IMMUNOLOGICAL REACTIVITY IN CHILDREN WITH CHRONIC GLOMERULONEPHRITIS

Abstract

Purpose. The purpose is to study the state of immunological reactivity in children with chronic glomerulonephritis. Patients and methods. 288 children with chronic glomerulonephritis were examined, of which boys accounted for 64.6%, girls — 35.4%. The mean age was 10.63 ± 3.88 years. Children are divided into 3 groups: Group I — 104 children with nephrotic form, Group II — 96 children with hematuric form, Group III — 88 children with mixed form. In the serum are identifi ed: CD3 + , CD4 + , CD8 + , CD16/56 + , CD19 + , CD95 + -subpopulations of lymphocytes; IgA, M, G; cytokines — IL-1β, IL-8, TNF-α, IFN-α, IL-4 and IL-10; the level of circulating immune complexes, the test for the reduction of nitrous tetrazolium (HST test), the phagocytic index and the phagocytic activity of neutrophils. Results. Immunological reactivity in children with chronic glomerulonephritis is characterized by a statistically significant increase in T-helpers (by 36.2% and 41.9% in nephrotic and mixed forms), apoptosis marker (by 50.5%, 51.7% and 65.4% respectively, in children with nephrotic, hematuric and mixed forms), parameters of humoral immunity, the level of circulating immune complexes (2.4, 2.2 and 2.6 times, respectively, in nephrotic, hematuric and mixed forms, p < 0.05), pro-inflammatory cytokines and decreased T-killers, B cells and phagocytic activity. At the same time, the degree of expression of immunoglobulin changes was higher with nephrotic (IgA 2.1 times, IgM 2.2 times, IgG 1.7 times, p < 0.05) and mixed forms (IgA 2.0 times, IgM 1.8 times, IgG 1.6 times, p < 0.05) with chronic glomerulonephritis. The level of TNF-α in children with a hematuric form exceeded the control ones by 3.9 times (p < 0.01), with the nephrotic and mixed form in 4.2 (p < 0.01) and 4.3 times (p < 0.01) respectively. The level of IL-1β and IL-8 was higher in nephrotic form in 2.0 and 1.5 times (p < 0.05), with hematuric — in 1.8 and 1.4 times (p < 0.05), at mixed — in 2.0 and 1.5 times (р < 0.05) accordingly. The average level of IFN-γ, regardless of the form of CGN, exceeded the control level by 1.8 times (p < 0.05). Conclusion. Children with chronic glomerulonephritis have an imbalance in the immune system. It should be noted that the very presence of chronic inflammation is accompanied by a violation of immunological reactivity. In children with chronic glomerulonephritis, hyperreactivity of immunity is noted.