Immunological Disorders In Patients Research Articles

Immunological disorders in patients with acute pleural empyema

In case of acute pleural empyema pronounced violations of cellular and humoral factors of immunity as well as non-specific resistance of the body are revealed. Dynamics of laboratory and immunological changes of 64 patients with acute pleural empyema who were treated with classical and minimally invasive surgical methods has been studied. Patients were classified into 5 groups in accordance with severity of the disease, which was determined according to the criteria which comprise such clinical and laboratory parameters as: respiratory rate, heart rate, blood pressure, temperature reaction, the number of affected particles, leukocytosis, SpO2. All the patients underwent a standard examination as well as determination of serum concentration InterLeykin 6 (IL-6), InterLeykin 8 (IL-8), Tumor Necrose Factor α (TNF-α), C-Reactive Protein (CRP). Assessment of cytokine spectrum of blood serum of patients with acute pleural empyema allows stating the condition of hypercytokinemia with an increase in pro-inflammatory cytokines. Meanwhile the degree of their increase differed depending on the severity of course of acute pleural empyema. Study of structure of cytokine status allowed identifying those patients with severe course of pleural empyema had a significant increase in IL-6 and CRP concentrations. Nevertheless, the severe course of the disease is associated with insufficient increase of IL-8 and TNF-α. Deficiency of IL-8 and to a less extent IL-6 is expressed in patients of the older age group. In the general blood test, there have been identified higher indicators of total number of leukocytes, neutrophils, pronounced shift of the leukocyte formula to the left, increases of erythrocyte sedimentation rate in patients with a severe course of the disease. There have been identified factors which affect severe course of acute pleural empyema: decrease in oxygen saturation to less than 94%, severity of shortness of breath, which exceeds 2 points on the Borg scale, damage to 3 or more segments of lung tissue, and also numerous clinical signs of violation of anti-infective protection, pronounced decrease in neutrophils, an increase in the concentration of C-reactive protein and insufficient increase of IL-8 and TNF-α in blood serum. Keywords: acute purulent diseases of the pleura, respiratory failure, interleukin 6, interleukin 8, tumor necrosis factor α, C-reactive protein.

Mechanisms of formation and classification of secondary immunodeficiency states in uveitis

Background. The role of immunological disorders in the pathogenesis of uveitis has been proven by numerous studies. However, there are different views on the timing and methods of immunocorrection. In our opinion, this issue should be solved on the basis of determining the mechanisms of the formation of immunodeficiency states in uveitis. The purpose of this work was to develop a classification of secondary immunodeficiency states in uveitis according to the mechanism of formation. Materials and Methods. The paper presents the results of the examination of 370 patients with uveitis (416 eyes; 179 were men, 191 were women, aged from 16 to 87 years; the duration of the disease ranged from 1 month to 32 years) who were treated in Kharkiv Regional Clinical Hospital, were under dispensary supervision at Kharkiv Regional Anti-Tuberculosis Dispensary and Kharkiv Regional Dispensary for Radiation Protection of the Population, or were examined, consulted and treated on an outpatient basis. The observation period was up to five years. Results. Based on the study of immunological changes in patients with uveitis, the dynamics of immunological disorders in relapses of the inflammatory process in the uveal tract, clinical and immunological features of various forms of uveitis, and the results of correction of immunological disorders in patients with uveitis, a classification of secondary immunodeficiency states in uveitis according to the mechanism of their formation was proposed. On its basis, the principles of correction of immunodeficiency states in patients with uveitis were developed. Keywords: infectious uveitis, noninfectious uveitis, cellular immunity, humoral immunity, correction principles, immunological disorders.

Immunological disorders in patients with mammary gland pathology in infertility associated with anovulation

