Хирургия как метод иммунокоррекции

Abstract

Deformity of the uterine cervix is often accompanied by immunological disorders in the cervical mucus, chronic inflammation, cellular changes in the columnar epithelium with several other changes, which eventually leads to the failure of the cervix as a “biological valve” of the female reproductive system. Identification of the pathogenesis underlying the development of these disorders is an important task for modern gynecology aimed at restoring the function of the cervix. Objective. To provide pathophysiological rationale for reconstructive plastic surgery as a method of correction of mucosal immunological homeostasis. Patients and methods. A total of 94 women were examined: 64 of them (the study group) underwent cervical reconstructive surgery by the flap technique of complete layer-by-layer dissection; 30 women were included in the control group. The levels of immunoglobulins and proinflammatory cytokines in the cervical mucus were determined in all patients of the study group before surgery and 6 months after it. Immunological tests were also performed in the control group (once). Results. Satisfactory surgical outcomes were achieved among all observations. The analysis of immunoglobulins and cytokine profile showed that immunological parameters were restored in 90% of patients with initially “moderate” abnormalities and in 75% of patients with initially “severe” abnormalities. Conclusion. The efficacy of reconstructive surgery using complete layer-by-layer dissection technique for cervical deformity in restoring the immunological homeostasis of the cervical mucus was proved, and the pathophysiological mechanisms of this effect were substantiated. Key words: cervix, cervical mucus, deformity, immunoglobulins, cytokine profile, immunological homeostasis