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Diseases of the respiratory tract occupy one of the leading places among pathologies in people of working age in the world. According to the data of world studies, it can be considered that these two comorbidities are mutually aggravating, but scientists do not have a unanimous opinion about whether this is a simple coincidence or whether these pathologies are pathogenetically related. There is considerable evidence that asthma patients do not achieve adequate asthma control worldwide. Yes, according to Maria Sandra Magnoni et al. 77.8% of patients with asthma have an uncontrolled course of asthma, although 68.4% of them believe that they have sufficient asthma control, and their treatment does not require correction. Therefore, taking into account all of the above and taking into account the low level of asthma control in patients with comorbid pathology who often suffer from bacterial and viral diseases, we believe that a more detailed study of the immunological status of these individuals is necessary in order to optimize treatment and prevention measures. Aim: to investigate the effectiveness of alternative ways of asthma control in patients with bronchial asthma against the background of overweight or obesity. Materials and methods. At the I stage, 255 patients with BA were examined. According to the study design, patients were selected according to the "inclusion/exclusion" criteria at this stage. The study was randomized. Allocation of patients into groups was carried out by the method of simple randomization with elements of stratification. Groups are statistically significant. Statistical processing of the results was carried out using parametric and non-parametric analysis methods. Resalts. Overweight or obese patients had a more severe course of bronchial asthma than patients with a normal body mass index. Overweight or obese patients were found to have higher levels of systemic inflammation, namely eosinophilic cationic protein levels and erythrocyte sedimentation rate, than patients with a normal body mass index. In addition, a close direct correlation was established between the severity of the course of bronchial asthma and indicators of eosinophil cationic protein (r=0.97; p˂0.001). After pharmacological correction, there was an increase in asthma control in patients with different severity of the course (р˂0.001; p˂0.001; p˂0.001, respectively), a decrease in the frequency of exacerbations (p˂0.05), a reduction in the number of hospitalizations (p˂0, 05) and the number of acute respiratory diseases (p˂0.05) in patients with bronchial asthma against the background of excess body weight or obesity. The use of the developed treatment-prophylactic complex using the drug bacterial lysate and inosine pranobex together with training in the Asthma School and standard treatment contributes to increasing asthma control and compliance with the doctor, reducing the number of exacerbations and hospitalizations per year in patients with bronchial asthma against the background overweight or obesity.
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2. The scale of the spread of asthma [Electronic resource].
World Health Organization. Access mode: http://www.who.int/respiratory/asthma/scope/ru
3. Health statistics and information systems [Electronic resource]. World Health Organization. URL: http://www.int/healthinfo/global_burden_disease/
4. Solovieva I. A., Sobko E. A., Demko I. V., Kraposhina A. Yu. Bronchial asthma and obesity. Therapeutic archive. 2017. No. 89 (3). pp. 116–120.
5. Peters U., Dixon A. E., Forno E. Obesity and asthma. The Journal of Allergy and Immunology. 2018 Vol. 141, iss. 4. P. 1169–1179.
6. Role of adipokines and hormones of obesity in childhood asthma / H. Yuksel et al. Allergy, asthma & immunology research. 2012. Vol. 4. P. 98–103.
7. Baffi C. W., Winnica D. E., Holguin F. Asthma and obesity: mechanisms and clinical implications. Asthma Research and Practice. 2015. Vol. 1. P. 1.
8. Sideleva O., Black K., Dixon A. E. Effects of obesity and weight loss on respiratory tract physiology and asthma inflammation. Pulmonary pharmacology & therapeutics. 2013. Vol. 26, No. 4, pp. 455–458.
9. Sideleva O., Dixon A. The many faces asthma in obesity. Journal of cellular biochemistry. 2014. Vol. 115. P. 421–426.
10. Melnik O. B. Features of the transition and optimization of the treatment of bronchial asthma due to obesity Abstract of the thesis. dis. to-that honey. Sciences: 14.01.02 Bukovinian State Medical University. Chernivtsi, 2019: 67.