The objective: to study the state of the immune system in women with pathology of the mammary glands and infertility, and on the background of menstrual cycle disorders.Materials and methods. The research was performed in two stages. The first (1) stage included examination of women with infertility associated with anovulation who had breast pathology. These patients were divided into three groups: 1.1 group – 44 patients with diffuse fibrocystic breast disease (FBD), 1.2 group – 4 patients with fibroadenoma of the mammary glands, 1.3 group (control one) – 37 patients without pathological changes in the mammary glands.During the second (2) stage of the study, 110 women were examined: 2.1 group – 52 patients with regular menstruations and luteal phase insufficiency (LPI) and 2.2 group – 58 patients with anovulatory cycles.During two research stages, the immune status (CD3, CD4, CD8, immunoregulatory index (CD4/CD8), CD72, CD16, circulating immune complexes) and cytokine profile (IL-1, IL-2, IL-6, TNF-α, INF) in venous blood were determined. Differences were considered statistically significant at p<0.05.Results. A significant increase in the CD8 index was found in the group of patients with normal mammary glands (34.7±6.9 pg/ml; p<0.05) and with a diffuse form of FBD (35.13±6.9 pg/ml; p<0.05) versus its normal level in the group of patients with fibroadenoma (26.5±15.9 pg/ml; p>0.05).During the analysis of the CD16 level, it was determined its significantly increased to 18.8±3.1 pg/ml (р<0.05) in patients with LPI and regular menstrual cycle and to 26.3±4.8 pg/ml (р< 0.05) – in patients with anovulation without LPI, the difference between the groups was significant. The level of CD16 was significantly higher in anovulatory menstrual cycle disorder without LPI compared to patients with menstrual cycle disorder and LPI.The concentration of TNF-α in patients with a regular menstrual cycle (998.1±166.3 pg/ml; p<0.05) and with an anovulatory cycle without LPI (1029.3±187.1 pg/ml; p<0.05) was significantly higher compared to normal values (778.5±64.0 pg/ml). The level of IL-2 was significantly lower than normal indices. Thus, in the group of women with LPI, this indicator was 17.13±2.85 pg/ml (р<0.05), and by anovulation without LPI – 16.84±3.07 pg/ml (р<0.05) versus normal parameter 22.29±0.81 pg/ml.Conclusions. In patients with diseases of the mammary glands and infertility associated with anovulation without LPI, a significant decrease in the activity of T2-helpers (IL-2) and an increase in the activity of T1-helpers (TNF-α) were determined in cases of anovulation without LPI compared with cases of luteal phase insufficiency.

Idiopathic non-cirrhotic portal hypertension in a patient with Talaromyces marneffei infection: a case report

BackgroundThe etiopathogenesis of idiopathic non-cirrhotic portal hypertension (INCPH) is so far poorly understood. Altered immunity, blood diseases, infections, congenital defects and drug exposure have been documented in a part of patients with INCPH owing to increased recognition of the disorder in patients with HIV, or various haematological disorders or autoimmune diseases. We aim to discuss the possible etiopathogenesis of INCPH.Case presentationWe reported that a patient with intestinal infection of T. Marneffei and hyper-IgE syndrome, a group of rare primary immunodeficiency disorders, was finally diagnosed with INCPH for gastroesophageal variceal bleeding. The diagnosis was mainly based on histopathological features. Transjugular intrahepatic portosystemic shunt was performed and there was no recurrence of melena during the six-month follow-up.ConclusionIn the context of immunodeficiency, INCPH may associated with intestinal infections. Thus, screening for enterogenic infection and immunological disorders in patients with unexplained portal hypertension is necessary.

Changes in the immunological reactivity in patients with coxarthrosis and the factors that determine them

Background. The participation of immune responses in the pathogenesis of degenerative-dystrophic diseases of the synovial joints determines the feasibility of using more rational approaches to assessing the immune status of patients with this pathology. Despite the ongoing immunological studies in patients with degenerative-dystrophic diseases of the hip joint, there are questions related to the functioning of the immune system as a whole, which require additional research.The aim of the study was to establish the features of the relationship between the indicators of the immune status and to identify the factors that determine the nature and severity of immunological disorders in patients with coxarthrosis.Material and methods. The study is based on the results of immunological parameters in 73 patients (mean age – 45.3 ± 2.56 years) with stage III dysplastic coxarthrosis. The data obtained using cluster analysis made it possible to distribute patients into two groups. The first clinical group included 46 patients, the second one – 27 patients. The control group consisted of 28 clinically healthy individuals. Mathematical processing of the results was carried out using the Statistica 6.0 software package (StatSoft Inc., USA) and the mathematical package Mathcad 2001 Pro (MathSoft Inc., USA).Results. The levels of CD4+ and CD8+ cells and IgA were determined as the classification features that make the greatest contribution to the division of the studied groups. Model experiments have shown that a specific combination of the magnitude of each of the noted factors with a certain degree of probability makes it possible to assess the state of the initial immunological reactivity and verify the nature and severity of immunological disorders.Conclusion. The information obtained is of great importance, since it allows predicting the course of the recovery period after surgery and assessing the risk of developing possible postoperative complications in patients with severe articular pathology.

