Immune system indicators in patients with community-acquired pneumonia and gastroesophageal reflux disease
https://doi.org/10.21886/2712-8156-2025-6-3-61-68
Abstract
Objective: to investigate the immune status of patients with community-acquired pneumonia (CAP) and GERD.
Materials and Methods: 136 patients were observed, including 100 patients with САP at an average age of (42.3 ± 2.9) years, including 34 patients with САP combined with GERD NERD (group I), 66 patients with САP without of GERD (group II), 36 patients with GERD without CAP observed on an outpatient basis, Group III. The control group consisted of 34 practically healthy donors. Diagnosis of CAP and GERD was carried out in accordance with the existing recommendations. The examined patients had the state of indicators of cellular and humoral immunity and phagocytic activity of monocytes in the dynamics of treatment.
Results: patients with CAP combined with GERD and dyspepsia symptoms have a higher level of systemic inflammation than patients with CAP without GERD. The course of CAP combined with GERD is accompanied by secondary immune deficiency due to cellular and humoral immunity, with an imbalance in the phagocytic activity of monocytes. Laboratory signs of systemic inflammation and immune disorders are not fully resolved during the clinical recovery of patients.
Conclusions: the identified changes create the preconditions for a personalized approach to the treatment of such patients, with the possible addition of drugs with anti-inflammatory and immunocorrective effects to reduce the likelihood of early and late complications of both comorbid diseases.
About the Authors
A. S. BisovRussian Federation
Aleksey S. Bisov, 2nd year postgraduate student
Department of Internal Medicine, Pulmonology and Allergology
Lugansk
G. P. Pobedyonnaya
Russian Federation
Galina P. Pobedennaya, MD, PhD, prof., head of the Department
Department of Internal Medicine, Pulmonology and Allergology
Lugansk
I. S. Kotova
Russian Federation
Irina S. Kotova, MD, PhD, Associate Professor
Department of Internal Medicine, Pulmonology and Allergology
Lugansk
References
1. Hsu WT, Lai CC, Wang YH, Tseng PH, Wang K, Wang CY, et al. Risk of pneumonia in patients with gastroesophageal reflux disease: A population-based cohort study. PLoS One. 2017;12(8):e0183808. DOI: 10.1371/journal.pone.0183808
2. Larina V.N., Bondarenkova A.A., Lunev V.I., Golovko M.G. Extra-esophageal symptoms of gastroesophageal reflux disease, as manifestations of polymorbidity. Experimental and Clinical Gastroenterology. 2019;(6):4-8. (In Russ.) DOI: 10.31146/1682-8658-ecg-166-6-4-8
3. Ivashkin V.T., Sheptulin A.A., Zolnikova O.Yu., Okhlobystin A.V., Poluektova E.A., Trukhmanov A.S., et al. New Coronavirus Infection (COVID-19) and Digestive System. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2020;30(3):7-13. (In Russ.) DOI: 10.22416/1382-4376-2020-30-3-7
4. Gel’tser B.I., Kim A.P., Kotel’nikov V.N., Makarov A.B. Features of immune response in patients with community-acquired pneumonia with endogenous intoxication of different degrees of severity. Cytokines and inflammation. 2015;14(3): 35-41. (In Russ.) eLIBRARY ID: 26511105 EDN: WIDSCV
5. Kozlova I.V., Lipatova T.E., Shuman Mohamad Ali Trad. The changes of immune homeostasis at patients with gastroesophageal reflux disease and Barrett’s esophagus. Vestnik VolGMU. 2006;2:27-31. (In Russ.)
6. Ivashkin V.T., Trukhmanov A.S., Maev I.V., Drapkina O.M., Livzan M.A., Martynov A.I., et al. Diagnosis and Treatment of Gastroesophageal Reflux Disease (Clinical Guidelines of the Russian Gastroenterological Association, Russian Scientific Medical Society of Internal Medicine, Russian Society for the Prevention of Noncommunicable Diseases, Scientific Community for Human Microbiome Research). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(5):111-135. (In Russ.) DOI: 10.22416/1382-4376-2024-34-5-111-135
7. Plotnikova E.Yu., Gracheva T.Yu., Moskvina Ya.V. Influence of psychosomatic factors on the course of the digestive system diseases. RMJ. 2017(10):754–759. (In Russ.)
8. Ershov A.V. С-reactive protein in the diagnostics of communicative pneumonia. Consilium Medicum. 2019;21(3):15-19. (In Russ.) DOI: 10.26442/20751753.2019.3.190259
9. Naushirvanov O.R., Nigmatullin R.Kh., Kutuev Z.Z., MirkhaidarovA.M. Free radical oxidation, immunological reactivity and their interrelation in community-acquired pneumonia. The Bulletin of Contemporary Clinical Medicine. 2020;13(6):28-32. (In Russ.) DOI: 10.20969/VSKM.2020.13(6).28-32
10. Ivanova I.A., Filippenko A.V., Pavlovich N.V., Aronova N.V., Tsimbalistova M.V., Anisimova A.S., et al. Immune status of patients with community-acquired pneumonia associated with a new coronavirus infection and other viral and bacterial pathogens. Russian Journal of Infection and Immunity = Infektsiya i immunitet, 2024;14(2):267–276. (In Russ.) DOI: 10.15789/2220-7619-ISO-17589
11. Lyamina S.V., Maev I.V., Kalish S.V., Andreev D.N., Kladovikova O.V., Malyshev I.Y. Features of the functional activity of macrophage link of immunity with gastroesophageal reflux disease depending on the type of reluctate: in vitro model. Terapevticheskii arkhiv. 2018;90(2):19-23. (In Russ.)
12. Karimov M.M., Zufarov P.S., Sobirova G.N., Rustamova M.T., Karimova D.K., Khairullaeva S.S. Combination therapy of gastroesophageal reflux disease in comorbidity with functional dyspepsia. Experimental and Clinical Gastroenterology. 2024;(8):158-162. (In Russ.) DOI: 10.31146/1682-8658-ecg-228-8-158-162 DOI: 10.26442/terarkh201890219-23
13. Drossman DA. Functional Gastrointestinal Disorders: History, Pathophysiology, Clinical Features and Rome IV. Gastroenterology. 2016:S0016-5085(16)00223-7. DOI: 10.1053/j.gastro.2016.02.032. Epub ahead of print.
14. Garnacho-Montero J, Barrero-García I, Gómez-Prieto MG, Martín-Loeches I. Severe community-acquired pneumonia: current management and future therapeutic alternatives. Expert Rev Anti Infect Ther. 2018;16(9):667-677. DOI: 10.1080/14787210.2018.1512403
Review
For citations:
Bisov A.S., Pobedyonnaya G.P., Kotova I.S. Immune system indicators in patients with community-acquired pneumonia and gastroesophageal reflux disease. South Russian Journal of Therapeutic Practice. 2025;6(3):61-68. (In Russ.) https://doi.org/10.21886/2712-8156-2025-6-3-61-68