Immunological Parameters In Patients Research Articles

Topical issues in the treatment of chronic tonsillitis

The article is devoted to the problem of chronic tonsillitis. The widespread prevalence of the disease, as well as the high risk of complications from vital organs, make this problem especially urgent. The article describes in detail the factors contributing to the formation of a focus of chronic inflammation in the amygdala. Special attention is paid to the microbiological aspects of the inflammatory process, anatomical, topographic and physiological features of the tonsils, as well as their immune function. The histological changes that form against the background of a long-term chronic inflammatory process in the tonsils are described. Changes in the parenchyma of the amygdala during inflammation can be expressed both by hyperplasia and by involution of follicles with the formation of infiltrates and the subsequent development of abscesses. In the final stages of an active inflammatory process, connective tissue grows, replacing lymphoid tissue. In the paratonsillar tissue and the capsule of the amygdala, an overgrowth of connective tissue is also observed, which is accompanied by the formation of nested infiltrates around small vessels, most pronounced at the upper pole of the amygdala. According to this classification, two clinical forms of chemotherapy are distinguished: simple and toxic-allergic of two degrees of severity. Further, in accordance with this classification, the basic principles of treatment are presented. Then the features of conservative therapy and the benefits of the herbal preparation are described. The composition of this drug includes marshmallow root, chamomile flowers, horsetail herb, walnut leaves, yarrow herb, oak bark and dandelion herb. The results of several clinical trials of the drug indicate its positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All this allows us to recommend wider inclusion of this combined herbal medicinal product in the complex of treatment of chronic tonsillitis.

Role of Hematological and Immunological Parameters in COVID-19 Patients.

Background:The ongoing pandemic of coronavirus disease 2019 (COVID-19) which was caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to efforts from the medical and scientific community in understanding the biological basis of COVID-19 pathophysiological mechanisms. Thus, analysis of various hematological and immunological parameters may be helpful for COVID-19 infection evaluation for risks involved and effectiveness in management.Aim:The aim of this study was to analyze the role of various hematological and immunological parameters in patients infected with SARS-CoV-2.Materials and Methods:This retrospective analysis was performed on 300 patients who tested positive for SARS-CoV-2 by quantitative reverse transcription–polymerase chain reaction analysis. All participants of the study were divided into – (a) Group I: patients with mild symptoms and normal chest radiographic findings; (b) patients with moderate disease presenting with fever and cough along with other respiratory symptoms, and (c) patients suffering from severe disease. Data collection was done from all patients at the time of hospital admission for hematological and immunological parameters – (a) total leukocyte count, (b) lymphocyte count, (c) lymphocytic subset count, (d) lactate dehydrogenase (LDH) levels, (e) D-dimer, (f) C-reactive protein (CRP), and (g) ferritin levels. SPSS 22.0 software was used for determining P values by independent t-test and Chi-square test.Results:The median age was 65 years (interquartile range –57–71 years). While comparing white blood cell and lymphocyte counts, extremely significant P values were obtained. D-dimers and ferritin levels demonstrated extremely significant P values while both LDH and CRPs showed statistical significance. Correlation of lymphocytic subsets showed extreme significance in total lymphocyte counts in mild-to-moderate as compared to severely infected patients while both CD4+ and CD8+ counts demonstrated statistical significance in mild-moderate infected cases. Statistical significance was noted in D-dimer, CRP, and LDH levels also.Conclusion:Assessment of hematological and immunological parameters can be used to plan the management of COVID-19 patients.

