Modern approaches to the treatment of patients with chronic obstructive pulmonary disease: long-term results of observation after the use of β-glucans

December 13, 2022
775
Resume

Objective: to investigate the effectiveness of using the complex of β-glucans Immunsil™ D3 in patients with frequent exacerbations of chronic obstructive pulmonary disease (COPD).

Object and methods of research. 42 patients with COPD who had 2–4 clinical exacerbations during the previous year were under observation for 2 years. Patients of the 1st group (n=22) received tiotropium bromide and standard treatment for exacerbations; patients of the 2nd group (n=20) additionally used Immunsil™ D3 1 capsule 2 times a day for 1 month.

Results. The use of the Immunsil™ D3 complex ensured an increase in the number of cells with the activity of natural killers and cells of the monocyte-macrophage series, and also contributed to the recovery of the immunoregulatory index (p<0.05). These changes were largely leveled off by the end of the 2nd year of observation. The use of the Immunsil™ D3 helped to reduce the number of exacerbations of COPD (p>0.05) and significantly reduced the need for antibiotics in patients with COPD (p<0.05) for 1 year. During the next year of observation, the difference between the groups was significantly less pronounced.

Conclusion. Immunsil™ D3 can be recommended for patients with COPD with frequent clinical exacerbations. It is advisable to annually repeat the course of β-glucans in patients with frequent clinical exacerbations of COPD.

References

  • 1. http://www.ifp.kiev.ua/ftp1/metoddoc/nastanova_hozl_2020.pdf.
  • 2. goldcopd.org/wp-content/uploads/2020/03/GOLD-2020-POCKET-GUIDE-ver1.0_FINAL-WMV.pdf.
  • 3. Dransfield M.T., Kunisaki K.M., Strand M.J. et al. for the COPD Gene Investigators (2017) Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med., 195: 324–330.
  • 4. Beeh K.M., Derom E., Echave-Sustaeta J. et al. (2016) The lung function profile of once-daily tiotropium and olodaterol via Respimat® is superior to that of twice-daily salmeterol and fluticasone propionate via Accuhaler® ENERGITO® study. Int. J. Chron. Obstruct. Pulmon. Dis., 11: 193–205.
  • 5. Abudagga A., Sun S.X., Tan H., Solem C.T. (2013) Exacerbations among chronic bronchitis patients treated with maintenance medications from a US managed care population: an administrative claims data analysis. Int. J. Chron. Obstruct. Pulmon. Dis., 8: 175–185.
  • 6. Dhamane A.D., Moretz C., Zhou Y. et al. (2015) COPD exacerbation frequency and its association with health care resource utilization and costs. Int. J. Chron. Obstruct. Pulmon. Dis., 10: 2609–2618.
  • 7. Donaldson G.C., Seemungal T.A., Patel I.S. et al. (2003) Longitudinal changes in the nature, severity and frequency of COPD exacerbations. Eur. Respir. J., 22: 931–936.
  • 8. Halpin D.M.G., Decramer M., Celli B.R. et al. (2017) Effect of a single exacerbation on decline in lung function in COPD. Respir. Med., 128: 85–91.
  • 9. Kerkhof M., Freeman D., Jones R. et al. for the Respiratory Effectiveness Group (2015) Predicting frequent COPD exacerbations using primary care data. Int. J. Chron. Obstruct. Pulmon. Dis., 10: 2439–2450.
  • 10. Müllerová H., Shukla A., Hawkins A., Quint J. (2014) Risk factors for acute exacerbations of COPD in a primary care population: a retrospective observational cohort study. BMJ Open, 4(12): e006171.
  • 11. Müllerova H., Maselli D.J., Locantore N. et al. (2015) Hospitalized exacerbations of COPD: risk factors and outcomes in the ECLIPSE cohort. Chest, 147: 999–1007.
  • 12. Pasquale M.K., Sun S.X., Song F. et al. (2012) Impact of exacerbations on health care cost and resource utilization in chronic obstructive pulmonary disease patients with chronic bronchitis from a predominantly Medicare population. Int. J. Chron. Obstruct. Pulmon. Dis., 7: 757–764.
  • 13. Vestbo J., Edwards L.D., Scanlon P.D. et al.; ECLIPSE Investigators (2011) Changes in forced expiratory volume in 1 second over time in COPD. N. Engl. J. Med., 365: 1184–1192.
  • 14. Wheaton A.G., Cunningham T.J., Ford E.S., Croft J.B. for the Centers for Disease Control and Prevention (2015) Employment and activity limitations among adults with chronic obstructive pulmonary disease — United States. MMWR Morb. Mortal. Wkly Rep., 64: 289–295.
  • 15. Bollmeier S.G., Hartmann A.P. (2020) Management of chronic obstructive pulmonary disease: A review focusing on exacerbations. Am. J. Health Syst. Pharm., 77(4): 259–268.
  • 16. Ali M.F., Driscoll C.B., Walters P.R. et al. (2015) Beta-glucan-activated human B lymphocytes participate in innate immune responses by releasing proinflammatory cytokines and stimulating neutrophil chemotaxis. J. Immunol., 195: 5318–5326.
  • 17. Soltanian S., Stuyven E., Cox E., Sorgeloos P., Bossier P. (2009) Beta-glucans as immunostimulant in vertebrates and invertebrates. Crit. Rev. Microbiol., 35: 109–138.
  • 18. Vetvicka V., Richter J., Svozil V. et al. (2013) Placebo-driven clinical trials of Transfer Point Glucan #300 in children with chronic respiratory problems: Antibody production. Am. J. Immunol., 9: 43–47.
  • 19. Zipfel C., Robatzek S. (2010) Pathogen-associated molecular pattern-triggered immunity: Veni, vidi…? Plant. Physiol., 154: 551–554.
  • 20. Dawood M.A.O., Eweedah N.M., Moustafa E.M., Shahin M.G. (2019) Synbiotic effects of Aspergillus oryzae and beta-glucan on growth and oxidative and immune responses of Nile tilapia, Oreochromis niloticus. Prob. Antimicr. Prot., 12(1): 172–183.
  • 21. Vetvicka V. , Vannucci L., Sima P. (2019) Beta Glucan: Supplement or Drug? From Laboratory to Clinical Trials. Molecules, 24(7): 1251.
  • 22. Господарський І.Я., Рега Н.І., Господарська Х.О. (2021) Сучасні підходи до терапії пацієнтів із хронічним обструктивним захворюванням легень. Укр. мед. часопис, 6: 45–49.