Indicators of the immune status in patients with chronic wounds depending on the stage of the infectious process and the structure of the wound microbiota

Abstract

The results of immunophenotyping of peripheral blood leukocytes were analyzed in 105 patients with chronic wounds ( the main group , wound duration more than 3 weeks ) at various stages of the infectious process : colonization (n=39), critical colonization (n=37) and infection (n=29). The comparison group consisted of 22 patients with acute wounds ( wound duration up to 4 days ), in which microorganisms were not detected in the wounds . In the main group , changes in immunological reactivity were revealed in the form of an increase in the relative content of T- lymphocytes and a decrease in NK cells , lower indicators of early activation markers on T- helpers and T- cytotoxic lymphocytes (CD4+/CD38+/CD3+, CD8+/CD38+/CD3+, CD3+/ CD71+) and HLADR on B- lymphocytes , a high level of expression of late markers of T- cell activation (CD3+HLADR+). In the comparison group , the levels of expression of integrins (CD11a, CD11b, CD11c) on neutrophils and lymphocytes , as well as the transferrin receptor (CD71) on neutrophils , monocytes and lymphocytes were higher than in the main group . An increase in the activity of neutrophils in the form of expression of CD11a molecules was revealed with the progression of the infectious process in a chronic wound , which may be an additional diagnostic sign of the transition from the stage of colonization to the stage of critical colonization and infection . The highest values of CD11a and CD11c on neutrophils were recorded in the presence of S. aureus monocultures in chronic wounds , the lowest values were recorded when P. aeruginosa and A. baumannii monocultures were isolated from wounds .