Инфекция и иммунитет. 2015; 5: 63-70
СОСТОЯНИЕ КЛЕТОЧНОГО И ГУМОРАЛЬНОГО ИММУНИТЕТА В ЗАВИСИМОСТИ ОТ ИСХОДА РАСПРОСТРАНЕННОГО ГНОЙНОГО ПЕРИТОНИТА
https://doi.org/10.15789/2220-7619-2015-1-63-70Аннотация
Целью исследования явилось изучение состояния клеточного и гуморального иммунитета у больных с распространенным гнойным перитонитом (РГП) в зависимости от исхода заболевания. Обследовано 50 больных РГП внебольничного и госпитального происхождения. Исследование фенотипа лимфоцитов крови проводили методом проточной цитометрии. Концентрацию иммуноглобулинов и цитокинов определяли иммуноферментным методом. Установлено, что состояние иммунной системы при РГП характеризуется лейкоцитозом, относительной лимфопенией, увеличением концентрации провоспалительных цитокинов, а также снижением содержания цитотоксических и активированных Т-лимфоцитов. Состояние клеточного звена иммунной системы при неблагоприятном исходе РГП характеризуется снижением уровней γδТ-лимфоцитов и NKT-клеток при повышении количества В1-лимфоцитов. Состояние иммунной системы при благоприятном исходе РГП характеризуется снижением количества NK-клеток в периферической крови и повышением содержания Th2-лимфоцитов. Увеличение количества Th2-клеток определяет усиление стимулирующего влияния Т-клеточного звена на гуморальный иммунитет, что проявляется в увеличении концентраций IL-4 и IgA, что и является важным фактором в иммунопатогенезе РГП, определяющим его благоприятный исход.
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Russian Journal of Infection and Immunity. 2015; 5: 63-70
THE CELLULAR AND HUMORAL IMMUNITY STATE DEPENDING ON THE OUTCOME OF A WIDESPREAD PURULENT PERITONITIS
https://doi.org/10.15789/2220-7619-2015-1-63-70Abstract
The aim of the study was to examine the state of cellular and humoral immunity in patients with widespread purulent peritonitis (WPP) in depending on the disease outcome. The study involved 50 patients with community-acquired and hospital origin WPP. The testing of blood lymphocyte phenotype was performed by flow cytometry. The concentration of immunoglobulins and cytokines were measured by ELISA. It was established that the immune system state by WPP is characterized by leukocytosis, relative lymphopenia, increasing concentrations of pro-inflammatory cytokines, as well as decrease of the cytotoxic and activated T-lymphocytes content. The state of the cellular immunity in case of unfavorable outcome of the WPP is characterized by decreased of the γδT-lymphocytes and NKT-cells levels with increasing amounts of the B1-cells. The immune system state in case of a favorable outcome of the WPP is characterized by a decrease in the number of NK-cells in peripheral blood and increased levels of Th2-lymphocytes. Increasing of the Th2-cells number determines the increase in stimulating effects of T-cell on the humoral immunity, that is manifested in increasing concentrations of IL-4 and IgA, which is an important factor in the immunopathogenesis of the WPP determining its favorable outcome.
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