Chronic obstructive pulmonary disease is a preventable and treatable disease. It is characterized by persistent airflow limitation that is usually progressive and associated with enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Although COPD affects the lungs, it also results in significant systemic disorders and exacerbates comorbidities [1].

According to the WHO, chronic obstructive pulmonary disease is the leading cause of death in the world. Over the past three years, the concept of chronic obstructive pulmonary disease and approaches to treatment have seen considerable changes. Until 2011, according to the guidelines of the Global Initiative for Chronic Obstructive Lung Disease (GOLD), spirometry was to be used in determining the severity of COPD, which measures the forced expiratory volume after taking a short-acting bronchodilator [1]. In 2011, GOLD experts have made some major changes to the guidelines.

COPD exacerbations have a negative impact on patient's quality of life, lead to worsening of clinical symptoms and function of the lung. COPD, being a major cause of seeking medical aid, is associated with a significant mortality and results in considerable economic and social costs. Taking into account current recommendations for the treatment of COPD and research data on the resistance of respiratory pathogens, inhibitor-protected penicillin for oral administration may be considered a medicine of choice in the empirical antibiotic therapy for mild to moderate COPD exacerbations.

The medical and social significance of bronchial asthma (BA) is explained by its high incidence (5-10%), dramatic decline in the quality of life of patients and high cost of treatment. Severe exacerbations of asthma may cause death at any age. Studies carried out in different countries of the world revealed inadequate asthma control in clinical practice [1, 2]. For example, in 56% of Russian patients who seek medica aid of specialists and GPs the disease is not controlled [3]. The treatment of asthma needs to improved.

Despite recent advances in the diagnosis and treatment, bronchial asthma (BA) remains the biggest challenge among chronic lung nosologies, as well as in total among chronic diseases both in children and adults. In September 2011, UN high-level meeting on non-communicable diseases (NCDs) focused on the fact that BA and other non-communicable diseases are a growing threat to global health, social welfare and economic development. A global action plan was proposed for the prevention and control of non-communicable diseases, including chronic diseases of the respiratory tract.

According to the modern idea, bronchial asthma (BA) is a chronic inflammatory disease of the airways in which many cells and cellular elements play a role. Chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, (especially at night or in the early morning). These episodes are usually associated with widespread, but variable, airflow obstruction within the lung that is often reversible either spontaneously or with treatment [1].

OBJECTIVE. This study evaluated the effects of ebastine on serum eosinophil cationic protein (ECP) levels in patients with bronchial asthma. PATIENTS. Twenty patients with bronchial asthma and low efficiency of current therapy (11 patients with atopic disease and 9 with non-atopic disease) were enrolled in the study. METHODS. In an open-label design, all patients received ebastine 10 mg/day for 4 weeks and serum ECP levels, peripheral blood eosinophil counts, morning peak expiratory flow rate (PEFR) and thresholds for airway hyper-responsiveness (Dmin in asthgraphy) were determined before and after treatment. RESULTS. Serum ECP levels and peripheral blood eosinophil counts were significantly decreased. No significant change was found in the non-atopic patients, while the serum ECP level was significantly (p<0,001) decreased in the atopic patients. Furthermore, no significant change in Dmin was found, but PEFR was significantly (p<0,019) increased in the atopic type. CONCLUSION. Ebastine not only inhibits type I allergic reactions, but may also inhibit airway inflammation by reducing serum ECP levels, particularly in patients with atopic bronchial asthma.

Therapy resistant asthma (TRA) is most difficult to treat and its course is least predictable. TRA remains least studied despite the fact that its many mechanisms have been detected. There is still no clear definition of TRA phenotype, and the terminology has not been widely used so far. The purpose of the study was to evaluate the role of pharmacogenetic factors in therapy with glucocorticosteroids and β2-agonists in TRA patients and work out criteria for predicting therapy resistance based on genetic markers. The paper presents the results of the studies which helped to identify the phenotype of TRA taking into account its pathogenetic and clinical heterogeneity, to determine predictors of the disease and establish uniform criteria for diagnosis taking into account genetic determinants.

The most widespread bronchial obstruction diseases are bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Exacerbations of asthma and COPD are typically accompanied by acute bronchial obstruction syndrome (BOS). It is common knowledge that first-line drugs in the emergency care of patients with acute BOS are short-acting bronchodilators and glucocorticoids. Short-acting bronchodilators are used in the treatment of exacerbations, to prevent risk of exacerbation or as a symptomatic treatment of BA and COPD, in accordance with clinical and functional symptoms and the course of the disease (controlled, partly controlled, uncontrolled BA) [1] .

Osteoporosis (OP) is a progressive multifactorial systemic skeletal disease resulting from a loss of bone mass and damage of bone structure (microarchitectonics). Chronic obstructive pulmonary disease (COPD) and bronchial asthma (BA) are major contributors to the development of osteoporosis.

Disseminated lung diseases are still a difficult diagnostic problem. Modern endoscopic techniques for minimally invasive diagnostics allow to verify the diagnosis in more than 3/4 of patients. However, the incidence of diagnostic errors at initial evaluation without biopsy remains high. The reasons for errors are the actual complexity of differential diagnosis of disseminated processes, failure to properly examine the patients, late or insufficient use of high-resolution computed tomography and bronchoscopy with releveant biopsies.

Respiratory infection in cystic fibrosis develops in the first years of life and plays a key role in shaping the prognosis of the disease. Microbiology of respiratory infection in such patients is significantly different from that in patients without cystic fibrosis. Adequate antibiotic therapy with inhaled drugs can delay and sometimes even prevent the onset of chronic Pseudomonas aeruginosa infection, while significantly extending the years of qualitative life of patients with cystic fibrosis.

Infectious inflammatory diseases of the respiratory tract occupy the first place among infectious diseases. Pneumonia is the most common infectious cause of death in the world, making the problem of rational antibiotic therapy of respiratory tract infections no less relevant. A large arsenal of antibacterial drugs, on the one hand, increases the chances of treatment of various infections; on the other hand, doctors need specific knowledge about numerous antibiotics and their properties (action spectrum, pharmacokinetics, side effects, etc.).

Recent advances in immunology show that virtually all processes in the body and, consequently, all diseases are caused by immune disorders to a certain extent. The immune system recognizes and eliminates foreign compounds - antigenes, both exogenous and endogenous, while innate and acquired immunity regulates homeostasis [11, 12].

The latest, so-called respiratory, fluoroquinolones are a group of antimicrobial agents (AMA), most commonly prescribed for community-acquired lower respiratory tract infection (caLRTI), which is a relevant issue in routine clinical practice.

Each year acute bronchitis affects about 5% of the world population. Majority of patients seek medical care when symptoms become severe, especially in the first week of the disease. So far, acute bronchitis is a reason for one million doctor visits per year.

Materials of the concluding conference of young scientists of MSUMS named after A.I. Evdokimov, 2013