Orlova V. The influence of tobacco smoking upon the formation subclinical system inflammatory reaction in chronic heart and pulmonary failure

The pathogenesis of chronic heart failure (CHF) and chronic pulmonary failure (CPF) in patients with long-term smoking experience was investigated. The purpose of research is to give a scientific substantiation of advisability of usage and to evaluate the clinical efficacy of standardized artichoke extract for the correction of imbalance of cytokine homeostasis in the complex therapy of CHF and CPF in persons with long-term smoking experience. These methods of investigation were used in the research: general clinical, laboratory, instrumental methods, immunoenzyme assay of cytokine level, cell immunity investigation; usage of physical exertions in 6-MWD-test and the necessity for the hospitalization for the evaluation of the clinical efficacy of the treatment. The method of the correction of systemic inflammatory reaction with standardized artichoke extract for these patients was developed and introduced into clinical practice. It is proved that more than 10 years experience of smoking in patients with CHF (I-II FC, NYHA) and CPF (I-II stage) was characterized by significant increase of systemic pro-inflammatory cytokine capacity - the TNF-alfa, IL-1beta, and IL-6. It forms the conditions for the implementation of cytokine-associated mechanisms of progression of the pathology in cardiovascular and bronchopulmonary system. The plasmin-induced and lipopolysaccharide-induced synthesis of pro-inflammatory cytokines TNF-alfa, IL-1beta, and IL-6 by mononuclear leukocytes was revealed for the first time in these patients. The participation of tissue factors of bronchi (resistant to dilution in systemic circulation) in the formation of leukocyte(mononuclear)-dependent system cytokine imbalance in experimental model of tissue extracts (in vitro) was revealed for the first time in persons with long-term smoking experience. The new fact is the usage of standardized artichoke extract (hofitol) as the modulator of cytokine imbalance and the functional activity of mononuclear leukocytes in the complex therapy of CHF and CPF in persons with long-term smoking experience.