Immunoregulatory Index Research Articles

Effectiveness of new antituberculosis drugs in the treatment of children and adolescents with chemoresistant tuberculosis

BACKGROUND. There is a significant decrease the effectiveness of antituberculous (anti-TB) treatment on the background of multidrug and extensive drug resistance (MDR/XDR) of Mycobacterium tuberculosis. Therefore, in order to increase the effectiveness of treatment MDR-/XDR-TB a new antimycobacterial drugs such as bedaquiline (Bdq), delamanid (Dlm) and pretomanid have been introduced both for adults, children and adolescents in recent years. MATERIALS AND METHODS. On the basis of a retrospective cohort analysis of the data of patients' medical records the evaluation of the clinical effectiveness of chemotherapy with Bdq and Dlm was carried out. The main group: 40 children and adolescents with MDR-/XDR-TB of lungs, who received complex antimycobacterial therapy (AMBT) with Bdq and Dlm. The control group consisted of 27 patients who received complex AMBT without Bdq and Dlm. Age range – from 3 to 18 years. RESULTS AND DISCUSSION. On the background of AMBT during the first 3 months of treatment was established stopping bacterial secretion among all patients of main and control groups. However, in control group compare to main one stopping bacterial secretion was significant slowly (p<0.05). At the stage of completion of the intensive phase of AMBT, the normalization of immunological indicators occurred in 29.6±2.8 % of control group and in 43.4±4.5 % of main one. A significant difference between the groups among the immunoregulatory index CD3+CD4+/CD3+CD8+, IgM and circulating immune complexes was obtained. Among children and adolescents of the main group positive dynamic of immunological changes were observed 1.5 times more often. Among all patients of main group the resolution of the infiltration, consolidation of the focus and the absence of decay cavities were ascertained at the end of the anti-TB course. Anti-TB treatment with the formation of small residual changes into lung tissue ended in 77.5 % patients of main group. In 12.5 % cases of control group destructions persisted and bacterial excretion resumed. A large residual changes such as multiple dense foci, fibrosis and residual decay cavities in control group were observed 2.3 times more often (51.9 % vs 22.5 %), p<0.05, than in main one. Using Bdq and Dlm among children and adolescents with MDR-/XDR-TB significantly increased efficiency of complex treatment. Among main group (72.5 %) compare to control (33.3 %) one the results of treatment to be considered “cured” were 2.2 times more likely and 1.5 times less often – “completed” (27.5 % vs 51.8 % respectively). The success rate of treatment among children and adolescents who received Bdq and Dlm was 100.0 % and among patients without these new drugs – 85.2 %. CONCLUSIONS. The criteria used show that AMBT combined with Bdq and Dlm is 1.5-2.2 times more effective (according to a separate criterion) than AMBT without these drugs.

Clinical and immunological features of rotavirus infection in children infected with herpesviruses

The basis for conducting the study was the absence in the scientific literature of works devoted to the study of clinical and immunological features of rotavirus infection (RVI) in children against the background of the latent form of herpesvirus infection (lHVI) caused by cytomegalovirus (CMV) and human herpesvirus type 6 (HHV-6). The aim - to identify clinical and immunological features of RVI in children with lHVI caused by CMV and HHV-6 that will contribute to the early diagnosis of lHVI in patients. Materials and methods. A total of 81 children aged 12-36 months with RVI were examined. The Group 1 included 33 children who were not found to be infected with any of the herpesviruses. The Group 2 included 17 children who were suffering from RVI against the background of lHVI caused by CMV. The Group 3 included 31 children suffering from RVI against the background of lHVI caused by HHV-6 type. Statistical processing of the results was carried out using the IBM® SPSS® 25.0 program for Microsoft® Windows®. The results. The presence of lHVI caused by CMV in the acute period (AP) of RVI leads to lower indicators of temperature reaction, lower frequency of vomiting, a decrease in the immunoregulatory index (IRI) against the background of an increase in the level of CD8+ T-lymphocytes. In addition to lower numbers of the temperature reaction, the level of IgA was increased in children with lHVI caused by HHV-6. During the convalescent period (CP), CMV is associated with an increase in the duration of fever and diarrhea, an increased content of CD8+ T-cell counts, and lower IRI, CD16+, CD22+ T-cells, and IgM scores. In patients with lHVI caused by HHV-6, fever, diarrhea, and catarrhal syndrome persisted longer against the background of reduced levels of IRI, CD22+ T cells, and IgM. Conclusions. lHVI is caused by CMV and HHV-6, it has different effects on clinical and immune indicators in children with RVI. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution indicated in the work. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Clinical and immunological efficacy of complex therapy for bronchial asthma in children with the inclusion of components of far eastern brown algae

