Object of the study: occupational bronchitis in combination with arterial hypertension. Purpose of the study: improvement of the diagnosis of occupational bronchitis in combination with arterial hypertension on the basis of immune status and cytokine system investigation, and also of assessment of the role of immune inflammation in the development and progression of combined pathology. Methods of the investigation: general clinical, immunological, immunoenzyme, cytometric and statistical ones. Theoretical and practical results: The role of immunoinflammational disturbances in the development of occupational bronchitis was proved in workers of dust professions of machine-building industry. The disbalance in immune status, the prevalence of immunodepression states with decrease in indices of nonspecific immunity and cellular component was determined. This take place on the background of activation of humoral immunity with increase of IgM, IgG, IgE and circulating immune complexes concentratons. It was showed, that the development of occupational bronchitis is associated with disbalance in regulation effect of cytokines TNF?, IFN?, IL-4. It was determined, that in patients with occupational bronchitis in combination with arterial hypertension the immunoinflammatory process is more active, with increase of humoral response (predominantly of IgG, circulating immune complexes levels) on the background of cellular immunodepression. There was proved the role of TNF? in the development of respiratory symptomatics. There was estimated the role of cytokines IFN?, IL-4 and subpopulations of Т-helpers of 1 and 2 types in the regulation of immune response. There were stated the peculiarities of changes in immune status and cytokine profile in patients of different occupational groups. It was showed that the most significant immunoinflammatory disturbances were characteristic for electrowelders, less substantial – for molders and grinders. Independently from the occupation, while increase of exposition of the dust on anorganism there was stated the suppression on non-specific and cellular components of immunity. There was determined the role of cytokines in the progression of occupational bronchitis. There was revealed the presence of direct correlation links between TNF? and the intensity of the pathological process, between IFN? and the frequency of exacerbations of occupational bronchitis. Negative correlation links were stated between TNF? and 6-minute walk distance, between IL-4 and spirography indexes (FEV1 and FEV1/FVC). The reasonability of quality of life estimation as an additional criterion of health state and as an index of control on the course of the disease. Novelty: the peculiarities of clinical course of occupational bronchitis in combination with arterial hypertension were stated in different occupational groups. This helped to determine the most informative indexes of progression of occupational bronchitis into chronic obstructive pulmonary disease. There were revealed the changes of immune status and cytokine profile as an immunoinflammatory marker of pathologic process in patients with occupational bronchitis in combination with arterial hypertension and their role in the progression of the diseases. Degree of introduction: the suggested methods of diagnosis were introduced in the work of the clinics of Scientific-Research Institute of Labor Hygiene and Occupational Diseases of Kharkiv State Medical University, therapeutical departments of Medical-Sanitary Department of Kharkiv Turbine Plant, Sumy City Clinical Hospital №4, Dnipropetrovsk Central Regional Hospital, Dnipropetrovsk City Clinical Hospital №6, they are used in the pedagogical process and practical work of the Department of Internal and Occupational Diseases of Kharkiv State Medical University. Sphere of application: medicine, therapeutic, occupational pathology departments.