EFFECT OF EXOGENOUS NITRIC MONOXIDE THERAPY ON IMMUNOLOGICAL PARAMETERS IN BISPHOSPHONATE OSTEONECROSIS OF THE JAWS

Bisphosphonate osteonecrosis of the jaw (BONCH) is a drug-induced osteonecrosis in patients with a history of malignancies. It is characterized by progressive destruction of the jawbone with the development of a chronic inflammatory process in the parotid tissues. For the treatment of the disease, the use of exogenous nitrogen monoxide (NO) synthesized using the Plason device is proposed. The study of immunological parameters in patients with BONCH in the main group (n = 26), who received NO-therapy, and in the comparison group (пи = 27), who received traditional sanitation with 0,05 % chlorhexidine bigluconate. The dynamics of indicators in the main group - a decrease in the activity of the cellular link (activity of phago-quoting granulocytes and monocytes) to normal values, an increase in the intensity of local immunity (IgA) and a decrease in the concentration of humoral factors of acute (IgM) and chronic (IgG) inflammation p < 0,05) - confirms the anti-inflammatory and immunomodulatory effect of exogenous NO therapy. In the case of the comparison group, reducing only one indicator (AFM) to normal values does not allow us to prove the effect of traditional sanitation on immunological parameters in General. Thus, the use of exogenous nitrogen monoxide for patients with BONCH is justified both at the stage of preoperative preparation and as a basic conservative therapy if surgical treatment is not possible.

Прогнозування тяжких нападів астми фізичного навантаження у дітей за імунологічними показниками крові

Bronchial asthma is considered an umbrella diagnosis for various diseases with certain pathophysiological mechanisms (endotypes) and variable clinical manifestations (phenotypes). The phenotype of exercise-induced asthma is one of the most common variants of the disease in children and adolescents. The treatment tactic of acute asthma attack is unified and depends of the severity in contrast to preventive therapy the vector of which provides an individualized approach. However, the issues concerning the duration, frequency of administration and amount of drugs prescription not finally resolved. The purpose of the study was to evaluate the blood immunological parameters in patients with exercise-induced asthma phenotype to predict the severity of disease exacerbation and optimize the reliever therapy. Material and methods. We examined 43 children suffering from exercise-induced asthma. Two clinical groups were formed according to the severity of the exacerbation. The first group included 22 patients with moderate exacerbation of asthma, and the second group had 21 children with severe symptoms of the disease, which was interpreted as a severe asthma attack. There were not any significant differences by sex, place of residence, age and diseases duration among comparison groups. The obtained results showed a significant increase in the level of B-lymphocytes in patients of first clinical group (26.64 %) compared with children with severe exacerbation (20.40 %), increase content of T-lymphocytes (due to T-helper cells) in schoolchildren of the second clinical group (42.32 %) compared with patients with moderate asthma attack (33.32 %). The attributive risk of more severe disease exacerbation with B-lymphocytes ≤20 % and T- helper cells ≥20 % was 36.6 %, the relative risk was 1.9 with odds ratio 5.0. A significantly higher level of pharmazan-positive neutrophils in spontaneous and stimulated modifications of the nitro blue tetrazolium test was recorded in patients with moderate exacerbation (35.18 % and 45.09 %) compared with children of the second clinical group (19.33 % and 27.81 %). The content of neutrophils in the spontaneous nitro blue tetrazolium test ≤15 % allowed evaluating severe compared with moderate asthma attack with specificity of 95.5 %, positive predictive value of 90.9 %, and positive likelihood ratio 10.5. Conclusion. The use of certain immunological parameters allows working out an individual plan for asthma attacks and may reduce the frequency of severe exacerbations in children suffering from exercise-induced bronchial asthma

The efficacy of the diode laser at 800-980 nm as an aid to non-surgical therapy in periodontitis treatment: a review of literature.

The aim of this literature review is to assess the effectiveness of diode laser at a wavelength of 800-980 nm in addition to non-surgical periodontal therapy in periodontitis treatment. The authors performed an electronic research on Pubmed inserting as keywords: (laser OR laser therapy OR diode laser) and (periodontitis OR periodontal disease). The field has been narrowed to select only Randomized controlled clinical trials (RCT) performed from 2010 to 2020. The result of this research was 84 articles, of which eight were included in the review because they respect the inclusion criteria. The clinical, immunological, and microbiological parameters studied in the various clinical random trials were analysed. It has been shown that four out of eight studies have achieved greater benefits, in terms of clinical parameters, with the use of diode laser compared to Scaling and Root Planing. However, the greater increase in clinical parameters in diode laser-treated patients compared to the control group was mainly detected in the short term rather than in the long term. In terms of microbiological parameters, no improvement was detected after six months. Only one study reported six-month improvements in immunological parameters in patients treated with DL compared to the Scaling and Root Planing only group. In conclusion, considering the limitations of this review of literature, there is no evidence that the diode laser at 800-980 nm in addition to non-surgical periodontal therapy is more effective than SRP alone in the long term.

