International Medical Journal, Vol. 23., Iss. 3, 2017, P. 22−27.
THE ROLE OF APOPTOSIS IN THE COMBINED COURSE OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND TYPE 2 DIABETES MELLITUS
Kharkiv National Medical University, Ukraine
The review presents an analysis of literature on the pathogenesis of chronic obstructive pulmonary disease and type 2 diabetes mellitus. The presence of these pathologies mutually complicates their course and worsens the prognosis. Relevance of studying the comorbidity of COPD and type 2 diabetes mellitus, the activity of apoptosis mechanisms in these pathologies is emphasized. The actual markers of dysregulation of apoptosis of cells in the lungs and the events associated with it were identified. Controlled apoptosis is considered today as the main mechanism for maintaining the optimal balance of cells in the focus of inflammation, limiting the expansion of activated clones and preventing the development of autoimmune reactions. To assess the programmed cell death, the number of lymphocytes and neutrophil granulocytes expressing the markers of apoptosis −− CD95, CD95L and Bcl2 −− was detected. Dysregulation of apoptosis of cells in the lungs and events associated with it can play an important role in the pathogenesis of COPD. In a physiological state, neutrophils die with apoptosis, followed by phagocytosis of apoptotic bodies by macrophages. Delayed apoptosis of leukocytes may lead to overproduction of oxygen metabolites and proteolytic enzymes that cause tissue damage. The cause of progression of type 2 diabetes mellitus is persistent hyperglycemia, which leads to the development of oxidative stress in many tissues and, as a consequence, to the development of complications of diabetes mellitus. Literature analysis showed that today the effect of apoptosis in the combined course of COPD and type 2 diabetes is poorly understood. Detection of new apoptosis markers can deepen the knowledge of the pathogenesis of these diseases as well as optimize the diagnosis and develop new approaches to the treatment of COPD patients with concomitant type 2 diabetes mellitus.
Key words: chronic obstructive pulmonary disease, type 2 diabetes mellitus, apoptosis.