GLUCOSAMINYLMURAMYL DIPEPTIDE IN THE THERAPY OF PATIENTS WITH ATOPIC BRONCHIAL ASTHMA AND CLINICAL MANIFESTATIONS OF THE SYNDROME OF SECONDARY IMMUNE DEFICIENCY
Background. Glucosaminylmuramyl dipeptide (likopid) is a selective NOD2 receptor agonist, its ability to activate phagocytes proves its use in infectious manifestations in asthma patients. Its influence on the adaptive immunity, was studied. The aim of the study was to evaluate the effectiveness of likopid in patients with atopic bronchial asthma and recurrent infections of the respiratory tract. Materials and methods. 44 patients with uncontrolled atopic bronchial asthma with recurrent respiratory tract infections were examined. Patients of group I received likopid 10 mg orally once a day during 10 days additionally to the complex therapy. Patients of group II received only complex therapy without likopid. The immune parameters, disease control parameters, frequency of exacerbations and spirography data in patients of two groups before the treatment and after 10 days, 1 and 3 months were assessed. Results. Both I and II group patients (91,6%) showed similar deviations of the immune status parameters in general, a depression of the functional activity of phagocytes was noted in 83,3% of cases. Patients of group I were characterized by the achievement of better asthma control in 1 month of treatment, while the frequency of asthma exacerbations required revision of therapy was lower in patients of group I than in patients of group II (8,3% and 45%, respectively, p<0,001). The patients of group I, receiving likopid, had increased phagocytic activity after 10 days of treatment, while significant changes were recorded after 1 month of treatment; a decrease in these parameters was shown only in 45,8% (p<0,001) of patients in 3 months of treatment. The conclusion. The use of glucosaminylmuramyl dipeptide in atopic bronchial asthma accompanied with clinical manifestations of the secondary immune deficiency leads to correction of phagocytic activity, as well as to significant decreasing of infections incidence and improving of bronchial asthma symptoms control.