Differential immunotropic therapy of patients with acne

Acne (Acne vulgaris) is one of the most common skin diseases (registered in 80-90% of teenagers and young people of working age) with the localization of acne on exposed skin, has a chronic course that causes psycho-emotional changes in patients and reduces their quality of life.Objective. To improve the treatment of patients with acne depending onthe clinical manifestations of dermatosis and the state of their systemicimmunity through the differentiated use of immunotropic drugs.Material and methods. A comprehensive immunological examinationand treatment of 146 patients with acne aged 19 to 25 years, of which 77(52.7%) were female and 69 (47.3%) were male. The control groupconsisted of 35 healthy individuals (donors) of similar age and sex.Results. All 146 examined patients with acne were diagnosed with aninflammatory form of acne, including: in 37 (25.3%) patients - mildclinical course, in 83 (56.8%) - moderate severity and in 26 (17.9%) -severe clinical course of acne. The immunological study revealedsignificant changes in immune parameters in patients with severe andmoderate clinical course of acne, while a slight change in the immunitywas found in the patients with mild stage of acne. According to thesechanges in the immunological parameters of patients with acne, animmunotropic drug glucosaminylmuramyl dipeptide (lycopid) wasprescribed differently - 2 mg twice a day for 10 days (for the patients with moderate acne) and 10 mg once a day for 10 days (for the patients with severe clinical picture). This kind of treatment led to a positive dynamics of immunological parameters of the blood in such patients.Conclusion. Differentiated immunotropic therapy as a component ofcomplex treatment of patients with acne with the prescribtion of theimmunotropic drug glucosaminylmuramyl dipeptide (lycopid) allows usto improve the results of treatment, which is confirmed by the significantpositive dynamics of clinical and laboratory parameters.

Elevated interleukin levels are associated with higher severity and mortality in COVID 19 – A systematic review, meta-analysis, and meta-regression

Background and aimsCOVID 19 pneumonia commonly leads to ARDS. The occurrence of ARDS in COVID 19 patients is thought to occur secondary to an exaggerated immunologic response. In this meta-analysis, we aim to comprehensively study the various levels of immunological parameters in patients with COVID 19. Materials and methodsWe performed a systematic literature search from PubMed, EuropePMC, SCOPUS, Cochrane Central Database, and medRxiv with the search terms, “COVID-19” and “Interleukin”. The outcome of interest was prognosis in COVID 19 patients. ResultsWe performed meta analysis of 16 studies. Higher counts of CD4 and CD8 with Lower Levels of TNF-a, IL2R, IL6, IL8 were observed on patients with good prognosis compared to patients with poor prognosis; −0.57 (pg/mL) (−1.10, −0.04, p = 0.04), (I2 91%, p < 0.001); −579.84 (U/mL) (−930.11, −229.57, p < 0.001), (I2 96%, p < 0.001); −1.49 (pg/mL) (−1.97, −1.01, p < 0.001), (I2 94%, p < 0.001); −0.80 (pg/mL) (−1.21, −0.40, p < 0.001), (I2 79%, p < 0.001); −2.51 (pg/mL) (−3.64, −1.38, p < 0.00001), (I2 98%, p < 0.001) respectively. Meta-regression showed age and hypertension (coefficient: 1.99, and −1.57, p = 0.005, and 0.006) significantly influenced association between IL-6 and poor outcome. ConclusionElevated immune response to coronavirus occurs in COVID 19 patients. Higher counts of CD4 and CD8 were seen in patients with good prognosis compared to patients with poor prognosis, with Lower levels of TNF-a, IL2R, IL6, IL8, were observed in patients with good prognosis compared to patients with poor prognosis.

