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The lecture is dedicated to the idea of a role of psychosomatic disorders in the occurrence and development of asthma, on the diagnosis and treatment of the neuropsychic type of its course, and on possibilities for psychotherapeutic correction.

Aim: To reveal disturbances of peripheral blood lymphocytes apoptosis in different variants of bronchial asthma (BA)., Material and Methods: Apoptosis was studied in 20 healthy subjects, 70 BA patients: 32 patients with allergic BA (ABA) and 26 patients with non-allergic (NABA), 12 patients with BA treated with oral glucocorticosteroids. The following parameters of apoptosis were assessed: cell readiness for apoptosis (expression of CD95/Fas/APO-1 receptors), an early reversible stage of apoptosis (expression of phosphatidylserine on outer leaflet of lymphocyte membrane) and a late stage of apoptosis (the key effector caspase 3 activity)., Results: ABA is characterized by increased peripheral blood lymphocytes resistance to apoptosis: a decrease in expression of CD95/Fas/APO-1 receptors and phosphatidylserine on lymphocyte surface and caspase 3 activity. NABA is characterized by peripheral blood lymphocyte apoptosis activation at all stages: high expression of CD95/Fas/APO-1 receptors, expression of phosphatidylserine and caspase 3 activity. BA patients on systemic glucocorticosteroids are characterized by maximal expression of CD95/Fas/APO-1 receptors and phosphatidylserine on lymphocyte surface and the highest caspase 3 activity., Conclusion: The findings allow more accurate definition of the features of peripheral blood lymphocytes apoptosis in different variants of bronchial asthma and characteristics of relations between disturbed apoptosis and inflammation. Disturbances of apoptosis may be of pathogenetic importance in persistence ofallergic inflammation.

Aim: To assess efficacy of vaccine therapy with ribomunil in prevention of exacerbations and prolongation of remission in patients with obstructive pulmonary disease (COPD)., Material and Methods: Fifty three COPD patients were divided into two groups: 28 patients of the study group received ribomunil plus standard therapy; 25 controls received only standard treatment. The examination of the patients included blood count, sputum cytology, external respiration function test, immunological investigation (CD4+, CD8+, CD20+, CD25+ and CD95+; IL-4, IFN-gamma, complement). The examination was made before the treatment, 21 days, 3 and 6 months after its beginning. Ribomunil was given 3 tablets in the morning before meal for 4 days in a week for 3 weeks, 4 days each month for the following 5 months., Results: As a result of ribomunil treatment lymphocyte subpopulation normalized, immune response shifted to Th-1 dependent immune response, external respiration flow indices improved, remission prolonged., Conclusion: Ribomunil is recommended for wide application in the practice of COPD treatment

The development of nonspecific bronchial hypersensitivity and hyperreactivity in bronchial asthma and effectiveness of its correction with acupuncture were investigated in 152 patients with asthma and preasthma. 94 of them were subjected to acupuncture. The authors employed a complex of diagnostic methods with determination of 241 parameters processed later with the use of systemic modelling. Bronchial hypersensitivity as indicated by the response to acetylcholine was related to impaired coordination of bronchomotor tone regulating systems: parasympathetic part of the autonomic nervous system, eosinophilic and monocytic bronchial inflammation, glucocorticoid homeostatic alterations. The corrective role of acupuncture consists in reduction of nonspecific bronchial hyperreactivity, normalization of blood acetylcholine, resensitization of cell beta-adrenergic receptors, elevation of mean concentrations of 11-OCS and T-lymphocytes.

Nuclear-absorption spectrophotometry (AAC-508, Hitachi, Japan) and selective ionometry (microlyte, Kone, Finland) were employed to measure magnesium and calcium concentrations in the serum, red cells, lymphocytes, 24-h urine and exhaled air moisture in 40 patients with hormone-dependent asthma (BA) and 15 BA patients given beclomet, becotid in inhalations and injections of hydrocortisone, prednisolone and dexason. Intravenous infusions and steroid inhalations in moderate doses for 10-14 days induce only insignificant changes in bivalent cation homeostasis. Complications associated with deranged mineral metabolism occurred more frequently in BA patients on long-term (at least 4 years) courses of oral glucocorticoids. Increased renal and bronchial excretion of magnesium and calcium in patients with hormone-dependent BA with complications of glucocorticoid therapy shows its significant contribution to development of steroid osteopathy and myopathy.

A total of 31 patients with bronchial asthma were examined with the use of the brief dexamethasone test. Some patients with bronchial asthma seemed to have impaired glucocorticoid function of the adrenals. Based on the own investigations and the reported data it is concluded that patients with bronchial asthma may have different types of glucocorticoid deficiency, particularly at the expense of the impairment of the central mechanism of the regulation of glucocorticoid hormones. It has been demonstrated that the brief dexamethasone test can be used for studying the disorders of glucocorticoid function of the adrenals.

Hydrocortisone absorption by lymphocytes and red blood cells was reduced in patients with bronchial asthma (BA). Adrenaline produced the stimulatory effect on hydrocortisone absorption by lymphocytes and red blood cells in practically normal subjects and in BA patients in whom that effect was decreased. In patients with the steroid-dependent clinico-pathogenetic pattern of BA, hydrocortisone absorption by lymphocytes was reduced to a considerable degree. It is stressed that cellular mechanisms of glucocorticoid insufficiency are implicated in the BA pathogenesis.