Changes in the organism of patients with chronic inflammatory diseases of the upper respiratory tract at different periods after administration of influenza vaccine. Message 1. Status of congenital immune parameters after a single anti-influenza vaccination

Abstract

Introduction: Studies of the clinical status, production of antibodies to hemagglutinins of influenza A and B viruses and the content of immune complexes in patients with chronic inflammatory diseases (CID) of the upper respiratory tract (URT) before and within 36 weeks of vaccination after parenteral vaccination Vaxigrip leads to a short-term (~ 6 months) increase in anti-influenza hemagglutinin t itres. According to modern ideas about the mechanisms of antiviral protection, in addition to humoral, mainly due to antibodies, antiviral protection is largely due to the activation of innate immune factors, both systemic and local. Aim: to evaluate in the dynamics of observations the influence of a single parenteral influenza vaccination on the factors of innate immunity in patients with chronic inflammatory diseases of the upper respiratory tract. Material and methods: Among the factors of innate immunity a significant role is played by interferons, the activity of natural cytolytic cells (NK) of various histogenesis, phagocytic cells and non-specific proteins such as defensins, elafins. Therefore, quantitative and functional characteristics of NK-cells, phagocytic absorption activity of polymorphonuclear leukocytes (PMN), systemic content of γ-interferon (IFN-γ) were studied in patients at the systemic level. At the local level, the concentrations of defensin-β and α-interferon were studied in mucosa secretes (MS) according to modern ideas about the state of the mechanisms of innate antiviral immunity. From the autumn-winter period of 2019 to November 2020, 32 donors (control group) and 32 patients with CID of both sexes were examined, 11 of whom were diagnosed with chronic rhinosinusitis, 9 with chronic tonsillitis, and 12 with chronic pharyngitis. No vaccinations were given 1 year before the study. Samples of venous serum and oropharyngeal secretes of all clinically healthy patients, as well as persons with CID were obtained at the initial examination. After parenteral vaccination with Vaxigrip (SANOFI PASTEUR, S.A., France), blood and MS were tested twice more in vaccinated patients: 12 and 36 weeks after vaccination. The obtained samples of experimental material were stored at a temperature of -20 C◦ until the simultaneous determination of innate immune factors (interferons), in particular with the help of reagents from Cytokine, Hema Medica (RF), defensin-β (Hucalt-bio, the Netherlands). Measurements were performed on a microplate enzyme-linked immunosorbent assay "STAT FAX 2100 (USA). Statistical processing was performed using the non-parametric criterion "U" - Mann-Whitney or Fisher's exact method. Differences were considered statistically significant at p <0.05. The results were given in the form of arithmetic mean (M), median (Me) and percentiles (P25-P75). Results: In determining the role of innate immunity factors in vaccination with influenza vaccine, we conducted clinical and immunological examination of patients with chronic inflammatory diseases of the upper respiratory tract, which included systemic determination of γ-interferon, quantitative and functional activity of natural cytotoxic cells, phagocytosis activity at the stage of attraction and capture. Levels of α-interferon and defensin-β in oropharyngeal secretion (MS) were studied. It was found that before influenza vaccination in patients with chronic inflammatory diseases of the upper respiratory tract found an increased content of γ-interferon and decreased phagocytic activity of polymorphonuclear leukocytes. Decreased α-interferon and defensin-β concentrations were detected in MS patients before vaccination. After vaccination, there were positive changes in the direction of increasing the concentration of nonspecific local immunity factor – defensing 1β and partly in the observation period of 3 months after vaccination- α-interferon. Сonclusion: Among the factors of innate immunity in patients with CІD at the systemic level, decreased cytolytic activity of NK, increased levels of γ-interferon and decreased phagocytic function of neutrophils. Decreased concentration of α-interferon and defensin-1β is determined in the saliva of patients with CID. Vaccination of patients with chronic inflammatory diseases of the upper respiratory tract with influenza vaccine has a positive effect on the state of innate immune factors of local and systemic level: concentration of γ-interferon, phagocytic activity of neutrophils and enhancing the functional activity of natural killer cells, increase in saliva of defensin-1β.