Clinical efficacy and characteristics of immunological changes in patients with psoriasis following the combined use of sulfide peloids from Lake Saki

BACKGROUND: Psoriasis is a common disease, and many of its forms are resistant to treatment.&#x0D; AIM: This study aimed to analyze the effects of complex treatment with Lake Saki sulfide peloids on the clinical and immunological parameters patients with psoriasis.&#x0D; MATERIALS AND METHODS: The study included 90 patients with steady-state psoriasis of mild or moderate severity (51 men and 39 women) aged 2365 (mean age 37.3 12.7) years, who received treatment at the N.I. Pirogov Saki Military Clinical Health Resort of the Russian Ministry of Defense. The control group consisted of 30 apparently healthy volunteers.&#x0D; RESULTS: Taking into account the clinical and immunological parameters of patients with mild and moderate psoriasis, we have developed a complex differentiated method of treatment using Lake Saki peloids and brine supplemented with an alpha-lipoic acid preparation.&#x0D; CONCLUSION: The presented complex method of peloid balneotherapy in combination with alpha-lipoic acid preparation intensifies the 14-day course of sanatorium-resort treatment, increases the duration of remission, and enhances the quality of life of patients with mild-to-moderate psoriasis.

IL17A rs2275913 polymorphism and features of immunological parameters in patients with persistent allergic rhinitis during allergen-specific immunotherapy

Allergic rhinitis (AR) represents a global healthcare challenge. Epidemiology data demonstrate that around 20% of all-age group subjects suffer from allergic rhinitis. Over the last decades, AR incidence and morbidity have been markedly increased due to poorly understood causes. For instance, in the last decade AR prevalence has been elevated by 2-fold in Uzbekistan. However, medical records related to AR prevalence based on patient visit rate infer that it is dozens of times lower than actual data and reflects in no way severity of the problem, but sufficient enough to outline its large-scale spread. Allergen-specific immunotherapy (ASIT) requiring further development and adjustments represents one of the most promising approaches to treat allergic diseases. Some researchers note rise in respiratory tract allergic disease (AD) prevalence including caused by pollen allergens. Therapeutic interventions in this type of pathology emerging due to chronic inflammatory process mainly in airway mucosa are aimed at achieving good control over disease symptoms, lowering risk of subsequent exacerbations and preventing AD aggravation. IL-17 belongs to the Th17 cell-derived cytokines that was described relatively recently. IL17 genes encode six proteins (molecular weight 20-30 kDa), among which IL17A and IL17F display peak sequence homology and were studied in numerous cell types. IL-17 family proteins take part in various reactions of immune response being mainly secreted by Th17 cells. It was shown that immunological mechanisms particularly mediated by cytokines such as IL-17A involved in inflammation, regeneration and fibrogenesis are crucial in progression of diverse infectious diseases.

Dynamics of blood immunological parameters in patients with glial tumors of varying degrees of anaplasia

The patients with glial tumors of varying degrees of anaplasia represent an imbalance in the composition of different subpopulations of immune cells, which leads to both specific immunosuppression and stimulation of the tumor process. For a comprehensive clinical assessment of the state of immunity in the blood, it is recommended to determine the ratio of the absolute level of immune cells, which integrally reflects the violation of certain indicators of innate and acquired immunity. Objective: To determine the relationship between the absolute number of lymphocytes, neutrophils, and platelets in the peripheral blood in glial tumors of varying degrees of anaplasia and at the stages of surgical treatment. Materials and methods. The case histories of 95 patients with glial tumors before surgery, on the 5 th –7 th day after surgery and before reoperation were studied. There were 71 patients initially operated for glial tumors of varying degrees of anaplasia, 40 patients with glioblastomas, 15 patients with anaplastic, and 16 patients with diffuse astrocytomas. Twenty-four patients were re-operated. The comparison group (control) consisted of 28 patients with non-cancerous diseases of the CNS. The age of patients with brain tumors and the comparison group ranged from 35 to 65 years. To analyze blood immunologic parameters, hematologic analyzer Mindray 3000 plus was used to identify the absolute number of platelets, neutrophils, and lymphocytes as well as the ratio index of the absolute number of neutrophils to the absolute number of lymphocytes (n/l), the absolute number of platelets to the absolute content of lymphocytes (p/l), the ratio of the absolute number of platelets to the absolute content of neutrophils (p/n). Results. In malignant glial tumors (glioblastomas and anaplastic astrocytomas), the level of n/l is significantly increased compared to the diffuse astrocytomas, the stimulation of neutrophil production and inhibition of lymphocyte formation are identified. On the 5 th –7 th days after surgery, there is no recovery of subpopulations of immune cells in the peripheral blood. The recurrences of glial tumors are accompanied by the imbalance in the structure of immune cells in peripheral blood that does not depend on the degree of tumors anaplasia. Conclusions. Determining the ratio of the absolute content of immune cells in the peripheral blood can serve as an informative indicator of the direction of disorders in congenital and acquired immune systems, which should be taken into account in the treatment of tumors.

