PHAGOCYTIC ACTIVITY AND BLOOD NEUTROPHILS RESPIRATORY BURST STATE FEATURES AMONGST WIDESPREAD PURULENT PERITONITIS PATIENTS IN THE POSTOPERATIVE PERIOD DYNAMICS

Abstract

The research aim was to study the phagocytic activity and the blood neutrophils respiratory burst state amongst the patients with widespread purulent peritonitis (WPP) in the dynamics of the postoperative period. The study was involved patients with acute surgical diseases and injuries of the abdominal organs complicated by WPP. Blood sampling was performed prior to surgery (pre-operative period) and at 7, 14 and 24 day post-operative period. The neutrophil phagocytosis level was determined by flow cytometry using FITC-labeled staphylococcal protein A. There was counted the percentage of fluorescent neutrophils (defined as the phagocytic index — PI) and average of the cell fluorescence (phagocytic number — PN). According to the fluorescence intensity divided phagocytic neutrophils in an active (high PN) and weakly phagocytic (low PN). Condition of the respiratory burst in the neutrophils was examined using a chemiluminescent assay. It was found that patients with WPP in the preoperative period had increased phagocytic activity of the blood neutrophils. The maximum phagocytic activity observed on day 7 of the postoperative period and by 24 days the number of phagocytic cells is reduced to control level whereas phagocytic activity of the cells remains at the preoperative level. In the preoperative period in patients with WPP the amount of active phagocytic blood neutrophils 3.3 times higher than the number of weakly phagocytic cells. By the end of the observation period the number of active and weakly phagocytic neutrophils returning to normal. In the study of the state of respiratory burst in the neutrophils by the WPP patients discovered that the primary synthesis levels of reactive oxygen species (ROS) increases only with 7 days of postoperative period and the induced activity of NADPH-oxidase remains elevated to the end of the observation period. At the same time, the synthesis of secondary ROS in the blood neutrophil of the WPP patients increased already in the preoperative period and remains high until the end of the survey. Using correlation analysis it was found that if healthy people had a competitive relationship between the level of synthesis of primary ROS and the activity of phagocytosis then all detected correlations in the WPP patients characterized by high level of coordination between the respiratory burst and the phagocytic activity of the neutrophils. These relationships are identified in the preoperative period, postoperatively do not exist. It can be assumed that the surgery and the subsequent treatment leads to complete incoordination in the neutrophils the mechanisms of phagocytosis and respiratory burst.