The state of immunological reactivity and nonspecific protection factor (lysozyme) in children with reactive arthritis

Abstract

Aim. An improvement of diagnostics and prognostication of ReA clinical course in children on the base of studying the immunological reactivity and non-specific protection factor (lysozyme).Materials and methods. Examination of children took place in the municipal children’s cardiorheumatologic department of MHPI “Kharkov municipal children’s clinical hospital № 24" and municipal children’s polyclinic of the Kharkov city (№ 1, 2, 7, 12, 13, 14, 23).40 children with ReA underwent immunological examinations, detection of sIgA in the saliva and lysozyme in the blood serum in acute period and in 9–12 months after the beginning of disease. 19 children (47,5 %) – 2–6 years old, 21 children (52,5 %). – 7–14 years old. Boys – 22 (55,0 %), girls – 18 (45,0 %). The mean age of children in group was 7,2±0,32. The control group included 32 healthy children. The mean age of children in group was 7,4±0,54.The ReA diagnosis was set according to the order of Ukrainian MHP of 19.07.2005 № 362 “Protocol of diagnostics and treatment of disease of musculoskeletal system and connective tissue in children ICD-D М00-М25 arthropathies”.Immunological examinations included the study of indices of cellular, humoral, monocytic-phagocytic links of immunity, content of cytokines (IL-1β, IL-6), detection of sIgA and index of nonspecific protection factor (lysozyme).Assessment of results of researches was carried out using STATISTICА program for Windows (version 10.0), Microsoft Excel 2012, MATLAB 2015a.Results. In the ReA acute period in children was observed depression of T-system on the background of activation of immunity B-system as the reliable decrease of СD8, СD25 and increase of СD21. There was revealed an increase of IL-6, increase of phagocytic number, spontaneous NBT-test and spontaneous neutrophils activity index.The sIgA level reliably exceeded the standard. At determination of lysozyme the blood serum of patients with ReA in acute period was revealed its deficiency comparing with the standard.In 9–12 months after the beginning of disease in subgroup of children with prolonged and relapsing clinical course was preserved the increase of IL-6 level and decrease of CD8, CD25 and increase of CD21, increase of sIgA and low content of lysozyme. The indicators of the favorable ReA outcome (remission) are: normalization of indices of T- and B-cellular link of immunity, IL-6, sIgA and lysozyme.Conclusions.1. In the ReA acute period was detected the decrease of CD8, CD25, increase of CD21and IL-6. The phagocytic link of immunity functions in the hypercompensation mode with emaciation (decompensation) phenomena. The sIgA content is increased and lysozyme level is decreased.2. In 9–12 months after the beginning of disease in subgroup of children with remission was detected normalization of indices of T- and B-cellular links of immunity IL-6, sIgA and lysozyme. In subgroup of children with prolonged and relapsing clinical course was preserved increase of CD21, IL-6, sIgA and decrease of CD8, CD25 and lysozyme