Immunodiagnostics, immunotherapy and immunoprophylaxis in the department of otolaryngology. Message 1. Optimal indicators of systemic immunity in assessing the clinical and laboratory status of patients with inflammatory diseases of the upper respiratory tract (analytical generalization)

Abstract

Introduction: 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 current trends in assessing the immunological status, conditional variants of deviation from the norm, a decrease in the number of cells from the average statistical norm of the region and control parameters in the performing laboratory by 1.5 or 2 times were adopted, since deviations are within 30-60 % are borderline and quite easily compensated by the body. The aim of the work was to conduct an integrated analysis of data to determine the state of systemic immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal informa-tional indicators. Materials and methods: Immunological methods were used to examine 260 people with inflammatory pa-thology of the upper respiratory tract, of which 82 had chronic tonsillitis, 76 with chronic rhinitis, 70 with chronic pharyngitis and 32 people made up a control group of healthy donors. The age of the subjects ranged from 16 to 60 years, the duration of the disease from 1 year to 5 years, female patients predominated (≈60%). Examinations were conducted in the clinical remission stage. When assessing systemic immunity, the number of T-lymphocytes (CD 3, 4, 8), B-lymphocytes (CD22), NK (CD56), monocytes (CD14), concentration of immunoglobulins of classes M, G, A, E, cytokines with regulatory properties, interferon-γ-IL4 were determined. Functional tests in assessing systemic immunity are presented by determining the cytolytic activity of blood mononuclear cells in relation to avian xenogenic red blood cells and the activity of phagocytic blood cells in relation to latex particles at the absorption stage. Statistical processing was performed using the angular transfor-mation method "φ" according to Fisher and the "one-sided" criterion "U" Wilcoxon. Results: Based on a wide range of immunological studies in patients with chronic diseases of the upper respiratory tract, it seems most appropriate to use the following laboratory tests to assess systemic immunity to determine the characteristic deviations in the immune status of patients: High diagnostic value: - decreased serum IgA concentration (<0.5 g/l); - low level of activity of ECC of blood (<20% for xenoerythrocytes); - increased level of interleukin-1β (> 25 pg/ml); Relative diagnostic value: - determination of the degree of dysimmunoglobulinemia in serum; - increased titers of antibodies to streptolysin-O, other microbial antigens; - increased serum IgM. Conclusion: The developed criteria and approaches in assessing systemic immunity in patients with in-flammatory diseases of the upper respiratory tract can be used to examine patients and assess the effectiveness of the treatment.