Classical basic therapy for asthma is aimed at stopping inflammation, primarily atopic, and has achieved significant positive results in the treatment of the disease, which has led to a decrease in the severity of asthma. The proportion of patients in whom asthma control is achieved does not exceed 30%; complete control is achieved in 5%, that is associated with the influence non-atopic factors on the pathogenesis of BA, leading to the search for additional methods of correction. Despite the identified biological, immunomodulatory properties of the components of brown algae, the mechanisms of their action, in asthma, are not sufficiently illuminated, which became the purpose of this study: to determine the possible immunomodulatory effect of a functional food product in children with asthma based on brown algae (Far Eastern kelp) and its use in addition to standard therapy to improve control of the course of this disease. Children with asthma (n = 56) aged from 5 to 17 years were comprehensively examined and divided into 2 groups: those who received a functional food product in addition to standard therapy (n = 20) and those who received only standard therapy (n = 36). Laboratory tests included CBC, immunogram, cytokines (IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL- 10, IL-18, TNFá), blood ICC MPM, and herpesvirus DNA. Against the background of complex treatment, changes in the interleukin profile (IL-6, IL-10, IL-18) were noted, characteristic of a decrease in the intensity of inflammatory processes, including nonspecific ones, expressed in a tendency towards a decrease in the total number of lymphocytes, an increase in the immunoregulatory index both due to an increase in the number of T helper cells and and reduction of killer T cells. This was confirmed by a decrease in monocytes and ESR. Improved energy supply of immunocompetent blood cells (granulocytes and monocytes), a decrease in the number of patients with active replication of EBV and herpes virus type 6 indicate its immunomodulatory effect. The result of these changes was the positive clinical dynamics of asthma control indicators, which allows us to recommend the inclusion of a functional food product based on Far Eastern brown algae in addition to standard therapy for children with asthma aged 5-17 years.

Ratio of immune indices in women of the semi-arid region

Environmental and climatic factors have a significant impact on the immune system, shaping its composition and functions. The semiarid region of Aleppo, characterized by hot, dry summers and moderate, wet and cold winters, is also characterized by environmental pollution such as air pollutants and industrial chemicals. The interaction of these environmental and climatic factors can impair immune function by causing inflammatory responses, compromising the integrity of immune cells, and impairing the body’s ability to mount an effective immune response. To date, the physiological characteristics of the parameters of the human blood system and the development of physiological reactions of adaptive immune homeostasis depending on the territory of residence have not been sufficiently studied. In this work, we studied the state of immune indices in women living in the semi-arid region. Thirty women aged from 20 to 60 years without chronic and acute diseases were examined. Immunocompetence was assessed using white blood cell count, lymphocyte subset analysis and calculation of immune indices including neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), systemic inflammatory response index (SIRI), immunoregulatory index (CD4+/ CD8+) and lymphoproliferation ratio and apoptosis (CD10+/CD95+ and CD71+/CD95+). The results of the analysis showed that the median NLR was 2.18 (1.50-2.90), LMR 6.66 (5.47-8.87), SIRI 0.64 (0.45-0.98), immunoregulatory index 0.99 (0.84-1.27) and the ratio of lymphoproliferation processes to apoptosis (CD10+/ CD95+ and CD71+/CD95+) 0.95 (0.65-1.29) and 0.94 (0.78-1.11), respectively, which indicates a stressful state of immune homeostasis and signs of premature aging of the immune system. Neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), systemic inflammatory response index (SIRI), immunoregulatory index (CD4+/CD8+) and lymphoproliferation-apoptosis ratio were determined. (CD10+/ CD95+ and CD71+/ CD95+) in the examined women of the semiarid climate zone of residence, emphasizes the stressful level of immune homeostasis. The results obtained highlight the need for systematic individual biomedical monitoring to maintain immune homeostasis in populations inhabiting similar environmental conditions.

