THE ROLE OF HALOAEOROSOLTHERAPY IN IMMUNOREHABILITATION OF CONVALESCENTS AFTER COMMUNITY ACQUIRED PNEUMONIA

Aim: Investigation of the peculiarities of different haloaerosoltherapy regimes influence (treatment with different intensity of haloaerosol load) upon non-specific defense and cellular immunity at convalescents after community acquired pneumonia. Objectives: patients with community acquired pneumonia in the early convalescence period (after completing antibiotic therapy), who received treatment in conditions of artificial rock salt aerosol medium (haloaerosoltherapy). Material and Methods. 42 patients with non-severe community acquired pneumonia were examined in the early convalescence period before and after the course of haloaerosoltherapy, which was prescribed after antibacterial therapy. Immunological studies included: evaluation of phagocytic activity of neutrophils (PhAN - the percentage of phagocytic neutrophils), phagocytic number (PhN - average number of latex particles absorbed by a neutrophil); metabolism of neutrophils in the test with nitroblue tetrasolium (NBT-test) spontaneous and induced, which allowed to assess the functional reserve of neutrophils (FR); calculation of cytochemical coefficient (CCC) for lysosomal cationic proteins (LCP) and for myeloperoxidase (MPO) of neutrophils; number of T- and B-lymphocytes and their subpopulations (CD3 + -, CD4 + -, CD8 + -, CD22 + lymphocytes), calculation the number of 0- lymphocytes and the ratio of CD4 + /CD8 + lymphocytes. Laboratory examinations were also conducted in 21 practically healthy individuals (control group). Two regimes of haloaerosoltherapy were used in recovery treatment of patients with community acquired pneumonia: treating complex №1 (TC-1) with standard haloaerosol load and with increased haloaerosol load (TC-2). Results. After completion the antibiotic therapy at patients with community acquired pneumonia the moderate inhibition of phagocytic activity of neutrophils (47,6±0,58% to 55,5±1,14% in control group) remained and was accompanied with a decrease in neutrophil bactericidal capacity, mainly oxygen-dependent. However, the disturbances of cellular immunity was observed which manifested by reduced number of T-lymphocytes, mainly on account of Thelper cells and decrease of the CD4 + /CD8 + ratio and was accompanied by the elevation of 0lymphocytes percentage. Under the influence of recovery treatment on the base of haloerosoltherapy usage the positive dynamics of studied parameters was observed and it was more expressed when using treatment procedures with increased haloaerosol load. Conclusions. 1. The patients with non-severe community acquired pneumonia have moderate disturbances of neutrophils phagocytosis, associated with secondary T-cell dysfunction, which are accompanied with the increasing in the number of undifferentiated 0-lymphocytes and B lymphocytes, which remained after of completing of antibiotic therapy. These changes determine the necessity of recovery treatment in this stage of the disease. 2. Haloaerosoltherapy usage in the recovery treatment of convalescents after community acquired pneumonia improves the functioning of nonspecific defense and T-immunity. with more expressed effect while using more intensive haloaerosol load (TC-2). 3. After recovery treatment based on haloaresoltherapy usage most of the studied parameters were not improved up to normal values that determine the necessity of new treating complexes elaboration, perhaps with additional prescription of immunomodulators.