Clinical and experimental studies of immunо-infl ammatory mechanisms of anthracosilicosis formation

Abstract

Introduction. In the structure of occupational diseases of employees of the main professions of the coal industry, respiratory diseases are widespread, in the process of formation of which the key role belongs to the immune system of the body. Early manifestations of the development of professional pathology, as a rule, remain unnoticed, and therefore there is a need to study the pathogenetic mechanisms underlying its formation, not only in clinical, but also in experimental conditions, allowing to assess the premorbid state of the body for timely diagnosis and treatment and prevention.The aim of the study is to study the immune-infl ammatory mechanisms of anthracosilicosis formation on the basis of clinical and experimental studies.Materials and methods. We examined 204 miners working in underground conditions with a signifi cant dustiness of workplaces exceeding the maximum permissible concentration by 10 or more times. Th e main group consisted of 115 workers with a previously established diagnosis of “anthracosilicosis”. Th e comparison group was formed from 89 miners without a diagnosis of respiratory pathology, working in similar sanitary conditions. To assess the dynamics of immuno-infl ammatory mechanisms in the experiment, modeling of dust pathology of the lungs was performed on 310 white male laboratory rats (220-experimental and 90 — control).Results. In patients with anthracosilicosis, the development of immune failure of humoral immunity mechanisms was revealed, which was manifested by a signifi cant decrease in the level of serum IgG against the background of an increase in the absolute and relative number of B-lymphocytes. Th e formation of anthracosilicosis is characterized by the active development of the immuno-infl ammatory process (an increase in the level of pro-infl ammatory cytokines and proteins of the acute phase of infl ammation), the severity of which increases when the disease is complicated by respiratory failure. Activation of the synthesis of anti-infl ammatory IL-4, which is a powerful inhibitor of macrophage infl ammation and slows down the processes of fi brosis in the bronchopulmonary system, acts as a protective mechanism that prevents the formation of respiratory failure in miners with anthracosilicosis. Experimental modeling of anthracosilicosis revealed phase changes in the immune response. In the early period of exposure to dust factor was observed activation of humoral (increased level of all classes of immunoglobulins) and the subsequent development of the inflammatory process (increased concentrations of acute phase proteins of inflammation) in the background of the balance between subpopulations of T-lymphocytes to ensure proper development of protective immune response. Long-term intake of antigen was characterized by violations of humoral immunity, the predominance of cell-type reactions and the chronization of the infl ammatory process.Conclusions. Th e study of immuno-infl ammatory mechanisms of anthracosilicosis formation in clinical and experimental conditions indicates the activation of urgent adaptation and maintenance of compensatory and adaptive reactions of the body in the early period of contact with dust antigen. Th e chronic form of anthracosilicosis is characterized by an imbalance of regulatory mechanisms, ineffi ciency of local immunity and the intensive development of generalized immune infl ammation, which increases with the addition of infection and complication of respiratory failure.