Abstract
Aim of the investigation: to study immunological effectiveness of N-acetylcystein in complex basic therapy (salmeterol+fluticasone propionate 50/250 BID) vs salmeterol+fluticasone propionate 50/250 BID in severe persistent bronchial asthma patients.
Materials and methods: 30 patients in the age 37 – 75 years, male – 10, female – 20 with severe persistent bronchial asthma (FEV1< 60 %), out of exacerbations, after 2-weeks ²run-in² period (fluticasonum propionate 250 mcg BID, salbutamol PRN) were randomised 1:1 to receive salmeterol+fluticasone propionate 50/250 BID and N-acetylcystein 600 mg OD (I group) or salmeterol+fluticasone propionate 50/250 BID (II group) for 2 months. Salbutamol was allowed as rescue medication in both groups. Immunological reactivity (general and local immunity) was studied.
Results: after 2 months of studied therapy in I group patients it was noted the normalisation of haemogramme, disappearence of neutrophil left shift and eosinophilia, which took place before the beginning of treatment course; essential decrease of IL-8 till (32,7 ±12,1) pkg/ml, p < 0,05 vs initial data. In II group there were not significant changes vs initial level.
Content of neutrophils in sputum in I group patients decreased from (36,6 ±3,4) till (17,3 ± 2,6); level of IL-8 decreased from (742,5 ± 132,4) till (399,0 ±96,7) pkg/ml.
Conclusion: addition of N-acetylcystein to prolonged ß2-agonist + medium doses of ICS in basic therapy in the patients with severe persistent asthma promoted more expressive antiinflammatory effect.