THE EFFICIENCY OF REGIMES OF ANTIINFLAMMATORY THERAPY IN ASTHMATICS WITH COLD BRONCHIAL HYPERRESPONSIVENSS IN THE COMBINATION WITH SUBCLINICAL HYPOTHYROIDISM
The aim of the study was to search for the possibility of the achievement of control over bronchial asthma in patients with cold bronchial hyperresponsiveness concomitant with subclinical hypothyroidism in the regime of the step increase of the combined therapy during 24 weeks of examining. From the whole of 70 patients with uncontrolled asthma without evident pathology of the thyroid gland three groups for comparison were identified: the first group included 22 patients without cold bronchial hyperresponsiveness, the second group had 25 patients with cold bronchial hyperresponsiveness, the third group was comprised of 23 patients with cold bronchial hyperresponsiveness against subclinical hypothyroidism. At the same time the levels of thyrotropic hormone in the blood, the contents of oxidative stress products (TBA-responsive products of lipid peroxidation), antioxidant enzymes (superoxide anion scavenger) and inflammatory-cellular composition of the induced sputum were studied by the end of 24 weeks of therapy. The application of the regime of the step increase of the combined therapy by medication with budesonide/formoterol in the patients of the third group who demonstrated the highest level of oxidative stress associated with neutrophilic-eosinophilic pattern of inflammation in bronchi allowed to obtain the results of the achievement of bronchial asthma control equal to the ones obtained in the patients of the first and second groups, who had monotherapy (beclomethasone dipropionate in the regime of the step increase of the dose) and long treatment with the use of the fixed combination of budesonide/formoterol. The indices of oxidative stress in the 1 and 2 groups were less intensive and associated with eosinophils pattern of bronchial inflammation.