Changes in Immunological Parameters in Patients Treated Using Direct and Indirect Restorations of the Hard Tissues of the Anterior Teeth in Combination with an Antioxidant

The problem of aesthetic restoration of the hard tissue defects in the anterior teeth and the choice of materials for quality restorations, which can include direct composite or indirect ceramic restoration, in particular ceramic veneers, is currently extremely important in clinical dental orthopedics. Currently used composite and ceramic materials are known to have different effects on the conditions of the marginal periodontium and the local immunity in the oral cavity. Therefore, we propose a new approach to treatment, which is the use of indirect ceramic restorations in combination with an antioxidant. The purpose of this article is to increase the effectiveness of treatment in patients with defects in anterior teeth using indirect ceramic restorations with antioxidants. To study the intensity of immune reactivity in patients with existing defects of the coronal part of the anterior teeth, we analyzed the levels of lysozyme and sIgA in the oral fluid. The results of the studies confirm the advantages of indirect ceramic restorations over direct composite ones in the treatment of hard tissue defects in the anterior teeth, taking into account the levels of immunological reactivity and using an antioxidant drug Resverasin.

остеолиза как предиктора развития асептической нестабильности эндопротеза тазобедренного сустава (обзор литературы)

Implant survival is a very important outcome measure of surgical treatment of patients with severe degenerative joint disease in the hip. The aim of this review is to summarize the present knowledge on the possibilities for earlier laboratory diagnosis of osteolysis and prognostic approaches to prevent aseptic loosening of prosthetic implants. Results Periprosthetic osteolysis is often seen as an early sign of an adverse event associated with the development of unstable total hip arthroplasty (THA). A lot of data support the concept of osteolysis as a condition caused by biomechanical stresses, surgery specific factors, preoperative decrease and postoperative loss of bone mineral density, vascular impairment and chronic inflammation. Hemostasiological, biochemical and immunological parameters of patients were explored before and after THA. Surgical intervention was treated as the cause of secondary immunodeficiency, and results of the recovery period evaluated with regard to the extent to which immunodeficiency appeared to be compensated. Dynamics in stress related bone remodeling around the implant was found to be be a marker for early detection of osteolysis and prediction of aseptic loosening of THA, as well as control over the target of drug exposure. Conclusion Literature review suggests that there is a common understanding of the pathogenesis of osteolysis and the development of aseptic loosening of THA, and there is scanty data on the laboratory markers for early diagnosis and prediction of the complication that would require further study.

The role of herbal medicine in the treatment of chronic tonsillitis

The article presents our own research data on systemic immunity status in patients with chronic tonsillitis (CT) and microbiological profile of the flora isolated from the tonsils in CT. The study showed that phagocytic index in neutrophils decreased by 81.9% and the phagocytosis in neutrophils reduced by 67.2% in patients with CT. We studied microbial flora of the tonsils and its persistent properties in CT. The steps for that were as follows: we evaluated the antilysocyme (ALA), anti-interferon (AIA), anticomplementary (ACA) activities of the isolated microorganisms as possible ways to stand against the oxygen-independent mechanism of phagocytosis. Most strains of Staphylococcus aureus had ALA, AIA and AСA, while most strains of Streptococcus pyogenes had ALA, less frequently AСA and did not show AIA. We found antibacterial polyresistance in 56.0% of pathogens among the selected strains in the examined patients with CT. A comparative analysis of species antibiotic resistance showed that the largest number of multiresistant strains were S.aureus - 62.0%. The set of revealed persistent properties of chronic tonsillitis pathogens serves as underlying rationale for the search for new methods of therapy using drugs of non-antibacterial origin, affecting the factors of bacteria resistance to inborn and acquired immunity. It is possible, and necessary that attention be paid to phytotherapy in the search for such new methods. Tonsilgon N is one of the complex phytotherapeutic products, which efficacy and safety has been proven in clinical trials, and the main pharmacological properties are confirmed in in vitro and in vivo preclinical studies. It contains marshmallow root, chamomile flowers, horsetail grass, walnut leaves, yarrow grass, oak bark, and dandelion grass. The clinical studies revealed that it has positive effect on the dynamics of both clinical and microbiological, immunological parameters in patients with chronic tonsillitis. All these things allow us to recommend that this complex herbal product be more often included into the comprehensive treatment of chronic tonsillitis.

