Инфекция и иммунитет. 2021; 11: 111-122
Основные и малые субпопулции лимфоцитов крови и цереброспинальной жидкости при менингитах у детей
https://doi.org/10.15789/2220-7619-MAM-1255Аннотация
Введение. Анализ современных литературных данных указывает на недостаточную изученность субпопуляционного состава лимфоцитов крови и цереброспинальной жидкости (ЦСЖ) при нейроинфекциях у детей. Установлено, что клетки основных популяций лимфоцитов делятся на множество малых (минорных) субпопуляций.
Цель данного исследования — изучить относительное содержание основных и малых субпопуляций лимфоцитов крови и ЦСЖ детей, переносящих серозный менингит (СМ) (вирусный) или гнойный менингит (ГМ) (бактериальный).
Материалы и методы. Методом проточной цитометрии проведено фенотипирование лимфоцитов крови и ЦСЖ детей в возрасте от 4 месяцев до 17 лет с диагнозом СМ (n = 86) и ГМ (n = 39). В качестве сравнения исследованы образцы крови и ЦСЖ детей, переносящих ОРВИ с синдромом менингизма (n = 27). Исследовано относительное содержание основных субпопуляций: CD3+ Т-лимфоцитов, Т-хелперов — CD3+CD4+ Th, цитотоксических Т-лимфоцитов — CD3+CD8+ CTL, натуральных киллеров — CD3-CD16+CD56+ NK, В-клеток — CD3-CD19+); малых субпопуляций лимфоцитов: двойных позитивных (DP) (CD3+CD4+CD8+), двойных негативных (DN) (CD3+CD4-CD8-) Т-клеток, NKT (CD3+CD16+CD56+), CD3-CD8+ NK, CD3+CD8dim и CD3+CD8bright).
Результаты. В остром периоде ГМ и СМ в крови и ЦСЖ выявлены достоверные отличия от группы сравнения в содержании основных и малых субпопуляций лимфоцитов. Характерным для субпопуляционного состава лимфоцитов крови при СМ явилось преобладание Т-клеток, Th, CTL, NK, NKT, DN, CD3-CD8+ NK, CD3+CD8bright и CD3+CD8dim при существенном более низком содержании B-клеток по сравнению с ГМ. В ЦСЖ детей с СМ превалировали Т-клетки и Th, тогда как количество B-клеток и CD3-CD8+ NK было ниже по сравнению с показателями при ГМ. В динамике заболевания также выявлены различия субпопуляционного состава ЦСЖ и крови в зависимости от нозологической формы при сохранении отличий от группы сравнения некоторых основных и малых субпопуляций лимфоцитов. Расчет соотношения «ликвор/кровь» для основных и малых субпопуляций лимфоцитов выявил в группе сравнения превалирование в ЦСЖ большинства субпопуляций (коэффициенты варьировали от 1,2 до 16,4), за исключением B-клеток, NK и CD3-CD8+NK, количество которых в ЦСЖ было сниженным по сравнению с кровью (коэффициенты варьировали от 0,07 до 0,31). При СМ и ГМ происходили различные изменения соотношения «ЦСЖ/кровь» для большинства исследованных субпопуляций в остром периоде и периоде реконвалесценции с характерными особенностями для каждой нозологической формы.
Заключение. Полученные результаты свидетельствуют о наличии особенностей в активации системного и интратекального иммунного ответа при серозных (вирусных) и гнойных (бактериальных) менингитах у детей и могут быть использованы в качестве дополнительного дифференциально-диагностического критерия.
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Russian Journal of Infection and Immunity. 2021; 11: 111-122
Major and minor lymphocytes subpopulations in peripheral blood and cerebrospinal fluid of children with meningitis
https://doi.org/10.15789/2220-7619-MAM-1255Abstract
Introduction. The analysis of current publications indicates at our insufficient understanding of subpopulation composition of lymphocytes in peripheral blood and cerebrospinal fluid (CSF) during pediatric neuroinfectious diseases. It has been found that the main lymphocyte populations are divided into many small (minor) subpopulations.
The purpose of this research was to assess percentage of major and minor blood and CSF lymphocyte subsets in children with aseptic viral meningitis (AM) or bacterial purulent meningitis (BM).
Materials and methods. Phenotyping of blood and CSF lymphocytes of children aged from 4 months to 17 years diagnosed with AM (n = 86) and BM (n = 39) was carried out by using flow cytometry. As a comparison group, we analyzed peripheral blood and CSF samples collected from children with acute respiratory viral infections (ARVIs) associated with syndrome of meningism (n = 27). There was evaluated percentage of the major cell subpopulations (CD3+ T-lymphocytes, T-helpers — CD3+CD4+ Th, cytotoxic T-lymphocytes — CD3+CD8+ CTL, natural killer cells — CD3-CD16+CD56+ NK, B-cells — CD3-CD19+), as well as minor lymphocyte subsets (double positive (DP) (CD3+CD4+CD8+), double negative (DN) (CD3+CD4-CD8-) T-cells, NKT (CD3+CD16+CD56+), CD3-CD8+ NK, CD3+CD8dim and CD3+CD8 8bright).
Results. It was found that the acute period of BM and AM vs. the comparison group (ARVI) was characterized by significant differences in the blood and CSF composition of major and minor lymphocyte subsets. In particular, blood T-cells, Th, CTL, NK, NKT, DN, CD3-CD8+ NK, CD3+CD8bright and CD3+CD8dim dominated in parallel with significantly lowered B-cell frequency in AM vs. BM. In the CSF of children with AM, T-cells and Th prevailed, whereas count of B-cells and CD3-CD8+ NK was lower compared to those in BM. In addition, further differences were revealed in CSF and blood cell subset composition depending on nosological entity, while maintaining differences in some major and minor lymphocyte subpopulations lacked in the comparison group. Calculating the CSF/blood ratio for the major and minor lymphocyte subsets uncovered the prevalence for the majority of cell subpopulations (the coefficients ranged from 1.2 to 16.4) in the CSF of the comparison group (ARVI), except B-cells, NK and CD3-CD8+ NK (coefficients ranged from 0.07 to 0.31). AM and BM were featured with various changes in the CSF/blood ratio found for most of the studied subpopulations in the acute period as well as the recovery phase highlighted with characteristic traits for each nosological form.
Conclusion. The data obtained indicate about finding specific features in the activation of systemic and intrathecal immune response during viral and bacterial meningitis in children, which may be used as an additional differential diagnostic criterion.
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