[Preasthma and bronchial asthma: problems of clinical immunology]

The paper is concerned with the results of a study of the nature of immunological disorders in 150 patients with chronic bronchitis and preasthma and in 203 patients with bronchial asthma (BA). Subpopulation analysis of immunocompetent cells with the help of monoclonal antibodies permitted the detection of certain differences in the regulatory link of immunity in patients with different types of chronic nonspecific pulmonary diseases. Patients with purulent bronchitis demonstrated a decrease in the level of the population of T-helpers and a tendency to an increase in the level of T-suppressors, whereas preasthmatic patients demonstrated a decrease in the level of T-helpers in parallel with a sharp deficiency of T-suppressors. An analysis of immune disorders in BA patients revealed the same line of immunological shifts as in preasthmatic patients, however a degree of the affection of the suppressor systems was much greater. The study has shown that immune disorders typical of BA, are revealed even at the early stages of disease, i.e. at the preasthmatic stage. Possible immune mechanisms of pathogenesis of chronic bronchitis, preasthma and BA are discussed. A conclusion is made that immunological investigation including the determination of the levels of T-helpers and T-suppressors and their ratios (the so-called immunoregulatory index) in combination with other methods makes it possible to detect persons at risk of developing BA, at the early stages of development of disease. Immunocorrective therapy is recommended to such patients to prevent development of chronic bronchitis into BA.