Targeting and Modulation of the Natriuretic Peptide System in Covid-19: A Single or Double-Edged Effect?

Natriuretic peptide system (NPS) is a group of peptide hormones or paracrine factors, including atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and natriuretic peptide precursor C (NPC), that are structurally related. The physiological effects of NPS include natriuresis, increased glomerular filtration rate, inhibition release of renin, vasopressin, and aldosterone, sympathetic inhibition, vasodilatations, and prevents cardiac hypertrophy and remodeling. ANP has immunological effects, as it is produced locally from immune cells; it regulates innate and adaptive immune responses. Metabolism and degradation of ANP are achieved by neutral endopeptidase (NEP), also known as neprilysin. Coronavirus disease 2019 (Covid-19) pandemic may lead to acute lung injury (ALI) and/or respiratory distress syndrome (ARDS). The underlying causes of inflammatory and immunological disorders in patients with severe Covid-19 are connected to the immune over-stimulation with the subsequent release of pro-inflammatory cytokines. Covid-19 severity is linked with high ANP serum levels regardless of acute cardiac injury. Inflammatory stimuli appear to be linked with the release of NPs, which anti-inflammatory effects prevent the development of ALI/ARDS in Covid-19. Therefore, neprilysin inhibitors like sacubitril increase endogenous NPs and may reduce the risk of ALI in Covid-19 due to the potentiation of endogenous anti-inflammatory effects of NPs. However, sacubitril increases gastrin-releasing peptide, cathepsin G and release of pro-inflammatory cytokines that are inactivated by neprilysin. In conclusion, NPs and neprilysin have cardio-pulmonary protective effects against Covid-19-induced ALI/ARDS. Neprilysin inhibitor sacubitril has dual protective and harmful effects regarding metabolizing vasoactive peptides by neprilysin. These findings require potential reevaluation of the effect of neprilysin inhibitors in managing Covid-19.

Heterogeneity of benign prostatic hyperplasia

Background. Benign prostatic hyperplasia (BPH) is a histologically determined condition of the male body and is characterized by glandular-stromal multi-focal proliferation originating from the paraurethral and (or) transition zone of the prostate gland. Proliferative processes in the body are under the control of the immune system. Identifying and understanding the immunological aspects of prostatic hyperplasia can help control prostate tissue growth, improving men's quality of life. The aim of our study was to conduct a pilot study, assessment of the immune status of patients with benign prostatic hyperplasia. Materials and methods. The study included patients having stage 2 BPH (according to Guyon’s updated classification system (n=8)) and patients who did not have clinical and morphological manifestations of BPH. The subjects underwent standard examinations in accordance with the clinical protocol of the Ministry of Health of the Republic of Belarus. The immunogram indicators included: the main subpopulations of lymphocytes (CD3 T lymphocytes, CD4 T helper cells, CD8 T cytotoxic lymphocytes), the ratio of Th/Tc, CD19 B lymphocytes, the level of serum immunoglobulins IgG, IgM, IgA and circulating immunocomplexes (CIC), as well as phagocytic index and phagocytic number. Results. Patients with BPH had statistically lower levels in the number of phagocytosed units compared to the patients without BPH. Furthermore, patients with BPH have highly variable results for immune system indices. Thus, the ratio of Th/Tc ranged from 1,3 to 2,3 units, and the level of CIC – from 10 to more than 300 units. The variability of the results obtained allowed us to divide patients with BPH into two groups: first group (n=3) with normal indices for levels of CIC and for the ratio of Th/Tc; the second group (n=5) with the indices for levels of CIC and for the ratio of Th/Tc that significantly exceeded the reference values. None of the patients in the second group had a concomitant autoimmune disease. Conclusions. Patients with BPH have a dysfunction of the immune system. Even having such a small number of enrolled subjects, it is possible to form subtypes of patients with BPH – they are future phenotypes. The study aiming at finding immunological disorders in patients with benign prostatic hyperplasia should be continued.

