Особенности нетотической активности лейкоцитов у больных с хроническим тонзиллитом

Abstract

The proportion of patients with chronic tonsillitis (CT) who visit otorhinolaryngologists in outpatient practice ranges from 4 to 35%. Increasingly, opportunistic microflora acts as a source of inflammation. An aggravating factor in the development of a chronic focus of inflammation is a change in the activity of the immune response. A few years ago, a new mechanism of behavior of human phagocytic cells in the implementation of nonspecific immunoreactivity was discovered – that is, formation of neutrophil extracellular traps (NETosis), associated with the adoption of a suicidal decision by the cells, in which chromatin is deconcentrated, and neutrophil extracellular traps (NEТs) are formed, which are released into the surrounding tissues for capturing pathogens and exposing them to high doses of antimicrobial proteins and enzymes. The significance of this immune mechanism and its role in the pathogenesis of СT remains unexplored. To date, laboratory methods for assessing the health status of patients with CT demonstrate insufficient specificity and accuracy. It remains relevant to develop a method for examining CT patients, which would allow the doctor to clearly establish the form of the disease, select the treatment, and adequately assess the health of the patient with CT during the follow-up care. Such a method, in our opinion, can be an assessment of the level of NETs in the blood and on the surface of the lacunae of the palatine tonsils (PT). 71 patients (median 38±9.86 years) were examined. The control group consisted of 54 practically healthy volunteers (median 38±10,9 years). The NETosis activity of leukocytes was evaluated in parallel in whole blood and smears from the surface of the lacunae of the PT. The data obtained indicate the undeniable diagnostic significance of the NETosis activity, considering the presence of a direct relationship with the form of CT. Therefore, the assessment of the level of NETosis can be proposed as a promising laboratory criterion for the severity of the patient’s condition, predicting the course of the disease and the effectiveness of the treatment.