Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)1990-472XФедеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации1159810.18499/1990-472X-2026-27-1-%pUnclassifiedThe role of immunomodulation in the correction of a disadaptive immune response in patients with infectious exacerbation of chronic obstructive pulmonary diseaseKupriyanovaArina<p>Assistant Professor of Infectious Diseases and Clinical Immunology</p>arina.kupriyanova.2000@mail.ruKrasnorutskayaOlga<p>MD, Head of the Department of Infectious Diseases and Clinical Immunology</p>lech@vrngmu.ruBugrimovDaniil<p>PhD, Associate Professor of Pathological Anatomy</p>patanat@vrngmu.ruФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России0604202627103042026Copyright © 2026, Medical Scientific Bulletin of Central Chernozemye (Naučno-medicinskij vestnik Centralʹnogo Černozemʹâ)2026<p>The article analyzes the role of disadaptive trained immunity in the pathogenesis of chronic obstructive pulmonary disease and the formation of antibiotic resistance during infectious exacerbations of the disease. The results of a prospective comparative study involving 60 patients with stage IIIII COPD, divided into a main group and a control group of 30 people each, are presented. It was shown that the inclusion of sodium deoxyribonucleate in the standard treatment regimen was accompanied by a more pronounced clinical improvement: an increase in saturation to 97% versus 95% in the control (p=0.015), a decrease in cough intensity (p=0.001), and normalization of sputum rheology. A significant correction of the immune response was noted, manifested by a decrease in IL-8 levels from 12.52.3 to 5.41.36 pg/ml (p0.001) and an increase in -interferon from 6.60.8 to 8.81.1 pg/ml (p0.01). The proportion of resistant strains decreased from 40% to 10.3% (p0.001), and the microbial load decreased from 10⁶ to</p>
<p>5.510 CFU/ml (p0.001). The obtained data confirm the effectiveness of the immunocorrective approach in the complex therapy of COPD.</p>сhronic obstructive pulmonary disease (COPD), trained immunity, maladaptive immunity, sodium deoxyribonucleate, antibiotic resistance, and immunomodulatory therapy.хроническая обструктивная болезнь лёгких (ХОБЛ), тренированный иммунитет, дезадаптивный иммунитет, дезоксирибонуклеат натрия, антибиотикорезистентность, иммуномодулирующая терапия.[1. Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease (2024 Report) URL: https://goldcopd.org/ (дата обращения: 11.02.2026).][2. Global Initiative for Chronic Obstructive Lung Disease 2023 Report: GOLD Executive Summary / A. Agustí, B.R. Celli, G.J. Criner [et al.] // European Respiratory Journal. – 2023. – Vol. 61,][№ 4. – P. 2300239.][3. Advocating the role of trained immunity in the pathogenesis of ME/CFS: a mini review / B. Humer, W. A. Dik, M. A. Versnel // Frontiers in Immunology. – 2025. – Vol. 16. – P. 1483764. – DOI: 10.3389/fimmu.2025.1483764.][4. Trained immunity in the lung / E. Idiiatullina, D. Parker // eLife. – 2025. – Vol. 14. – P. e104918. – DOI: 10.7554/eLife.104918.][5. Innate immune reprogramming in circulating neutrophils of COPD patients / B. Mariotti [et al.]][// Journal of Allergy and Clinical Immunology. – 2025. – [In press].][6. Роль цитокинов IL-4, IL-6, IL-8, IL-10 в иммунопатогенезе хронической обструктивной болезни легких / Е. Ю. Трушина, Е. М. Костина, Б. А. Молотилов [и др.] // Медицинская иммунология. – 2019. – Т. 21, № 1. – URL: https://cyberleninka.ru/article/n/rol-tsitokinov-il-4-il-6-il-8-il-10-v-immunopatogeneze-hronicheskoy-obstruktivnoy-bolezni-legkih (дата обращения: 11.02.2026).][7. Интерлейкин-8 способен поддерживать провоспалительную активность моноцитов (макрофагов) человека / М. Е. Меняйло, В. В. Малащенко, В. А. Шмаров [и др.] // Гены и клетки. – 2018. – Т. XIII, № 1. – С. 42-49. – URL: https://cyberleninka.ru/article/n/interleykin-8-sposoben-podderzhivat-provospalitelnuyu-aktivnost-monotsitov-makrofagov-cheloveka (дата обращения: 11.02.2026).][8. Оценка уровня экспрессии TLR-9 рецепторов при введении препарата Деринат / Д. Ю. Бугримов, Д. В. Лядов, О. Н. Красноруцкая, А. А. Климович // Вестник новых медицинских технологий. – 2012. – Т. XIX, № 2. – С. 102-103. – URL: https://cyberleninka.ru/article/n/otsenka-urovnya-ekspressii-tlr-9-retseptorov-pri-vvedenii-preparata-derinat (дата обращения: 11.02.2026).]