Determination of pro-inflammatory and humoral factors in gonarthrosis in women with hypertension and overweight

Purpose of the study. The purpose of the work. to study the influence of pro-inflammatory cytokines and neurohumoral factors of adipose tissue on the pathogenesis of HA in women with NM and hypertension to further improve the effectiveness of treatment of this group of patients.
 Materials and methods. We examined 198 women with GA and GA in combination with GC and NM aged 40 to 70 years (average - 62.6 ± 1.9 years) with a disease duration of an average of 13.4 ± 3.8 years. In order to analyze the impact of comorbid pathology on the underlying disease, all surveyed women were divided into three groups. The first group (G1) included 59 women with symptoms of HA without concomitant pathology, the second (G2) group - 74 women with HA and GC, and the third (G3) 65 women with HA and GC and NM. All patients underwent standard general clinical examination. In order to study the neurohumoral aspects of the disease, enzyme-linked immunosorbent assay of C-reactive protein, tumor necrosis factor, interleukin-1beta, interleukin 6, interleukin 10 and leptin was performed.
 Results. It was found that the combination of excess weight with the course of HA leads to a more significant increase in the production of proinflammatory cytokines compared with patients with HA without concomitant pathology (p <0.05). Direct correlations have been established between weight gain and increased levels of proinflammatory cytokines and adipose tissue neurohumoral factors.
 Conclusions. The combination of inflammatory and destructive changes in the joints in HA with weight gain and increased blood pressure, creates conditions for the development of severe immunological disorders in patients and requires pharmacological correction.

Justifications for differentiated approach in correction of some changes of the immunologic disorders in patients with rapidly progressing generalized parodontitis with different drug susceptibility of the parodontal bacteria

Rapidly progressing generalized perio­dontitis (RPGP) still remains an extremely important medical problem, despite certain achievements in solving most of the issues of etiology, pathogenesis and treatment. The study included 102 patients with rapidly progressing periodontitis of I-II and II-III degrees of severity, with ineffective and inconsistent results of previous treatment who were examined and treated in the clinic of the Department of Surgical Dentistry, Periodontics and Implantology of the SE «Dnipropetrovsk medical academy of Health Ministry of Ukraine». On the basis of the diagnostic and therapeutic measures carried out, it was established that, in patients with rapidly progressing generalized periodontitis, the formation of various drug sensitivity in periodontopathogenic microorganisms to protocol antibacterial therapy is closely associated with immunological protocol diseases. The presence of drug-resistant bacteria in the periodontal tissues is combined with a more pronounced immunodeficiency in the mechanisms of systemic and local protection than when the lesions are colonized by drug-sensitive periodontal microorganisms. The revealed features of immunity disorders in patients with RPGP with drug-resistant infection to conventional antibiotic therapy are manifested by a decrease in CD3+ lymphocytes, cells with cytostatic activity (CD4+, CD16+) expressing receptors for the activation of lymphocytes CD25+, HLA-DR and apoptosis CD95+), against the background of a slight increase in CD20+, CD116+, CD54+, significant inhibition of the synthesis of SIgA, IgM, α-INF, γ-INF; a pronounced increase in the production of pro-inflammatory cytokines IL-1β and TNF-α. The need for a differentiated approach in the correction of immunological disorders in patients with RPGP depending on the detected sensitivity and resistance of periodontal pathogenic bacteria to the protocol generally accepted antibacterial therapy has been clearly proved; this provides a faster relief of the infectious and inflammatory process (on average on 3.6±0.2 day) in more than 90% of cases, normalization of the parameters of immunological reactivity in 93.3% of the observed and stable clinical remission of the disease.

