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Diagnostic value of inflammatory biomarkers among mining and metallurgical workers with pneumoconiosis in combination with chronic obstructive pulmonary disease

Diagnostic value of inflammatory biomarkers among mining and metallurgical workers with pneumoconiosis in combination with chronic obstructive pulmonary disease

ISSN 2223-6775 Ukrainian journal of occupational health Vol.18, No 4, 2022


https://doi.org/10.33573/ujoh2022.04.277

Diagnostic value of inflammatory biomarkers among mining and metallurgical workers with pneumoconiosis in combination with chronic obstructive pulmonary disease

Kovalchuk T.A., Rubtsov R.V.
State Institution "Ukrainian Research Institute of Industrial Medicine" Kryvyi Rih


 Full article (PDF): ENG / UKR

Introduction. Respiratory diseases are among the most common in Ukraine. They are the cause of a rapid and irreversible deterioration in the quality of life, high rates of disability and mortality. Among occupational lung diseases, the leading nosological forms among industrial workers are chronic obstructive pulmonary disease (COPD) and pneumoconiosis. When studying the pathogenetic mechanisms of formation of systemic inflammation in the combined course of pneumoconiosis and COPD among workers in mining and metallurgical industries, the content of inflammatory markers has not yet been determined. The need to solve the problem of early diagnosis and treatment of sick workers determined the relevance of this research.

The aim of the research is to study the features of changes in indices of systemic inflammation markers among workers in mining and metallurgical industry with pneumoconiosis in combination with COPD.

Materials and methods of research. The indices of some inflammatory markers were studied among workers in mining and metallurgical industries with occupational lung diseases. 30 patients with pneumoconiosis in combination with COPD were examined, as well as 17 patients with pneumoconiosis, 32 patients with COPD of occupational aetiology. The control group included 13 practically healthy workers.

Results. Among workers of mining and metallurgical industry with pneumoconiosis in combination with COPD, the content of C-reactive protein, in comparison with control group, was 3.7 times higher (p < 0.01). This index was 2.4 times higher than among patients with pneumoconiosis and, conversely, 2.2 times lower (p < 0.01) than among patients with COPD of occupational aetiology. Compared with control group, the content of IL-1β among patients with pneumoconiosis in combination with COPD was higher by 1.4%; among patients with pneumoconiosis - by 59.8%, and among patients with COPD of occupational aetiology it was lower by 15.7%. The content of IL-4 among patients with pneumoconiosis in combination with COPD and COPD of occupational aetiology was higher by 31.2% and 7.3%, respectively; among patients with pneumoconiosis, on the contrary, it was lower by 4.3%. The content of IL-6 among sick workers was higher: among patients with pneumoconiosis in combination with COPD by 3 times (p < 0.002), among patients with pneumoconiosis by 3.4 times (p < 0.002), among patients with COPD by 2.7 times (p < 0.01). The content of TNF-α factor among sick workers exceeded those in the control group, respectively, by 27.9% among patients with pneumoconiosis in combination with COPD, by 2.1 times (p < 0.002) among patients with pneumoconiosis and by 17.3% among patients with occupational COPD. In comparison with patients with pneumoconiosis in combination with COPD, the content of IL-1β among patients with pneumoconiosis was higher by 57.6%, among patients with COPD, on the contrary, it was lower by 17.3%. The content of IL-4 among patients with pneumoconiosis in combination with COPD was lower by 36.9% and 22.3%, respectively. The content of IL-6 was higher among patients with pneumoconiosis by 12.8% and lower among patients with COPD of occupational aetiology by 11.2%. The content of TNF-α- factor among patients with pneumoconiosis was higher by 63.7% (p < 0.002), among patients with COPD it was lower by 9.0%. Conclusions. Among workers of mining and metallurgical industry with pneumoconiosis in combination with COPD, an increase in the content of IL-1β and IL-4 is an activation marker with subsequent regulation of non-specific protection and specific immunity, stimulation of cell accumulation processes, which are the basis for formation of allergic reactions among patients. An increase in the content of IL-6 and TNF-α- factor indicates destructive processes in the lung parenchyma and bronchial mucosa, the emergence and formation of autoimmune processes, the development of cellular protective processes, the activation of the "acute phase" of inflammation with hyperproduction, primarily C-reactive protein. These changes activate the immune system, lead to the occurrence of non-specific reactions, the formation of a predisposition to the development of infectious complications. They determine the unfavourable prognosis of hyperproduction of proinflammatory triggers interleukins -1, -6, TNF-α- factor, and are the basis for measures aimed at the early diagnosis, treatment and prevention of pneumoconiosis in combination with COPD among workers in mining and metallurgical industries.

Keywords: pneumoconiosis, chronic obstructive pulmonary disease, workers, inflammatory markers.

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