Імунологічні особливості у вагітних із великими акушерськими синдромами

Aim of the research – to evaluate the adaptive capabilities of the immunological system in pregnant women who had complications from the group of major obstetric syndromes (МОS) for the further development of an algorithm for the prevention of this complication. Materials and methods. The main study group (MG) - 99 pregnant women who had a complication from the group of MOS, which was clinically manifested by placental insufficiency (PI); control group (CG) - 50 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. The number (x109/l) and relative (%) of lymphocyte subpopulations CD3+ (T-lymphocytes), CD4+ (helper-inducers), CD8+ (cytotoxic suppressors), CD56+ (natural killers), CD19+ (B-lymphocytes) were determined; the presence of antiphospholipid antibodies (APA); total hemolytic activity of the classical way of complement activation (CH50); levels of IgG, IgM, IgA. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistical 6.0 programs. Results. In the I and II trimesters of pregnancy in MG and CG, a tendency to decrease was observed, СM4+ (51.8±2.5% and 48.9±1.6; 58.4±2.3% and 55.6±2.6%), and СD8+ (24.6±2.4% and 21.2±1.2%; 31.3±2.5% and 30.9±2.7%), which led to an increase in the immunoregulatory index (СD4+/СD8+) in MG (р<0.05). The level of СD19+, during gestation there was an increase in their relative number in MG (13.6±0.98%; 16.4±2.03% and 21.1±2.01%) (p<0.05); a predominance of the percentage of CD56+ lymphocytes, which have the properties of natural killers, was observed in pregnant MG (12.3±1.7%; 15.1±1.7%; 13.9±1.73% vs. 8.6±1.4%; 8.1±1.18%; 7.2±0.98%; p<0.05). Hemolytic activity of the classical pathway of complement activation (CH50) in MG pregnant women was 1.5 times higher compared to CG pregnant women (p<0.05). APA, represented by IgG to cardiolipin, were detected in 47 (47.5%) pregnant women MG and 4 (8.0%) women pregnant CG (p<0.05). Conclusions. Іn pregnant women with МОS, there is an immune maladaptation that progressively increases in the dynamics of gestation and is manifested by excessive activation of natural killers (CD56+), an increase in the immunoregulatory coefficient (CD4+/CD8+), an increase in the percentage of B-lymphocytes (CD19+), dysimmunoglobulinemia, which is accompanied by high indicators of the general hemolytic activity of the classical pathway of complement activation (CH50), the presence of APA. The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research. The author is stating no conflict of interests is declared.

FEATURES OF THE T-IMMUNE SYSTEM IN PATIENTS WITH GLOMERULONEPHRITISES WITH NEPHROTIC SYNDROME

The study of issues related to glomerulonephritises with nephrotic syndrome is one of the urgent problems of medicine due to their prevalence worldwide, mainly in the young age group. Medical workers distinguish primary (idiopathic) nephrotic syndrome, which occurs in 80–90% of cases, and secondary nephrotic syndrome, mainly associated with systemic autoimmune diseases, diabetes mellitus and neoplasms. Glomerulonephritises, manifested by nephrotic syndrome (membranous nephropathy, focal segmental glomerulosclerosis, nephropathy with minimal changes), are known to be autoimmune diseases. To date, the immunological mechanisms of the pathogenesis of glomerulonephritises with nephrotic syndrome associated with the T-system of adaptive immunity remain unexplored. The aim of the study was to study the role of the T–immune system in the pathogenesis of primary nephrotic syndrome based on the study of immunoregulatory, activated T-cell subsets in patients with this pathology. Material and methods. 136 patients with chronic glomerulonephritis with nephrotic syndrome were selected for the study. The assessment of the T-immune system included determination of the lymphocyte phenotype of immunoregulatory T-cell subsets (T-helper/inducers, cytotoxic T-lymphocytes), various subpopulations of activated T-cells (activated T-lymphocytes; activated T-lymphocytes expressing CD25–alpha chain of IL-2 receptor; activated cytotoxic T-lymphocytes expressing HLA-DR and CD38) and regulatory T-cells (Treg cells). Study results. In the patients of the examined cohort, an increase in the number of T-lymphocytes and T-helper cells, as well as activated T-lymphocytes expressing HLA-DR antigens, was found. At this, the content of cytotoxic T-cells and the number of activated T-cells expressing the IL-2 – CD25 receptor did not differ from similar indicators in healthy individuals. The levels of Treg cells and activated cytotoxic T-lymphocytes with the CD3+CD8brightCD38+ phenotype were reduced. The immunoregulatory index (T-helpers/cytotoxic T-lymphocytes) was increased, due to an increase in the number of T-helper cells against the background of an unchanged number of cytotoxic T-lymphocytes. Conclusions. The results of the study indicate that the main features of the T-system of the immune response in primary nephrotic syndrome are imbalance in the ratio of the content of immunoregulatory cells due to predominance of T-helper cells and a decrease in the number of Treg cells.