11. Osipova G. L. Bronchial asthma and viral infection. Asthma and allergies. 2014. No. 3. P. 3–7.
12. Castillo J. R., Peters S. P., Busse W. W. Asthma exacerbations: pathogenesis, prevention and treatment. The journal of allergy and clinical immunology. In practice. 2017 Vol. 5, No. 4, pp. 918–927.
13. Th1-related disease development during omalizumab treatment. P. Two cases with severe asthma / H. Hayashia et al. Allergology International. 2018 Vol. 67, iss. 3. P. 405–407.
14. Zhang Y., Zhang L. Prevalence of Allergic Rhinitis in China. Allergy, asthma & immunology research. 2014. Vol. 6, No. 2, pp. 105–113.
15. Arkhipov V. V., Grigorieva E. V., Gavrishina E. V. Control of bronchial asthma in Russia. Results of the NIKA multicenter observational study [Electronic resource]. Pulmonology. 2011. No. 6. P. 87–93. Access mode: https://doi.org/10.18093/0869-0189-2011-0-6-87-93
16. A bacterial extract of OM-85 Broncho-Vaxom prevents allergic rhinitis in mice / L. Han et al. Article in American Journal of Rhinology and Allergy. 2014. Vol. 28, No. 2, pp. 110–116. doi:10.2500/ajra.2013.27.4021
17. Gosavi S., Nadig P., Haran A. Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication. Journal of Clinical and Diagnostic Research. 2016. Vol. 10, 6. P. OC31–35.
18. Asthma control in primary care: the results of an observational cross-sectional study in Italy and Spain / M. S. Magnoni et al. The World Allergy Organization journal. 2017 Vol. 10, N 1. P. 13.
19. Novosad S., Khan S., Wolfe B., Khan A. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype Journal of Allergy (Cairo). 2013. doi:10.1155/2013/538642.
20. Bulgakova V. A., Balabolkin I. I., Sedova M. S., Shmakova S. G. Clinical and immunological efficacy of inosine pronobex in acute respiratory infections in children with atopic bronchial asthma. Pediatric pharmacology. 2010. V. 7, No. 3. S. 98–105.
21. Lauener R. Genetics of asthma. Global Atlas of Asthma. European of Allergy and Clinical Immunology. 2013. P. 23–24
22. Marko M., Pawliczak R. Obesity and asthma: risk, control and treatment Postpy dermatologii i alergologii. 2018 Vol. 35, No. 6, pp. 563–571.
23. Martin R. J. Complementary, alternative, and integrative therapies for asthma [Electronic resource]. 2018. URL: https://www.uptodate.com/contents/
24. Effects of weight loss on asthma control in obese patients with severe asthma / S. A. Dias-Júnior et al. The European respiratory journal. 2014. Vol. 43,
N 5. P. 1368–1377. doi: 10.1183/09031936.00053413.
25. Cramer H., Posadzki P., Dobos G., Langhorst J. Yoga for asthma: a systematic review and meta-analysis. Annals of Allergy, Asthma and Immunology. 2014. Vol. 112. P. 503.
26. Body mass index and asthma severity in the National Asthma Survey / B. Taylor et al. Thorax. 2008. Vol. 63. P. 14–20.
27. Baffi C. W., Winnica D. E., Holguin F. Asthma and obesity: mechanisms and clinical implications. Asthma Research and Practice. 2015. Vol. 1. P. 1.
28. Asthma control in primary care: the results of an observational cross-sectional study in Italy and Spain / M. S. Magnoni et al. The World Allergy Organization journal. 2017. Vol. 10, N 1. P. 13.
29. Association of Obesity with Asthma Severity, Control and Quality of Life / S. Maalej et al. Tanaffos. 2012. Vol. 11, N 1. P. 38–43.
30. Sepiashvili R. I. Physiology of the immune system. Moscow: Medicine–Health. 2015. 352 p.