Zacharova M. The pathogenetic role and correction of misbalance of the cytokine homeostasis in patients with combined course of liver cirrhosis and chronic obstructive pulmonary disease

The thesis is devoted to investigating of the peculiarities of misbalance of cyto-kine homeostasis, cell immunity system and functional integration of immune and haemostatic systems in patients with combined course of liver cirrhosis (LC) and chronic obstructive pulmonary disease (COPD). COPD in patients with LC creates the conditions for the increasing of the systemic concentration of pro-inflammatory cytokines and growth factors, the develop-ment of specific Th2–variant of immune misbalance, the misbalance functional integration of immune and fibrinolytic systems. It is characterized by decreasing of leu-kocytic fibrinolytic activity and the changes of the expression of superficial ТР-, uPA- and tPA-receptors on lymphocytes, misbalance of leukocytic (immune) regulation of cytokine homeostasis under the influence upon the cytokines synthesis by bronchial epithelial cells. It forms creates the conditions for the chronic course (progression) of pathological process in the liver and in the broncho-pulmonary system. The ability of pentoxyphylline-dependent modification of lymphocyte receptors as regards the expression of ТР- and uPA receptors, and the possibility of mediated (through uPA–induced leukocytic (lymphoid) regulation of cytokine synthesis TNF-? and TGF-?1 by bronchial epithelial cells) cytokine-modulating effect of pentoxyphylline were estimated. The clinical efficacy of pentoxyphylline usage for the correction of cytokine mis-balance in patients with combined course of LC and COPD due to decreasing (under the influence of pentoxyphylline) TGF-?1 and TNF-? was proved.