Chronic obstructive pulmonary disease (COPD) is a problem whose urgency is growing rapidly around the world. The main risk factor for COPD development is smoking. Epidemiological studies, conducted in most countries of the world, found a significant increase in the number of patients among tobacco smokers. According to WHO, there are more than 1.1 billion of smokers all over the world, and it is the most common bad habit that leads to the occurrence of COPD.
Aim: Тo study the impact of smoking on the condition of proteinase-inhibitory system in patients with COPD.
Materials and methods: The study involved 164 men with COPD aged from 36 to 59 years, with disease duration from 9.2 to 15.3 years. Depending on the clinical and functional characteristics of the disease, the severity degree, as well as taking into account active smoking. To assess the nature and prevalence of chronic inflammation in COPD patients, fiber-optic bronchoscopy (FBS) was conducted. To determine nicotine dependence in smokers, the questionnaire by K.O. Fagerstrom was used. Study of the activity of protease-inhibitory enzymes in bronchoalveolar fluid was conducted with conversion of enzyme activity in total amount of proteins by Lowry method.
Results: In bronchoalveolar fluid of patients with COPD, the imbalance in the protease-inhibitory system was revealed with predominance of proteinase potential: in smokers, the activity of TR group increases as compared with the group of healthy individuals and non-smokers with COPD. It has been found that the imbalance in protease-inhibitory system in patients progresses depending on the index “pack-years” of smoking. High rates of α2MH in bronchoalveolar fluid at increased inflammatory activity indicate that in the depletion α1AT, the present inhibitor can perform basic protection functions. It has been revealed that the most informative indicator in assessing the state of proteinase-inhibitory system in patients with COPD is the ratio of trypsin/α1antitrypsin.