Advancing diagnostics of chronic paradontitis in children

Chronic periodontitis in children and adolescents holds a lead place in morbidity pattern of dental pathology. Development of chronic periodontitis is accompanied by emergence of various complications in the maxillofacial region, leading to bite disturbance being of high relevance for pediatric patients. These and other complications are related to immune system immaturity in children and adolescents as well as virulence of microorganisms. However, the immunological changes developing in children with chronic periodontitis remain poorly studied. The aim of the work was to improve diagnostics of chronic periodontitis in children and adolescents based on informative parameters of systemic immunity and discriminative models taking into account such changes. We examined systemic immunity in 127 children and adolescents with chronic periodontitis, aged 12 to 16 years, by using flow cytometry and enzyme immunoassay. In control group, age-matched 108 patients lacking overt somatic and dental pathology were enrolled. Generation of mathematical models was carried out by using a discriminative approach, whereas informativeness was assessed in accordance with generally accepted formula. Relative and absolute count of peripheral blood CD13+ cells exert the peak informativeness holding the first and second ranking places with marked dominance of informativeness value for assessing relative amount of CD13+ cells are among immunological parameters in children with chronic periodontitis. High informativeness value evidencing about pronounced intensity of developed pathological changes and diagnostic significance for chronic periodontitis in children is intrinsic to the relative percentage of peripheral blood CD8+ cells being slightly lower than that one in absolute count of CD13+ cells. On the other hand, humoral immune-parameters were of lowest informative value among all analyzed immunological parameters in patients with chronic periodontitis serum referring to all antibody classes. Generated discriminative models for the most valuable immunological parameters ensure adequate medical diagnostics for chronic periodontitis in childhood. Diagnostic sensitivity for created mathematical models was high and reached 0.94, whereas diagnostic specificity — 0.92. Immunological examination of patients improves diagnostics of chronic periodontitis. It was found that patients with chronic periodontitis had lowered immune status peaking in decreased absolute and relative count of peripheral blood CD3+ lymphocytes. Finally, parameters of humoral immunity in children with chronic periodontitis were also reduced.

Changes in immunological parameters in patients treated using direct and indirect restorations of the hard tissues of the anterior teeth in combination with an antioxidant.

The problem of aesthetic restoration of the hard tissue defects in the anterior teeth and the choice of materials for quality restorations, which can include direct composite or indirect ceramic restoration, in particular ceramic veneers, is currently extremely important in clinical dental orthopedics. Currently used composite and ceramic materials are known to have different effects on the conditions of the marginal periodontium and the local immunity in the oral cavity. The condition of periodontal tissues should be taken into account when choosing a way to eliminate this pathology. Therefore, we propose a new approach to treatment, which is the use of indirect ceramic restorations in combination with an antioxidant. The purpose of this article is to increase the effectiveness of treatment in patients with defects in anterior teeth using indirect ceramic restorations with antioxidants. To study the intensity of immune reactivity in patients with existing defects of the coronal part of the anterior teeth, we analyzed the levels of lysozyme and sIgA in the oral fluid. The results of the studies confirm the advantages of indirect ceramic restorations over direct composite ones in the treatment of hard tissue defects in the anterior teeth, taking into account the levels of immunological reactivity and using an antioxidant drug Resverasin. According to the results of our clinical studies, Resverasin significantly shortens the duration of the adaptation period and increases immune reactivity in the oral cavity, especially in combined pathology.

