Abstract
BACKGROUND: Acute ixodid tick-borne borreliosis tends to turn into a protracted and chronic course. This suggests studying the causes of the violation of the immune status of a sick person. The central structural unit of immunity is the lymphocyte. It is known that the formation of specific T-lymphocyte subpopulations is based on the central role of IL-2, leading to the restructuring of cellular metabolic pathways. The regulation of signaling pathways and lymphocyte metabolism primarily determines disease outcomes.
 AIM: This study determines the pathogenetic mechanisms of the infectious and inflammatory processes in the erythemal form of acute ixodid tick-borne borreliosis based on the study of the lymphocytic lysosomal enzyme activity, the level of IL-2, and the clinical disease manifestations.
 MATERIALS AND METHODS: The main group is represented by 609 patients hospitalized at the Krasnodar City Clinical Hospital from 2010 to 2019. The study group comprised 45 patients with an erythemal form of acute ixodid tick-borne borreliosis. In the dynamics of the disease, the level of IL-2 and the cytochemical activity of acid phosphatase and non-specific alpha naphthyl esterase of lymphocytes were determined.
 RESULTS: During the height of ixodid tick-borne borreliosis, a decrease in the cytochemical activity of hydrolytic enzymes of lymphocytes was noted compared with the control group. IL-2 levels had a high dispersion and were associated with clinical disease manifestations. A low level of IL-2 correlated with a decrease in the activity of alpha-naphthyl esterase lymphocytes. During the period of convalescence, there was a restoration of lymphocytic enzymatic activity and an increase in the number of cells with a pronounced activity of alpha-naphthyl esterase, typical of T-lymphocytes with killer activity.
 CONCLUSION: The hydrolytic enzymes of the lysosomes of acid phosphatase and alpha-naphthyl esterase lymphocytes enable judging the intensity of intracellular metabolic processes and, combined with clinical disease symptoms and IL-2 activity, are indicators of the state of the immune process, supplementing the results of traditional immunological studies in patients with the erythema form of acute ixodid tick-borne borreliosis. The predominance of enzymatically inactive forms of T-lymphocytes in the acute period of the disease reflects a specific deficiency of T-cell immunity.
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