Prevention of occupational allergodermatoses using pathogenetically based techniques

Introduction. Currently, occupational skin diseases remain one of the important medical problems. In this regard, the search for new modern, promising methods for the prevention and treatment of skin diseases is relevant.
 The purpose of the study is to evaluate the effectiveness of treatment and preventive measures among industrial workers with occupational allergic dermatoses.
 Materials and methods. Two groups of patients with occupational allergic dermatoses (seventy seven cases) were examined and treated. In the control group (37 people), only traditional treatment was carried out; in the main group (40 people), the complex of treatment measures, in addition to conventional therapy, included the procedure of intravenous laser blood irradiation (ILBI). Biochemical and immunological studies were carried out using standard and unified methods.
 Results. The use of ILBI in patients with occupational dermatoses had a positive effect on the state of cellular and humoral immunity: the number of CD3+ and CD4+ lymphocytes increased by 1.2–1.5 times, the CD4+/CD8+ immunoregulatory index normalized, the content of B cells in the bloodstream decreased, and levels of immunoglobulins IgG, IgE up to 1.6 times and inflammatory mediators (interleukin -10, -4, 
 tumour necrosis factor-α) by 1.5–2.3 times. There was a 1.3-fold decrease in the content of ceruloplasmin, a protein in the acute phase 
 of inflammation, and a 1.3–1.4-fold increase in the activity of catalase and neutrophil myeloperoxidase. A more rapid regression of rashes, 
 a decrease in erythema, and the disappearance of itching was noted in the main group. The duration of the relapse-free period in this group is 1.9 times longer than in the control group.
 Limitation: study of the effectiveness of laser therapy in the treatment of patients with occupational allergic dermatoses according to clinical and laboratory parameters.
 Conclusion. The ILBI technique has shown its effectiveness and positive impact on the pathogenetic links in the development of occupational skin pathology, in comparison with traditional drug treatment. As a result, it can be used for immunorehabilitation, prevention, and treatment of this pathology.

Immunophysiological State of Dogs According to the Immunoregulatory Index of Their Blood and Spleens.

In this study, the immunological characteristics of a dog's body were established, allowing for a quick reaction to any changes in the immune status and the development of an immunodeficiency state. The immunoregulatory blood index was determined to indicate the ratio of T-helpers and T-suppressors. The immunoregulatory index of the spleen was determined as the ratio of CD4+ cells to CD8+ cells in the field of view of a microscope (eyepiece 10, objective 40) after obtaining histological preparations according to generally accepted methods. It was found that the number of T-helpers decreased by 0.13 × 1012/L, while the number of T-suppressors increased non-significantly by 0.01 × 1012/L after intensive exercise during tasks. The immunoregulatory blood index of dogs was 2.1 ± 0.1 and 1.7 ± 0.13 before and after intensive exercise, respectively. Lymphocytes with markers CD4+ and CD8+ were located almost all in the white pulp; in the red pulp, they were found alone, and their share was 3.4% and 1.9%, respectively. Lymphocytes with CD4+ markers in the spleen's white pulp were mainly concentrated in lymphoid nodules (60.7%), of which 20.1% were focused on the marginal zone, and slightly less in the light center (19.4%) and the periarterial zone (18.1%). Lymphocytes with CD8+ markers in the spleen's white pulp were also mainly concentrated in lymphoid nodules, but their number was 8.1% higher (68.8%). The immunoregulatory index of the spleen is 1.9. These findings emphasize the need for the assessment of the immunoregulatory index in service dogs to prevent the development of secondary immunodeficiency and allow them to properly perform their official duties.

Lymphocyte subpopulations: a potential predictor of a response in patients with immune thrombocytopenia

ABSTRACT Objectives Immune thrombocytopenia (ITP) is an autoimmune bleeding disorder caused by increased platelet destruction and altered production. Despite the well-described pathophysiological background of immune dysregulation, current treatment guidelines consist of monotherapy with different drugs, with no tool to predict which patient is more suitable for each therapeutic modality. Methods In our study, we attempted to determine differences in the immune setting, comparing the patients’ responses to administered therapy. During 12-month follow-up, we assessed blood count, antiplatelet autoantibodies, and T lymphocyte subsets in peripheral blood in 35 patients with ITP (newly diagnosed or relapsed disease). Results Our data show that the value of antiplatelet autoantibodies, the percentage of cytotoxic T lymphocytes, and the immunoregulatory index (IRI, CD4+ / CD8+ T cell ratio) differ significantly by treatment response. Responders have a higher IRI (median 2.1 vs. 1.5 in non-responders, P = 0.04), higher antiplatelet autoantibodies (median 58 vs. 20% in non-responders, P = 0.01) and lower relative CD8+ T cells count (P = 0.02) before treatment. Discussion The results suggest that immunological parameters (antiplatelet autoantibodies, relative CD8+ T cell count and IRI) could be used as prognostic tools for a worse clinical outcome in patients with ITP. Conclusion These biomarkers could be utilized for stratification and eventually selection of treatment preferring combination therapy.

