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Structural and metabolic changes were explored in 68 main bronchial mucosal biopsy specimens from 31 patients with fibrocavernous pulmonary tuberculosis. It was shown that He-Ne laser endobronchial therapy induced proliferative and metabolic processes (as judged from the level of DNA and RNA syntheses) in the damaged epithelium, which restored its structure and differentiation into celiary and goblet cells with normal ultrastructure having undergone a number of transitional forms. The proliferative and metabolic activity of endotheliocytes and stromal cells increased in the intrinsic layer of the mucosa, which was accomplished by formation of soft fiber connective tissue.

Seventy specimens of bronchoalveolar lavage were obtained from 30 patients with pulmonary tuberculosis during treatment with endobronchial laser. The lavage is shown to undergo marked qualitative and quantitative changes in response to He-Ne laser treatment: the proportion of macrophages goes up while that of neutrophils tends to a decrease. The laser is capable to induce metabolic and proliferative activity of alveolar macrophages indicated by RNA and DNA synthesis. Morphological alterations in the cells of the respiratory compartment suggest weakening of exudative-necrotic component of the inflammation as an underlying cause of laser efficacy.

The effectiveness of endobronchial low-energy laser therapy was studied in 28 patients with chronic nonobstructive bronchitis concurrent with thinning of bronchial mucosa. The course of treatment made it possible to obtain positive dynamics of most parameters of immunologic reactivity in CNB patients. Systemic immunity parameters, except for the NST and concentration of circulating immune complexes, underwent essential normalization. Marked positive changes were found in the parameters characterizing functional activity of alveolar macrophages: there was a 2.5-fold increase in adhesive properties and over 1.3-fold increase in the percentage of phagocytes. The level of secretory IgA rose significantly (by 3.5 times). Hence, a manifested therapeutic effect of this therapeutic method is mainly associated with its immune-stimulating action.

The results of a dynamic examination with the use of an electron microscope of semi- and ultrathin sections of the epithelial lining of the respiratory tract in the experimental dogs under endobronchial treatment of nonspecific endobronchitis with varying doses of low-energy radiation from helium-neon laser are presented. It was proved that the outcomes of regeneration of the bronchial mucosal membrane epithelium under endobronchial treatment of purulent endobronchitis with low-energy radiation of the helium-neon laser much depend both on exposure time (single doses of energy), and multiplicity (cumulative dose of energy), and the period after the laser therapy. The most favourable regeneration takes place under 5-minute (single dose of 4.5 J) radiation with 8 to 9 sessions (cumulative dose of 23.1 +/- 1.5 J). A regeneration most close to the normal condition of the bronchial mucous membrane epithelium is achieved at 2.5-3d months after the onset of the experiment (or a month after the laser therapy).

The rate of mucociliary transport (MCT) in dogs with an experimental pulmonary tuberculosis and concurrent suppurative endobronchitis (SEB) and just with the latter was measured. The treatment effect was achieved by an endobronchial radiation with a CO2-laser unfocused beam of 3.56 and 5.3 w/cm2 power density, and the dogs in the control group were subjected to an endobronchial introduction of furagin. A comparison of the endoscopic picture and MCT rate findings made it possible to believe that the latter index appeared to be more reliable than a visual inspection of the bronchial mucous membrane. An active specific process in the lungs brings about MCT rate inhibition while the concurrent SEB aggravates these changes to a great extent. The radiation of the bronchial mucous membrane with the CO2-laser unfocused beam produces an immediate positive effect on MCT rate normalization. Better results were observed at a power density of 3.56 w/cm2.

Results of endobronchial treatment of experimental purulent endobronchitis (PE) in dogs with low intensity He-Ne laser are presented. The endobronchial use of the laser energy in treatment of PE was shown expedient and valid. Comparison of the visual endoscopic picture with the findings of the histochemical and electron microscopic examination of the bronchial mucosa bioptates in the time course of the treatment provided establishment of the optimal regimen for the treatment of nonspecific PE with He-Ne laser.