Complement Activation in 22q11.2 Deletion Syndrome

The 22q11.2 deletion syndrome (22q11.2 del), also known as DiGeorge syndrome, is a genetic disorder with an estimated incidence of 1:3000 to 1:6000 births. These patients may suffer from affection of many organ systems with cardiac malformations, immunodeficiency, hypoparathyroidism, autoimmunity, palate anomalies, and psychiatric disorders being the most frequent. The importance of the complement system in 22q11.2 del has not been investigated. The objective of this study was to evaluate the complement system in relation to clinical and immunological parameters in patients. A national cohort of patients (n = 69) with a proven heterozygous deletion of chromosome 22q11.2 and a group of age and sex matched controls (n = 56) were studied. Functional capacity of the classical, lectin, and alternative pathways of the complement system as well as complement activation products C3bc and terminal complement complex (TCC) were accessed and correlated to clinical features. All patients in our study had normal complement activation in both classical and alternative pathways. The frequency of mannose-binding lectin deficiency was comparable to the normal population. The patients had significantly raised plasma levels of C3bc and a slight, but not significant, increase in TCC compared with controls. This increase was associated with the presence of psychiatric disorders in patients. The present study shows no complement deficiencies in 22q11.2 deletion syndrome. On the contrary, there are signs of increased complement activation in these patients. Complement activation is particularly associated with the presence of psychiatric disorders.

Сравнительная характеристика клинико-иммунологического статуса пациентов с аутоиммунным тиреоидитом и его сочетанием с сахарным диабетом 1 типа

Сравнительная характеристика клинико-иммунологического статуса пациентов с аутоиммунным тиреоидитом и его сочетанием с сахарным диабетом 1 типа

Assessment of the efficiency of sialosis treatment in patients with type 2 diabetes mellitus

Was to determine changes in the levels of cytokines in the oral fluid in patients with type 2 diabetes and sialosis, depending on the level of glycemia and the duration of type 2 diabetes, as well as in the dynamics of basic and complex treatment. Forty patients with type 2 diabetes were enrolled in the study and divided into two groups according to disease duration: group 1 comprised 15 patients having diabetes for ≤5 years, group 2 - 25 suffering for more than 5 years. The study revealed changes in pancreatic cancer immunological parameters in patients with sialosis and type 2 diabetes. Long course of diabetes led to an increase in the level of IL-2 and a decrease in IFN-γ in oral fluid. The level of IL-1β was the highest in the group of patients with a duration of diabetes ≤5 years. According to the data presented, the content of IL-1β, IL-2 in patients with diabetes is higher, and INF-γ is lower than in healthy individuals. In patients with sialosis on the background of type 2 diabetes before treatment there is a decrease in the level of IFN-γ in the oral fluid and its increase to 7.3±0.2 pg/ml after treatment. At the same time, when enzyme therapy was included in the treatment regimen, the increase in the level of IFN-γ in the main group was more pronounced and averaged 8.3±0.1 pg/ml, which was 1.2 times higher than the initial level (p<0,05). The inclusion of enzyme therapy in the complex therapy of patients with sialosis against the background of diabets, unlike traditional methods of therapy, made it possible to provide faster positive clinical dynamics, namely, under the influence of this drug, the pain stopped in a short time, salivation increased and the feeling of dryness disappeared. Along with a faster relief of clinical symptoms, normalization of the levels of IL-1β, IL-2 and an increase in IFN-γ by the end of treatment were noted.

627P - Immune status of patients with different stages of colorectal cancer with and without circulating tumour cells

BackgroundOur purpose was to study parameters of the cellular immunity in patients with different stages of colorectal cancer with and without circulating tumor cells (CTCs). MethodsThe presence of CTCs and parameters of the cellular immunity were studied in 60 colorectal cancer (CRC) patients: stage II – 20, stage III – 12, stage IV – 28 patients, adenocarcinoma in all cases. Blood levels of CTCs were determined before the treatment using the CellSearch System (Janssen Diagnostics, LLC) with iron microparticles coated with antibodies to epithelial cell adhesion markers EpCAM, CD45 and cytokeratins 8,18,19. Subpopulations of lymphocytes were studied using the FACSCantoII flow cytometer (BD): percentage of T-B-NК-cells, Tregs; activated CD4+ and CD8+ cells, naive T-lymphocytes and memory T cells; expression of CD335, perforin and granzyme B was evaluated in NК cells. ResultsThe results revealed a number of differences in immunological parameters in patients with and without CTCs. Stage II CRC with CTCs showed statistically significantly higher content of lymphocytes (19.1±2.7 vs 15.6±1.4%), CD335+ NK cells (44.9±7.6 vs 19.2±4.0%) and the respiratory burst index in granulocytes (97.5±1.6 vs 92.3±1.2%); p<0.05 in all cases. Stage III CRC with CTCs was characterized by decreased lymphocyte and monocyte levels, while granulocyte content increased. These patients demonstrated elevated levels of CD4+ cells with early and late activation markers: CD38+ and HLA-DR+ by 2 times, CD25+ by 6 times, p<0.05 in all cases. CTC-positive patients with stage IV CRC, compared to CTC-negative ones, showed lower levels of NK cells (16.6±2.0 vs 28.4±5.5%), CD4+CD69+(5.1±0.8 vs 8.2±1.0%), and CD8+CD25+(2.8±0.48 vs 5.5±1.1%; p<0.05). ConclusionsCTCs in locally advanced CRC is associated with stimulation of functional parameters of innate immunity and activated Th, while in metastatic CRC - with inhibition of cytotoxic lymphocytes of innate and adaptive immunity, which, apparently, is associated with poor prognosis. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