The impact of inhalation versus total intravenous anesthesia on the immune status in patients undergoing breast cancer surgery: a double-blind randomized clinical trial (TeMP).

Breast cancer (BC) mortality primarily stems from metastases rather than the primary tumor itself. Perioperative stress, encompassing both surgical and anesthetic factors, profoundly impacts the immune system, leading to alterations in neuroendocrine pathways and immune functions, potentially facilitating tumor progression and metastasis. Understanding the immunomodulatory effects of different anesthesia techniques is crucial for optimizing perioperative care in patients with BC. The neutrophil-to-lymphocyte ratio (NLR) serves as one of the key indicators of perioperative immune response. To compare the effects of inhalation anesthesia (IA) and total intravenous anesthesia (TIVA) on perioperative immune response in BC surgery patients. In this randomized, double-blind clinical trial, BC surgery patients were randomized to receive either TIVA with propofol or IA with sevoflurane. The primary endpoint was NLR assessment. Secondary immune parameters measured included natural killer cells, various T cell subsets, B cells, the immuno-regulatory index [T-helpers (CD3+CD4+)/cytotoxic T-cells (CD3+CD8+)], matrix metallopeptidases (MMP-9), complement components, and immunoglobulins, preoperatively and at 1 and 24 hours postoperatively. The study included 98 patients (IA: 48, TIVA: 50). The baseline characteristics exhibited remarkable similarity across the groups. No significant difference in absolute NLR values was found between IA and TIVA groups at any time point (1 hour: p = 0.519, 24 hours: p = 0.333). Decreased IgA and IgM levels post-surgery suggested potential negative impacts of IA on humoral immunity compared to TIVA. CRP levels increased more by 24 hours (p = 0.044) in IA compared to TIVA. No significant differences were observed in natural killer cells, T cell subsets, B cells, MMP-9 levels or complement components between groups. Significant differences in the immuno-regulatory index between the TIVA and IA groups at one hour postoperatively (p = 0.033) were not maintained at 24 hours. While there were no notable differences in NLR among the types of anesthesia, the observed disparities in immunoglobulin content and C-reactive protein levels between groups suggest that we cannot dismiss the potential immunosuppressive effects of inhalational anesthesia in breast cancer surgeries. Further investigation needed to clarify the impact of various anesthesia methods on immune function and their implications for long-term cancer outcomes.

The relationship between immunological and psychopathological characteristics in patients with focal epilepsy depending on the profile of interhemispheric asymmetry

To identify the possible influence of cellular immunity parameters and neurobiological variables (frequency of seizures of various semiotics and their severity) on comorbid psychopathological symptoms depending on the profile of interhemispheric asymmetry in patients with focal forms of epilepsy. The study included 92 patients with epilepsy (38 men, 54 women, mean age 38.7+8.45 years). Focal temporal lobe epilepsy was diagnosed in 36 patients, focal frontal lobe epilepsy in 16 patients, and temporal-frontal lobe epilepsy in 40 patients. For each type of seizure, severity was assessed according to the National Seizure Severity Scale (NHS3). The mental status of patients was assessed using the SCL-90 self-report questionnaire. The Annette scale was used to assess the profile of interhemispheric asymmetry. The number of different clusters of lymphocytes was studied, including the number of T-lymphocytes (CD3+), T-helpers (CD3+CD4+), T-cytotoxic (CD3+CD8+), T-NK (natural killers CD3+CD16+CD56+), B-lymphocytes (CD3-CD19+), as well as immunoregulatory index (CD4/CD8 ratio). In order to identify any possible relationships between neurobiological and immune variables, on the one hand, and the SCL-90 constructs, on the other hand, a separate correlation analysis of Spearman ranks within the left-handed group and the right-handed group was carried out. We revealed the differences between groups of patients with epilepsy with right and left profiles of hemispheric asymmetry regarding the relationship between the frequency of seizures, their severity and accompanying psychopathological variables, on the one hand, and between immunity indices and psychopathological constructs, on the other hand. It has been established that neurobiological and immune variables in left-handers can determine the psychopathological structure of the comorbid mental disorder. Prediction of concomitant psychopathological syndromes in patients with epilepsy on the basis of clinical data and data on immunity is quite possible, but only in left-handed patients.

Evaluation of the treatment strategy for complicated allergic rhinitis.

