness of therapy in an infectious process.
Eosinophilic cationic protein. Eosinophilic cationic protein C ECP is one of the components of specific secretory granules of human eosinophils. The main properties of ECP are due to its high arginine content. ECP is associated with the mechanisms of anthelmintic, antibacterial, antitumor, and certain antiviral activity of eosinophils. Severe eosinophilic inflammation, which is observed in an allergic reaction, can lead to damage to one's own tissues, one of the mechanisms of which is the toxic effect of ECP. The ECP level in most cases correlates with the severity of the clinical symptoms of AD, reflecting the severity of the eosinophilic component of inflammation, and can serve as a marker for determining the severity of AD with certain limitations. In atopic patients, higher ECP concentrations are observed, even when the number of eosinophils in the peripheral blood is normal. In the context of the widespread use of immunobiological drugs for targeted therapy, it is important that the ECP level exceeds the norm in both IgE-mediated and non-IgE-mediated atopy [1, 3, 6].
Determination of a1-antitrypsin in patients with rapid progression of COPD or in the presence of emphysema mainly in the basal parts of the lungs is recommended to determine the level of a1-antitrypsin in the blood [8].
In an inflammatory process in the lung tissue, a1-antitrypsin suppresses the function of elastase released from neutrophils, preventing the degradation of the connective tissue protein (elastin) in the walls of the alveoli and the development of emphysema. It modulates the local immune response, has antioxidant and antimicrobial effects, and inhibits proteolytic enzymes of apoptosis. The concentration of a1-antitrypsin increases significantly in acute inflammation of various etiologies, infectious, rheumatic diseases, malignant processes, with estrogen replacement therapy, taking oral contraceptives, increasing estrogen levels during pregnancy [7].
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