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    LEUKOTRIENE RECEPTOR ANTAGONISTS IN MANAGING SEVERE UNCONTROLLED ASTHMA
    (European Medical Group, 2017-08-03)
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    Goseva, Zlatica
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    Gjorchev, Angelko
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    IL-33 in patients with severe uncontrolled allergic asthma
    (European Respiratory Society, 2017-09)
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    Goseva, Zlatica
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    Angelko, Gjorcev
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    Analysis of Plasma Concentrations of Theophylline in Smoking and nonsmoking Patients with asthma
    (Scientific Foundation SPIROSKI, 2015-12-15)
    Zlatica Goseva
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    Angelko Gjorcev
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    Biserka Jovkovska Kjaeva
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    Correlation between plasma levels of IL-33 and Vitamin D in patients with severe uncontrolled allergic asthma
    (European Respiratory Journal, 2017-09)
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    Gjorchev, Angelko
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    Goseva, Zlatica
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    Relationship between Vitamin D, Inflammation and Lung Function In Patients with Severe Uncontrolled Asthma
    (Scientific Foundation SPIROSKI, 2017-12-15)
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    Jovkovska-Kaeva, Biserka
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    Breskovska, Gorica
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    Goseva, Zlatica
    BACKGROUND:Recently epidemiological studies showed that low vitamin D is linked toairway hyperresponsiveness, decreasedlung function, poor asthma control, and steroid–resistant asthma.AIM:We investigatedtherelationshipbetween Vitamin D, inflammation with circulating IL-33 and lung function in 30 patients with severe uncontrolled asthma. MATERIALS AND METHODS:The study included 30 patients with severe uncontrolled asthma. In each of them were measured serum levels of IL-33 and Vitamin D by the ELISA method. The pulmonary function is measuredby basic spirometry parameters, FEV1. The results were statistically elaboratedaccording to the Pearson’s Correlation Tests. RESULTS:The results showed statistically insignificant correlation between Vitamin D and IL-33, and Vitamin D with FEV1 (Vit.D/IL-33; r=0.11323, p=0.551); (Vit.D/FEV1; r=-0.1005; p=0.597) Correlation between IL-33 and FEV1 is negative but statistically significant (IL-33/FEV1; r=-0.5248; p=0.003). CONCLUSION:Because there arelittle studies about the link between vitamin D and asthma, further research toclarify the mechanism how vitamin D control the activity of CD4+ T cells and the related Th2-type cytokines in the parthenogenesis of asthma.
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    Biomarkers of Inflammation in Peripheral Blood during Treatment with Inhaled Corticosteroids in Patients with Asthma
    (ID-Design/Scientific foundation SPIROSKI, 2016-12-23)
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    Todevski, Dejan
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    Debreslioska, Angela
    BACKGROUND: The main attribute of asthma is inflammation, which leads to airway remodelling, bronchial hyper-reactivity and reversible or partly reversible airway obstruction. According to GINA, asthma is a chronic inflammatory disorder of the airways in which many cells play a role, in particular, mast cells, eosinophils (Eo), and T lymphocytes. Many cells and mediators take part in creating the asthmatic inflammatory reaction, but eosinophils play a central role.AIM: The aim of this study was to show the values of biological inflammatory markers (IL-5, Eo, and ECP) during treatment with ICS by non-invasive methods.MATERIAL AND METHODS: This study includes 30 patients of the Pulmonology and Allergology Clinic, Skopje, with confirmed asthma, treated with ICS. In all of the patients, we followed Eo count, ECP and IL-5 in peripheral blood at the beginning of the study, after 2 and six months treatment. Following the parameters during treatment with ICS we registered changes in all of the tested parameters.RESULTS: Our results show high level of the tested biomarkers at the beginning of the study, IL-5 in all patients (100%), Eosinophils in 80%, and ECP in 90% of the asthmatics. Following the parameters during treatment with ICS we registered changes in all of the tested parameters.CONCLUSIONS: Our conclusion is that the ICS objectively suppress the inflammatory reaction in asthma and the biologic markers (IL-5, Eo and ECP), which we have followed, can measure the accomplished effect. They could be used in everyday practice, not only as diagnostic parameters but also as valid therapeutic guides in the treatment of asthma.
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    Evaluation of IL-8 and MEF25-75 in patients with severe COPD who were treated with combined therapy of ICSs / LABAs plus tiotropium bromide
    (Europian Respiratory Society, 2013)
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    Zlatica Gosheva
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    Angelko Gjorchev
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    Suzana Arbutina
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    The aim of this study was to determine the effect of combined therapy of ICSs/LABAs plus tiotropiumbromide in patients with COPD, by analyzing of IL-8 and MEF25-75 at the beginning and after 6 months oftherapy. The study included 33 patients with severe COPD. In each of them were measured serum IL-8levels by the ELISA method and MEF25-75 which are indicated the small airways obstruction. They weretreated with combined therapy of ICSs/LABAs (500mcg) plus Tiotropium Bromide (18mcg) daily in durationof 6 months. The results were statistically elaborated according to the T-test for Dependent Samples. Theobtained results of IL-8 showed that the level of IL-8 before the start of therapy were much higher and thattreatment significantly reduces their value (t=3.13, p=0.003, p<0.05). The results of MEF 25-75 at the startof therapy were lower and after 6 months of treatment showed a slight improvement of lung function butstatistically insignificant (t= -0.83, p=0.41,p<0.05). The concentration of IL-8 is closely related with airwayobstruction in patients with COPD and may serve as a marker for evaluating the severity of airwayinflammation. ICSs/LABAs and tiotropium bromide have inhibitory effect on neutrophilic inflammationthrough the suppression of IL-8 production from epithelial cells and thus may contribute to lower cellularinflammation in COPD. Because it is a progressive disease and airflow limitation is not fully reversible, wecannot expect spectacular results like we show with the value of MEF25-75, but should strive to preventprogression and reduce airway remodeling with education, pharmacologic and non pharmacologic treatment
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    ROLE AND CLINICAL SIGNIFICANCE OF IL-33 IN PATIENTS WITH ASTHMA
    (Macedonian Medical Association / Walter DeGruyter, 2017)
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    Gjorchev, Angleko
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    Kaeva, Biserka
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    Goseva, Zlatica
    Introduction. Asthma is a chronic inflammatory disease of the airways in which many cells play a role with secreting a variety of mediators responsible for the clinical manifestation of asthma. It is assumed that IL-33 is one of the earliest-released mediators and can orchestrate the immune cascade of the disease. The aimof this study was to examine the role and clinical significance of IL-33 as a new and insufficiently explored mediator of inflammation in patients with uncontrolled moderate asthma. Methods. The study included 87 patients with asthma. Serum IL-33 was measured in all patients by ELISA method. The obtained data were statistically analyzedusing the Kolmogorov-Smirnov and ShapiroWilk's test. Qualitative data were presented in absolute and relative numbers, and quantitative data were presented with measures of descriptive statistics. Statistically significant values were considered for p <0.05. Results. Majority of included patients were female (75.86%). The average age of patients was 42.3±15.9 years. The results of IL-33 in all patients were significantly increased compared to the reference value of IL-33 which is 0 pg/ml. The average values of IL-33 ranged from 6.47±29.3 and they were insignificantly higher in the group with female patients compared to males (p=0.27), and insignificantly correlated with age (p=0.26). Conclusion. Even though a limited number of studies have explored the IL-33, results have shown higher serum level of IL-33 in asthma patients compared to healthy people, emphasizing the fact that IL-33 is an attractive candidate for targeted therapy and prognosis in asthma patients.