Aim: To carry out a comprehensive evaluation of treatment modification for patients with seasonal allergic rhinitis (SAR) complicated by anxiety-neurotic disorders. Materials and Methods: Patients with SAR in the acute stage on the background of anxiety disorders were studied. Immunological studies were carried out, an assessment of the dynamics of indicators of the quality of life of patients, the level of anxiety / depression was assessed. In the clinical group, a variant of therapy modification was proposed. Results: Significant changes in the subpopulation ratio of lymphocytes, an increase in the immunoregulatory index, which indicated the severity of the immunological process, were revealed in SAR patients in the acute stage against the background of anxiety disorders. At the same time, a significant activation of the humoral link of immunity was observed: an increase and a significant increase in IgE in the blood serum and an increase in the content of sIgA in the nasal secretion. In most patients, eosinophilia was found in the peripheral blood and in the rhinocytogram before treatment. In the study of the quality of life of patients, changes in many parameters were found. Conclusions: The combination of "Nazafort Allergy Protection" and Atarax seems to be the most successful, which significantly improved the physical and psycho-emotional state of patients with SAR, complicated by anxiety and neurotic disorders. This combination led to an increase in the stress resistance of patients.

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

PATHOGENESIS OF IMMUNE DYSFUNCTION IN THE SETTING OF METABOLIK SYNDROME IN CORONARY HEAT DISEASE. QUALIFYING SCENTIFYING WORK ON THE RIGHTS OF THE MANUSCRIPT

Стан загального імунітету в породілей із гнійними ранами під час воєнних дій

Purpose - to study the immune status of women giving birth with an infection of an obstetric surgical wound in the conditions of war, which will make it possible to develop and implement a pathogenetically justified method of wound infection therapy in the postpartum period. Materials and methods. We studied the immune status of 66 women in labor with an infection of an obstetric surgical wound in the conditions of war from February 24, 2022 and compared it with the indicators of general immunity of 76 women in labor with an infection of an obstetric surgical wound in peacetime. The material for the study of general immunity was peripheral blood, which was taken from the moment of infection of the obstetric surgical wound. To assess the state of general immunity, the total number of T lymphocytes (CD3+), their immunoregulatory subpopulations - T helpers/inducers (CD4+) and T suppressors/killers (CD8+), the number of B lymphocytes (CD22+), NK cells (CD16+) were counted), the immunoregulatory index (CD4+/CD8+) was calculated, the concentration of circulating immune complexes and immunoglobulins of classes A, M, G, phagocytic index and phagocytic number were determined. Statistical data processing was carried out using the package of application programs Microsoft Excel 5.0 and using the standard version Statistica 8.0. The difference in indicators was considered statistically significant at Р<0.05. Results. In women in labor with purulent wounds under the conditions of war under stressful conditions, there is a greater suppression of systemic immunity than in women in labor with this pathology in peacetime, which was manifested by T lymphopenia (decrease in CD3+ by 1.4 times, decrease in the level of T cells with helper activity (CD4+) by 1.2 times, immunoregulatory index (Tx/Tc) by 1.3 times), a decrease in the number of B lymphocytes (CD22+) and NK cells (CD16+) by an average of 1.2 times, a decrease indicators of immunoglobulins of classes A, M, G by an average of 1.3 times, phagocytic index) and phagocytic number relatively by 1.3 and 1.6 times, which led to an increase in the level of circulating immune complexes by 1.1 times. The absence of a significant difference between indicators of general immunity in parturient women with purulent wounds of the perineum and anterior abdominal wall was confirmed, which confirms the established doctrine that wounds of different localizations heal according to general laws and the body, namely the immune system, reacts equally to the wound process of any localization. Conclusions. When prescribing the treatment of an infection of an obstetric surgical wound, do not take into account the localization of the wound, since wounds of different localizations heal according to general laws and the immune system reacts in the same way. In women in labor with purulent wounds in wartime conditions, under stress, there is more suppression of systemic immunity than in women in labor with an infection of an obstetric surgical wound in peacetime, which increases the development and spread of the purulent-inflammatory process, increases the risk of severe septic complications, which leads to the development and implementation of a pathogenetically justified method of therapy of obstetric surgical wound infection in wartime conditions. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Features of immunological indicators in children with allergy modified by nickel contamination of biomedia and polymorphism of CPOX rs1131857 detoxification gene