Оценка влияния системной энзимотерапии на иммунные реакции при урогенитальной хламидийной инфекции

Assessment of the severity of immunological disorders in patients with hlamydia trachomatis (CT) infection and the effectiveness of antibacterial therapy in combination with systemic enzyme therapy for the eradication of pathogenic pathogen and correction of detected violations of the immune system. 84 patients with identified CT infection were divided into 2 clinical groups: group 1 (42 people) received antibiotic therapy with doxycycline monohydrate for 10 days, 100 mg 2 times a day (the first dose of 200 mg) at regular intervals (daily dose of 200 mg, course - 2.0 g.) in combination with phlogenzyme, 3 tablets 2 times a day within 14 days. The second clinical group (42 people) received only doxycycline monohydrate therapy at the same doses as in the first clinical group. In all patients with CT infection (84 people) and in the control group (32 practically healthy people), the activity of immune reac-tions in the body was additionally assessed by the level of cytokines (-INF, IL-1, IL-4, IL-6), circulating immune complexes (CIC), lactoferrin (LF) and 2-macroglobulin in blood serum. The level of CEC in the blood serum of patients with CT infection is significantly higher than the standard indicators (by 1.83 times) compared with the indicators of the control group (106.1+/-5.12 conventional units versus 57.8+/-3.39 conventional units, p<0.05). The level of -IFN in the blood serum of patients with CT infection is 1.64 times lower than in the control (28.9+/-4.15 pkg / ml and 47.3+/-4.26 pkg / ml, p<0.05), and indicators of IL-1 in blood serum - 3.12 times higher; the level of IL-6 is 2.13 times higher (p<0.001); the level of IL-4 is 1.65 times higher (p<0.05). The Lf level in patients with CT infection exceeded 2.37 times the indicator in the control group (1742.0+/-112.15 ng / ml and 732.1+/-36.11 ng / ml, p<0.001), 2-macroglobulin - in 1, 36 times (2.59 - 0.21 mg/l and 1.9 - 0.47 mg / l, p<0.001). The efficiency of clinical and microbiological cure in patients with CT infection, who received complex therapy with doxycycline monohydrate and phlogenzyme, was 97.6%. With monotherapy (doxycycline monohydrate), the effectiveness of clinical and microbiological cure was significantly lower - 78.6%, statistically significant (OR=11.2; 95% CI 1.3-247.9; p=0.007). The fact of a decrease in the activity of Th-2 type of the cellular link of immunity in patients with CT infection receiving systemic enzyme therapy drug was established. One of the pathogenetic mechanisms of CT infection is an imbalance in the cytokine profile, which manifests itself in an increase in the level of cytokines of the Th-2 (IL-6) type and a decrease in the Th-1 (-IFN) type. With the predominant production of pro-inflammatory cytokines (IL-1, IL-6), the dynamics of CT infection becomes chronic. A decrease in the reserve capacity of the proteolytic enzyme system during CT infection with a subsequent increase in the level of 2-macroglobulins in the blood contributes to the dysregulation of local inflammation processes and the formation of immune disorders. With a long course of CT infection, it is most advisable to use (as a basic pathogenetic therapy) systemic enzyme therapy (phlogenzyme). The effect of systemic enzyme therapy on immune responses in C. trachomatis enhances the activity of the Th-1 type of cytokines (-IFN) and a decrease in the level of 2-macroglobulins and pro-inflammatory cytokines (IL-1, IL-6) in the blood. Systemic enzyme therapy can significantly increase the effectiveness of antibiotic therapy and reduce the risk of side effects. The theoretical argumentation of the pathophysiological mechanisms of disorders in the interaction of the most important functional systems made it possible to substantiate new conceptual approaches to the therapy of CT infection, taking into account the level and specific disorders in the universal systems of homeostasis regulation. In particular, a pathophysiological basis has been provided to substantiate the advisability of combining antibacterial therapy with systemic enzyme therapy drugs to correct systemic immunological disorders in patients with CT infection.

Deregulation of the immune system in patients with chronic lymphocytic leukemia

Chronic lymphocytic leukemia (CLL) constitutes the most common leukemia in adults living in western countries. The clinical course of the disease is extremely heterogeneous and pathogenesis is still unknown. Immune system disorders in CLL patients are observed in the early stages of the disease and worsen during clinical observation. On the one hand, CLL patients are characterized by immunosupresion and on the other hand, autoimmune processes. The immunosuppression observed in patients with CLL is associated with disorders of non‑specific immune response as well as T‑cell and B‑cell response, leading to frequent and severe infections. The immune system of patients with CLL could be also inhibited by many immunosuppressive factors occurred in tumor microenvironment, including populations of immune cells, which include myeloid‑derived suppressor cells (MDSCs), T regulatory cells (Treg) and the newly described B regulatory cells (Breg). It was shown that CLL cells can regulate immune response and escape from the surveillance of the immune system through the PD‑1/PD‑L signalling pathway. Interestingly, reduced immune response in CLL patients may be accompanied by autoimmune processes clinically manifested as autoimmune cytopenias. The secondary autoimmune cytopenias complicating the course of the disease include autoimmune hemolytic anemia (AIHA), immune thrombocytopenia purpura (ITP), pure red cell aplasia (PRCA) and autoimmune granulocytopenia (AG). Identification of immunological disorders in patients with CLL is necessary to understand the biology of the disease and to select appropriate treatment patterns based on modulation of the immune system.

