Immunodiagnostics, immunotherapy and immunoprophylaxis in the clinic of otolaryngology. Message 2. Indicators of local immunity in assessment of clinical and laboratory status of patients in inflammatory ENT diseases (Analytical summary)

Abstract

Topicality: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account modern trends in assessing the immunological status, a mandatory component is to determine the state of local immunity in the upper respiratory tract. Aim: to conduct an integral analysis of data to determine the state of local immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal necessary informative indicators. Materials and methods: A generalization of the data of immunological studies of 168 people with inflammatory pathology of the upper respiratory tract (VDS) was carried out, of whom 42 had chronic tonsillitis (CT), 36 – chronic rhinitis (HR – catarrhal form), 40 – chronic pharyngitis (CP), 28 – secretory mean otitis media (CO), 22 people made up the control group (C) of practically healthy donors. The age of the surveyed was from 14 to 60 years, the duration of the diseases was from 1 to 5 years, female patients predominated (~ 60%). The examination was carried out at the stage of clinical remission. The material for the research was mixed saliva, in which the content of immunolobulins and citrokines was investigated by the ELISA method: enzyme immunoassay, the following factors of immunity and inflammation in the CGS were determined: - secretory and monomeric form of immunoglobulin A (Hema Medica, RF); - immunoglobulins of classes G, M (Hema Medica, RF); - interleukins – 1β; 4; 8; 10 (Cytokine, RF); - interferons α and γ (Cytokine, RF); - pro- and defensins (Nucalt bioteknology, Netherlands); - macrophage inflammatory protein-Mip-1b (Assauro, USA); - salivary lysozyme (Diagnostik Nord, Germany). Statistical processing was carried out using the methods of Student’s t-criterion and angular transformation “φ” according to Fisher. Results: Integral of all methods for determining various types of immunity in diseases of the upper respiratory tract with a chronic course is the insufficiency of factors of both innate and acquired immunity, especially during the period of clinical remission of the disease. A special role in protective reactions belongs to the humoral component, in which the most stable indicator is the level of class A secretory immunoglobulin; it has been shown that almost all the studied components of the immune response had abnormalities in the presence of a chronic inflammatory process in the upper respiratory tract and they can be presented as a line the degree of decrease in the frequency of deviations: secretory IgA, IgG., pro-inflammatory cytokines (IL1β and IL-8), γ-interferon, lysozyme, defensin-β, Mip-1b. Conclusion: The developed criteria and approaches to assessing systemic immunity in patients with inflammatory diseases of the upper respiratory tract can be used in examining patients and assessing the effectiveness of therapy.