Introduction. The impact of unfavourable environmental chemical factors on the human immune system predetermines the conditions for the formation of pathological conditions associated with allergies.
 The purpose of the study. To study the features of immunological indicator parameters in children with allergies modified by contamination of biological media with nickel and polymorphism of the detoxification CPOX rs1131857 gene.
 Materials and methods. A study was conducted one hundred eighty children suffering from various forms of allergies, permanently residing in the zone of the Far North (121 of them — under conditions of aerogenic exposure to nickel aerosols, and 59 children — in a “conditionally clean” territory). The subject of the study was biological media (blood). The change in the content of specific IgE to nickel was determined by an allergosorbent test with an enzyme label. The study of cell differentiation clusters included the use of flow cytometry (CD3+, CD19+, CD3+CD4+, CD3+CD8+, CD16+CD56+). Polymorphism of the CPOX (rs1131857) gene was studied by real-time polymerase chain reaction (PCR).
 Results. The analysis of the immune and genetic status of children with various manifestations of allergic pathology revealed cellular immunodeficiency (CD3+ CD4+, a decrease in the immunoregulatory index), the development of processes of hypersensitivity to chemical technogenic haptens (IgE to nickel), as well as an increased frequency of occurrence of heterozygous AC polymorphism of the second detoxification gene. phase CPOX rs1131857, verified by significant parameters of inheritance models (OR = 2.83; 95% CI: 1.14–7.01; 
 p < 0.05).
 Limitations. The present study is not exposed to the adult population, does not consume the population, and does not consume, except in the Far North.
 Conclusion. A feature of the course of allergic pathology in the children’s population of the Arctic, modified by contamination of biomedia with nickel and polymorphism of the detoxification CPOX rs1131857 gene, will be an increased frequency and duration of recurrence of allergopathology due to the addition of viral (decrease in cellular immunity) and hapten (nickel) components.

POSSIBILITIES OF CORRECTING CELLULAR-HUMORAL IMMUNE DISORDERS AND CYTOKINE STATUS IN HIGH-RISK PREGNANT WOMEN FOR THE DEVELOPMENT OF PREECLAMPSIA

POSSIBILITIES OF CORRECTING CELLULAR-HUMORAL IMMUNE DISORDERS AND CYTOKINE STATUS IN HIGH-RISK PREGNANT WOMEN FOR THE DEVELOPMENT OF PREECLAMPSIA

ПРОФИЛАКТИКА АНАСТОМОЗИТА ПОСЛЕ РЕЗЕКЦИИ ЖЕЛУДКА

The clinical, immunological and endoscopic features of anastomositis were studied in patients 
 after the stomach resection according to Billroth II in various modifications because of peptic ulcer disease.
 The study revealed the relationship in development of anastomositis with the level of populations T-lympho cytes, immunoregulatory index, circulating immune complexes, R-proteins in the early postoperative period 
 as well as before the operation. Disturbances in the immune system may lead to decrease in stability of mucosa 
 and to the increase of aggressive factors. The severity of disturbances in the functioning of the immune system 
 is interrelated with the presence of Helicobacter pylori infection. The higher the antibody titers to the antigen 
 CagA Helicobacter pylori, the more severe there may be the manifestations of immunopathological reactions 
 and the more severe the clinical signs of anastomositis. Immunological indicators and their dynamics may be 
 used both for the early diagnosis of anastomositis, and for the prognosis and prophylaxis of this postoperative 
 complication.

Features of T cell immunity depending on the content of natural killer cells in patients with acute coronary syndrome following COVID-19

