The impact of some non-drug treatments on the state of endotoxin-binding systems and level of systemic inflammation in patients with bronchial asthma in post-COVID period

INTRODUCTION: Bronchial asthma (BA) is one most common disease in the world, with complete control not exceeding 50%. A relevant research trend is the search for new methods of achieving control over BA, taking into account personalized approach.

AIM: Based on laboratory markers of endotoxin-binding systems and systemic inflammation, to evaluate the effectiveness of magnetic therapy (MT) and ‘dry’ carbon dioxide baths (DCDB) in combination with grape polyphenols (GP) in spa treatment of BA patients with past coronavirus infection.

METHODS: Patients (n=75) undergoing spa treatment in the Pulmonology Department of the Sechenov Academic Research Institute of Physical Treatment Methods, Medical Climatology and Rehabilitation, were divided into 3 groups: group 1 (n=25) — patients who additionally received MT and GP concentrate during treatment, group 2 (n=25) — DCDB and GP concentrate, group 3 (n=25) — only standard spa treatment. Before admission and after treatment, blood plasma was collected for analysis for the following markers: C reactive protein (CRP), bactericidal permeability increasing protein (BPI), lipopolysaccharide-binding protein (LBP), lipopolysaccharide, soluble form of CD14 protein (sCD14), zonulin.

RESULTS: The CRP level decreased only in group 1 — from 2.93 to 1.93 mg/l (p=0.011). The BPI level increased in all groups: in group 1 — from 65.50 to 70.70 pg/ml (p=0.012), in group 2 — from 57.60 to 95.00 pg/ml (p <0.001), in group 3 — from 64.90 to 88.30 pg/ml (p=0.008). The level of sCD14, which was initially absent in the blood of patients, after spa treatment increased to 1.54 ng/l in group 1 (p=0.003), to 7.20 ng/l (p <0.001) in group 2 and to 6.40 ng/l (p <0.001) in group 3. The level of zonulin increased several-fold in all groups: in group 1 — from 4.94 to 275.60 ng/ml (p <0.001), in group 2 — from 0.20 to 40.70 ng/ml (p <0.001), in group 3 — from 0.90 to 127.50 ng/ml (p=0.002).

CONCLUSION: Use of magnetic therapy and ‘dry’ carbon dioxide baths in combination with grape polyphenol concentrate enhances the effectiveness of classic spa treatment in patients with BA with past coronavirus infection: it activates endotoxin-binding systems and inhibits increased intestinal permeability. Magnetic therapy also reduces systemic inflammation.