PF395 COMPLEX EVALUATION OF CELLULAR AND HUMORAL IMMUNITY IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA

Background:Chronic lymphocytic leukemia (CLL) is typically associated with a significant immune deficiency resulting in elevated risk of infections ‐ the leading cause of death in CLL patients (pts). However, many specific mechanisms contributing to suppression of immunity in CLL are not yet well understood.Aims:Comprehensive assessment of immunological parameters in patients with CLL.Methods:We prospectively enrolled 126 CLL pts: 42 with clinically stable disease not requiring treatment (median age, 65 years; males, 50%; low/medium/high modified Rai risk, 59/36/5%) and 84 with CLL progression indicated for therapy (median age, 68 years; males, 64%; low/medium/high modified Rai risk, 0/43/57%). In addition, parameters of immunity were compared before and after first‐line chemoimmunotherapy in 39 pts (FCR, n = 13; BR, n = 15; G‐CLB, n = 5; R‐CLB, n = 6). Control group consisted of 46 healthy blood donors (median age, 40 years; males, 59%). Cellular subpopulations (CLL cells, T cells, Th and Tc cells, NK cells and polyclonal B cells) were quantified by flow cytometry (cytometer Navios, Beckman Coulter). Humoral immunity was evaluated by quantification of serum immunoglobulin concentrations (total IgG, IgG subclasses 1–4, IgA 1–2 and IgM) using Immunochemistry Image System (Beckman Coulter). Activation of complement was assessed by Wieslab Complement System Screen (Euro Diagnostica). Serum concentrations of immunity‐regulating cytokines (IL‐4, IL‐5, IL‐6, IL‐10, IL‐17A, IL‐17F, IL‐33 and IFN‐γ) were determined by xMAP multiplex technology (Luminex).Results:Serum IL‐4, IL‐6 and IL‐10 were elevated in CLL compared to controls (all p &lt;0.0001). Polyclonal B cells were decreased (p &lt; 0.0001) whereas Tc cells were increased (p = 0.019 and p &lt; 0.0001) in stable and progressive CLL in comparison to controls. Both CLL subgroups had significantly lower IgG, A and M when compared to controls (all p &lt; 0.0001). Progressive CLL pts had significantly higher numbers of NK cells (p = 0.0003) and stable CLL pts significantly higher IFN‐γ (p = 0.01) vs controls. Pts with progressive CLL had significantly lower concentrations of IgG, A, and M (p = 0.0012, p &lt; 0.0001 and p = 0.027) than stable pts. Chemoimmunotherapy resulted in significant decline of polyclonal B cells, NK cells, Th cells, Tc cells and T regs (all p &lt; 0.0001) but serum IgA and complement activation (both classical and alternative pathway) increased after therapy (p = 0.048, p = 0.002 and p = 0.0017).Summary/Conclusion:Conclusions: The present study identified multiple defects in cellular as well as humoral immunity in CLL pts. Clinical progression of CLL was associated with further decline of immune parameters. Cytoreductive therapy resulted in significant decrease in all physiological lymphocyte subpopulations; however, several markers of humoral immunity improved after treatment. The enrollment into the study continues and further analyses are underway including assessment of association of immune defects with infections and changes in immunological parameters over longer follow‐up. Supported by project PROGRES Q40/08, by DRO Ministry of Health (UHHK, 00179906) and by League Against Cancer Prague.image