Immunological disorders in patients with purulent-inflammatory pathology of ENT organs in conditions of comorbidity with diabetes mellitus

The article discusses the problems of the comorbid course of purulent-inflammatory diseases of the ENT organs and diabetes mellitus. The authors consider the main immunological factors of systemic and tissue immunity, which make it possible to detect immunodeficiency in conditions of purulent inflammation - immunoglobulins A, M, G, phagocytosis parameters, lysozyme, lactoferrin, general bactericidal activity, antibody affinity, determined in blood serum and saliva. In the course of the work, results were obtained that characterize a decrease in the systemic and tissue immune reactivity, which correlate with the degree of compensation of diabetes mellitus, which is a predictor of the occurrence and development of focal suppurative inflammation in the ENT organs. The authors conclude that rational antihyperglycemic therapy is necessary to maintain a satisfactory level of glycemia.

Differential diagnostics and correction of metabolic and immunological disorders in patients with hepatic cirrhosis, complicated hepatosplenomegalia and portal hypertension

The study of the role of the spleen in the pathogenesis of liver cirrhosis is important for treatment. Currently available literature data indicate the role of altered spleen functions in the pathogenesis of liver cirrhosis. The aim of this study was to clarify the features of the etiology and pathogenetic disorders in patients with hepatosplenomegaly. Materials and methods. We investigated the uniform elements of blood and blood serum from 58 patients with hepatosplenomegaly amid cirrhosis, portal hypertension complicated. Patients were divided into two groups depending on the antigenic load: I - patients with liver cirrhosis against the background of hepatitis viruses HBV/HCV and II - patients with autoimmune hepatitis against the background of herpes viruses CMV/VEB. Treatment of patients included the use of antiherpetic immunoglobulins and hematopoietic cord blood progenitor cells. Results. In patients of group I was detected an increase in the spontaneous oxidative activity of neutrophils and depletion of the oxidative reserve in oxygen-dependent phagocytosis. It activated the signaling pathways of pro-inflammatory cytokines IL-6 (an increase of 60 times). We found an increased content of CD22+ -plasma B-lymphocyte that elevated synthesized concentrations of IgA. In patients of group II were found an increase in the activity of C3 and a decrease in the C4-components of complement; thrombocytopenia due to the presence of platelet autoantibodies; increased synthesis of immunoglobulins IgM, IgG, increased synthesis of IFN-. All patients showed disturbances in the metabolism of amino acids in various metabolic cycles - ornithine, which disrupted the formation of urea and indicates the accumulation of ammonia, which can enhance the cytotoxic effect in group I; methionine with a violation of the formation of cystine from cysteine and the accumulation of homocysteine, which enhances the synthesis of IFN-γ, which was increased in group II by 4 times. Conclusions. Some etiological and pathogenetic features of the formation of liver cirrhosis complicated by portal hypertension and recurrent bleeding from varicose veins of the esophagus were revealed. The immunological and metabolic changes verified by us correlated with the disappearance of the clinical manifestations of the disease, improved well-being, and the absence of recurrence of bleeding.

Immunology-Rheumatology Approach to Sudden Sensorineural Hearing Loss.

