The composition of the intestinal microbiota, the level of lipopolysaccharides, TMAO in the blood, and other parameters of patients with COPD (n=50), asthma (n=50) and the control (n=40) will be assessed as factors associated with exacerbations and respiratory symptoms in the prospective study (12 months).

The patients from "Biobank of blood and feces for the development of a clinical and biological platform as a basis for an innovative approach to the prevention of chronic non-infectious diseases based on the composition of the intestinal microbiota" study will be included (cross-sectional study). The protocol of the above study included the assessment of socio-demographic, anthropometric data, clinical blood pressure (BP), ECG, blood tests, fecal microbiota studies, spirometry data, diet questionnaire. ABPM, HBP, other questionnaires (mMRC, CAT, ACQ-5, GMBQ) will be added to initial data (=visit 1). Than the four visits (2-5th visits) in 3 each months will be performed to assess respiratory symptoms, exacerbations of COPD/asthma, respiratory infections, therapy, BP, and other parameters. The standard statistical methods will be used.

Inclusion Criteria:

for control group:

• Normal spirometry results with bronchodilation test (salbutamol 400 mcg);
• Absence of COPD, asthma, chronic bronchitis and other lung diseases
• BMI<40kg/m2

for asthma/COPD groups:

• Primary medical documentation confirming the diagnosis of COPD or asthma
• Regular therapy for COPD, asthma and any chronic disease for at least 4 weeks prior to enrollment in this study.
• FEV1 / FVC <0.70 after inhalation of 400 mcg of salbutamol for patients with COPD
• BMI<40kg/m2

Exclusion Criteria:

• Exacerbation of chronic noninfectious diseases, including exacerbation of COPD / asthma, within 4 weeks prior to enrollment in this study.
• Exacerbation of COPD or asthma in the next 3 months, requiring the treatment of antibiotic therapy or systemic corticosteroids;
• Cerebral stroke, transient ischemic attack or myocardial infarction within 6 months before the date of enrollment in the study;
• Clinically significant chronic diseases (oncological, systemic diseases of the connective tissue, diseases of the blood system, heart failure, Crohn's disease, ulcerative colitis, etc. according to anamnesis);
• GFR <30 ml / min / 1.73m2;
• Atopy in a patient with COPD or a control group (any allergic manifestations - skin, nasal, conjunctival, food, etc.);
• Chronic respiratory diseases in a patient of the control group (COPD, asthma, chronic bronchitis, interstitial lung diseases);
• History of organ transplantation;
• Mental illness;
• Intestinal infection (food poisoning) in the next 3 months;
• Other acute infectious diseases. It is possible to turn on not earlier than 4 weeks after complete recovery and cessation of treatment;
• History of severe COVID-19;
• HIV infection, chronic viral hepatitis according to the history;
• Clinically significant oncological disease;
• Pregnancy and lactation;
• Alcoholism, taking narcotic drugs;
• Taking antimicrobial, probiotic drugs and systemic corticosteroids during the last 3 months;
• Genetic engineering / biological therapy.

Patients without COPD, asthma, chronic bronchitis and other lung diseases for control group. Patients asthma/COPD with for asthma/COPD groups.