Immunological changes in patients with community-acquired pneumonia with concomitant coronary artery disease during treatment with Simvastatin

Abstract

Introduction. Immunological changes in the elderly people with concomitant diseases affect all major parts of the immune status (cellular and humoral immunity, mucosal immunity, the complement system, and so on). With features of immune system in the elderly people related some of clinical problems: hypersensitivity to non- and intra-hospital infections, subacute infection that increases concomitant diseases, especially cardiovascular. Aim of this work was determination of the characteristics of immunological changes in patients with community-acquired pneumonia and concomitant coronary heart disease and their dynamics during treatment with Simvastatin. Material and methods. 50 patients with community acquired pneumonia the third group and 30 healthy individuals were included in an open prospective study. Immunogram definition was made by lymphocytes phenotyping tests rosette of particles coated with monoclonal antibodies. Immunoglobulin G, A, M were determined by radial immunodiffusion Agar gel by Mancini using monospecific sera. Also absorption capacity of the neutrophil count phagocytic index, phagocytic index, neutrophil bacterial activity by a test restore them of nitroblue tetrazolium were defined. Results. Subanalysis in patients with pneumonia with concomitant coronary artery disease, who were randomly assigned to receiving simvastatin, after treatment showed a statistically significant increase of IgG to 18.6% (p=0.02) of 9.57±4.64 to 11.36±3.7. The rest of the performance was not likely changed. After treatment of pneumonia with concomitant coronary artery disease treated and not treated with Simvastatin group the following immunogram indicators significantly differed: the relative number of lymphocytes, the number of CD8 relative and absolute number of CD22 cells, complement activity, completion of the index of phagocytosis. Thus in patients receiving Simvastatin after treatment were lower rates relative number of CD8 cells by 38% (p=0.037) – 18.2±7.38 vs 25.1±8.0; complement activity by 33% (p=0.03) – 66.9±14.8 vs 89.0±17.8; the absolute number of CD22 cells by 26.7% (p=0.005) – 17.68±7.03 vs 24.11±5.87; completion phagocytosis index by 6.3% (p=0.01) – 0.89±0.10 vs 0.95±0.11; and was higher by 36% (p=0.02), relative number of lymphocytes (27.07±5.94 vs 17.32±7.26), than patients who did not receive simvastatin. Conclusions. The Simvastatin use in the treatment of patients with community acquired pneumonia with concomitant coronary artery disease is accompanied by the following positive changes in the immunogram: reducing the number of stick-nuclear leukocytes by 52% and 36% of ESR, increasing content of IgG 18.6%. However, patients with coronary artery disease who did not use Simvastatin in the treatment of pneumonia, had further growth in immuno-reactivity index by 4% and reduction of IgG 12.6%. Immunogram in patients with coronary artery disease who received Simvastatin After a course of treatment was characterized by significantly lower performance of the relative number of CD8 cells by 38% (p=0.037); complement activity by 33% (p=0.03); the absolute number of CD22 cells by 26.7% (p=0.005); completion phagocytosis index by 6.3% (p=0.01); and higher by 36% (p=0.02) relative quantity of the number of lymphocytes than in patients who did not receive Simvastatin. The article presents data of changes in immune status in patients with community acquired pneumonia. There are positive changes in the cellular link of immunity in these patients. In pneumonia patients with concomitant coronary artery disease indicators of immuno- cellular reactivity after Simvastatin treatment were not changed significantly, but humoral immunity has been changed towards in growing of Ig G and M content.