Sensorineural hearing loss (SNHL) and vestibular dysfunction have been described in various autoimmune disorders and systemic vasculitides. A high prevalence of SNHL is reported to occur in established rheumatologic diseases; however, immunologic and rheumatologic disorders make up a small proportion of patients with sudden sensorineural hearing loss (SSNHL). This prospective study was carried out in order to determine the prevalence of rheumatologic and immunologic disorders in patients with SSNHL in Northeast Iran. Patients with a diagnosis of SSNHL referred to our University Hospital were enrolled in this prospective study conducted over a period of 3 years. Immunology-rheumatology evaluations were performed in all patients, including detailed history, physical exams and laboratory tests such as erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA), rheumatoid factor (RF), anti neutrophil cytoplasmic antibody (PR3, c-ANCA), perinuclear anti neutrophil cytoplasmic antibody (p-ANCA), antiphospholipid antibody, anti-cyclic citrullinated peptide (ACCP), and complement proteins C3 and C4. Eighty-three patients with a mean age of 42.04±16.94 years were admitted into the study. The female-to-male ratio was 47% to 53%. ANA was positive in one patient, RF in six, p-ANCA in two, ACCP in one, and antiphospholipid antibody was positive in three patients with low titers. No diagnosis of rheumatologic diseases was detected, except for one patient who was diagnosed with primary Sjögren's syndrome. Fewer than 5% all cases had specific positive immunologic tests. The low frequency of immunology-rheumatology positive tests and disorders in our patients with SSNHL indicates that it is not reasonable to routinely perform all related tests for every patient. Instead, clinical evaluations should be used to decide whether or not to conduct these tests.

Features of metabolic disorders in patients with hernias of lumbar spine associated with arterial hypertension

The combination of arterial hypertension (AH) with the spine pathology is a natural manifestation of connected structural-functional disorders.Aim is to determine the features of metabolic disorders in the organism of patients with hernias of lumbar spine, associated with arterial hypertension (AH), on the base of clinical-biochemical and immunological markers.Materials and methods. The study was carried out in 2016 on the base of SI “Institute of spine and joints pathology, named after prof. M.I. Sitenko, NAMS of Ukraine”. There were examined 37 patients with lumbar spine hernias: 23 – without concomitant pathologies, 14 – in association with AH of 1–2 degrees of І–ІІ stage. The control group – 30 persons, 13 men and 17 women. General protein, glycoproteins, chondroitin sulfates, C-reactive protein, glucose, urea, creatinine, β-lipoproteins, calcium, ALAT, ASAT, CPK, LDG, IL-1, IL-4 and IL-6 were determined in blood serum.Results of research. The content of interleukins in the group of patients with AH was higher than in the group of patients without it. In the group of patients with AH IL-1 was increased in 10,5 times, IL-6 – in 5,3 times that testifies to heavier immunologic disorders in patients with AH. The content of glycoproteins in patients without AH was increased by 55,8 %, in patients with AH – in 2,1 times comparing with control. The content of chondroitin sulfates in patients with hernias without AH was increased in 2,8 times, in ones with AH – in 4 times. LDG was increased, CPK – decreased in both groups. β-lipoproteins in blood of patients without concomitant AH was increased by 44,6 %, in patients with AH – by 67 %.Conclusions. In patients with lumbar spine hernias, associated with AH were observed heavier inflammatory-destructive disorders in the cartilage tissue. The increased content of β-lipoproteins in blood of patients with lumbar spine hernias, associated with AH comparing with patients without it may indicate age disorders of lipids metabolism. IL-1 and IL-6 уin patients with lumbar spine hernias, associated with AH were higher comparing with patients without it

КЛИНИКО-ИММУНОЛОГИЧЕСКИЕ ОСОБЕННОСТИ ОСТРОНЕКРОТИЗИРУЮЩЕЙСЯ ФОРМЫ КОЖНОГО ЛЕЙШМАНИОЗА

Objective: To study immunological disorders in patients with a rural (acute necrotizing) form of Cutaneous Leishmaniasis (CL). Methods: 80 patients were found under the observation in a rural (acute necrotizing) form of CL, including 23 (28.8%) men and 57 (71.2%) of women. The age of patients fluctuated from 16 to 60 years and over Results: The data showed that the oppression of the activity of the cellular immunity in patients with CL in comparison with healthy people, which indicates the significant of absolute and comparative numbers of CD3 lymphocytes (by 20%, p 0.01), the tendency of falling of absolute and comparative numbers of CD4 (T helper-inducers) and CD8 (T-cytotoxic) lymphocytes (correspondingly to 12% and 18%), as well as the absolute and comparative number of lymphocytes (by 12%) of peripheral blood. Conclusion: Thereby, in patients with acute necrotizing form of CL observes immunological disorders both in cellular and humoral components of immunity, which was depended on prescription of the process and the presence of complications. Keywords: Acute necrotizing cutaneous leishmaniasis, clinical and immunological features.

The clinical significance of natural autoimmunity in patients with adhesive process and external genital endometriosis

The article presents the results of a study of 71 patients with adhesive process diagnosed with external genital endometriosis (EGE) confirmed by laparoscopy. In accordance with the specific serum immunoreactivity evaluation, all patients were divided into 3 groups: Group A (normal response type), Group B (hyper-response type) and group C (hypo-response type). The duration of infertility was on average 6,1 ± 1,3 years. After surgery patients underwent antigonadotropic therapy with 3.75 mg buserelin (a course of 4--6 injections). Against a background of the baseline therapy, all patients in groups B and C underwent correction of immunological disorders. Conclusion: Management of immunological disorders in patients with adhesive process associated with EGE enhances the effectiveness of recovery of the reproductive function

THE INFLUENCE OF LEPTIN ON THE DEVELOPMENT OF IMMUNOLOGICAL DISORDERS IN PATIENTS WITH DIABETES MELLITUS TYPE 2 AND HYPOTHYROIDISM

The work deals with the determination of leptin and IL-6 influence on the development of immune disorders in patients with DM type 2 with hypothyroidism. There were examined 34 patients with diabetes mellitus type 2 and hypothyroidism and 27 patients with the primary hypothyroidism without DM. It was revealed that obesity is characterized with an increase of leptin and IL-6 levels that, in its turn, condition the development of system inflammation of the low intensity and result in the increase of risk of autoimmune changes. In patients with DM type 2 in combination with hypothyroidism on the background of obesity the indices of leptin, IL-6, CD4+, CD8+ and IRI reliably differed from the ones in the group of patients without obesity that testifies to the negative influence of obesity on the development of autoimmune immunological disorders in patients with DM type 2. There were established the correlations between BMI and leptin and IL-6 CD4+, CD8+, ІRI indices in patients with DM type 2 in combination with hypothyroidism.

Significance and detection of levels of IL-8,TNF-α in serum of patients with aplastic anemia

Objective To investigate the significance of levels of IL-8,TNF-α in serum of patients with aplastic anemia(AA).Methods Serum levels of IL-8 and TNF-α in 45 patients and 30 normal controls were measured by enzyme linked immunosorbent assay.Results The serum levels of IL-8,TNF-α increased significantly in AA and acute AA(AAA)group than in the control group(P＜0.05),there was no statistical significance between chronic AA(CAA)group and the control group(P＜0.05),and the levels in AAA group were much higher than in CAA group(P＜0.05).The serum level of IL-8 was positively related to TNF-αin AA group(r=0.682,P＜0.05).Conclusion There are immunological disorders in patients with AA and the overproduction of IL-8,TNF-α might be involved in the immunopathogenesis of AA,AAA. Key words: Anemia,aplastic; Interleukin-8; Tumor necrosis factor-α

Differences in clinical features between the Lambert-Eaton myasthenic syndrome with and without cancer: an analysis of 227 published cases

To compare the clinical features of patients with the Lambert-Eaton myasthenic syndrome (LEMS) associated with carcinoma, with patients having LEMS but no cancer, reports on LEMS patients were analyzed systematically. Cancer was detected (CD group) in 62% of the 227 included cases. This CD group showed a male predominance (70%). No sex difference was found in patients in whom no cancer was detected (NCD group). Median age at onset of LEMS in the CD group was higher than in the NCD group (58 and 49.5 years, P<0.01). Median interval between onset of symptoms and diagnosis of LEMS was longest in NCD cases ( P<0.001). CD patients had additional immunological disorders less frequently than NCD cases (6 and 27%, P<0.001). Symptoms distinguishing the CD group from the NCD group were weight loss ( P<0.001) and need for prolonged artificial ventilation after anaesthesia ( P<0.05). This analysis shows significant differences between CD and NCD cases of LEMS. The male predominance and higher age at onset in patients with a tumor probably reflects the characteristics of patients with small cell lung cancer. The high frequency of additional immunological disorders in patients without malignancy, together with the younger age at onset suggests a similar etiology as other non-paraneoplastic autoimmune diseases.