We examined 65 men with unstable angina and acute myocardial infarction (acute coronary syndrome - ACS) from 40 to 65 years old who had previously had COVID-19 and 20 people with ACS who had not undergone COVID-19. All persons also had hypertension, and they required stenting of the coronary arteries within the next 3 days after admission to the hospital. From the immunological parameters by flow cytometry on the Navios cytofluorimeter (BeckmanCoulter, USA), according to the standardized technology for assessing the lymphocytic link of immunity [1], the following were determined: ), CD45+ CD3+ CD8+ (cytotoxic T-lymphocytes), CD45+CD3-CD19+ (B-lymphocytes), CD45+CD3+CD16+CD56+ (TNK cells), CD45+CD3-CD16+CD56+ (natural killer cells), CD45+ CD3+CD4+CD25+CD127- (T-regulatory cells), CD45+ CD3+CD4+CD25+ (T-lymphocytes - early activation), CD45+CD3+HLA-DR (T-lymphocytes - late activation). All patients were divided into groups depending on the content of NK cells (natural killer cells). Patients who have had COVID-19 have 3 phenotypes of disorders (decreased NK cell count, normal and increased), while non-survivors have 2 phenotypes (decreased NK cell count and normal). The most severe condition and severity of immune disorders were found in patients who had undergone COVID-19. In patients with acute coronary syndrome and COVID-19, predominantly with normal and elevated levels of NK cells, compared with ACS patients without COVID-19, a more severe course of the disease was observed - patients with acute myocardial infarction prevailed, they had a higher mortality rate, the duration of treatment was increased, and stent thrombosis was also more common. In persons with ACS and COVID-19 with elevated NK cells, the maximum decrease in the T-cell immunity was observed: T-lymphocytes of general, T-lymphocytes-helpers, T-cytotoxic lymphocytes, T-lymphocytes of early activation, T-regulatory cells in absolute numbers compared to other groups. The lowest immunoregulatory index and, at the same time, the maximum number of T-NK-lymphocytes were observed in persons who had undergone COVID-19 and had reduced NK cells. The minimum number of T-NK lymphocytes was recorded in patients with low NK cells who did not have COVID-19. Minimal T-lymphocytes (CD45+CD3+CD4+HLA-DR+) of late activation were found in people who recovered from COVID-19 with elevated and normal NK cells. The lowest number of late activation regulatory T cells was observed in patients who did not have COVID-19, but were vaccinated, and had a normal content of NK cells. The study also allows us to more clearly define the groups of patients with ACS who need additional immunocorrection.

Effect of chicken infectious bronchitis vaccine on morphogenesis and differentiation of cells in caecal tonsils

The study of the chickens’ immune system morphofunctional state allows assessing critical periods of their development and the body as a whole, as well as the effectiveness of vaccine prevention methods. The purpose of this study was to identify morphological and immunohistochemical changes in the caecal tonsils of chickens aged 8, 20, 40, 90, 110 days for vaccine prevention of infectious bronchitis. During the study, the following research methods were used: cytological, histological, immunohistochemical, morphometric, light-optical, statistical. Histological preparations of caecal tonsils of poultry aged 8, 20, 40, 90, 110 days of vaccinated and unvaccinated groups were analysed and studied. Up to 20 days of age, no lymphoid nodules were detected in the caecal tonsils of chickens, both vaccinated and non-vaccinated groups. Histological and morphometric studies were conducted, which showed that vaccination of poultry accelerates the development of lymphoid formations in the early stages of the postnatal period of ontogenesis, especially in chickens aged 20 days, which is manifested by an increase in the number and size of lymphoid nodules of caecal tonsils relative to the control group. Immunohistochemical studies have established that the placement and accumulation of T-lymphocytes with markers CD4+ , CD8+ , as well as B-lymphocytes (CD20+ ) and CD45RA+ cells in caecal tonsils, namely in lymphoid nodules and diffuse accumulation of lymphoid cells, depend on the age of chickens and multiplicity of vaccinations. It was proved that in chickens aged 8 days, the number of T-lymphocyte subpopulations with surface markers CD4+ , CD8+ prevailed over CD45RA+ and CD20+ . With the increase in the number of immunizations (after three-fold vaccination against infectious bronchitis of chickens), immunocytometric studies indicated that in vaccinated chickens aged 40 and 90 days, there was a clear increase in the number of mature B-lymphocytes by 1.58 and 1.37 times, respectively. Considering the fact that the number of CD8+ lymphocytes in vaccinated chickens aged 40 days was 1.49 times greater than the number of CD4+ cells, this led to a sharp decrease in the immunoregulatory index of the caecal tonsils, which must be factored in when carrying out preventive vaccinations

Клинический анализ воспалительных заболеваний поверхности глаза после перенесенной SARS-CoV-2 инфекции и эффективность их лечения иммуномодулятором Имунофан

Purpose. To present clinical information about the results of our own observations of inflammatory diseases of the eye surface after a SARS-CoV-2 infection and the effectiveness of complex treatment, including the domestic regulatory peptide Imunofan. Material and methods. There were 19 patients (38 eyes) under observation – 12 women and 7 men, aged from 22 to 57 years. Clinically, all patients had corneal syndrome and redness of the eyes. The control group consisted of 10 people who received standard anti-inflammatory, keratoprotective and desensitizing therapy. The main group included 9 people who, in addition to the standard treatment regimen, received parabulbar injections of Imunofan (50 mcg every other day) in the amount of 10 injections. Before treatment, in order to substantiate the pathogenetic expediency of Imunofan administration, immunoregulatory index (IRI) was calculated. Evaluation of treatment results was carried out on 5, 7, 10 and 20 days of treatment with the calculation of the total index of inflammation. Results. According to the results of the examination, the predominant clinical forms of postcovid inflammation of the eye surface were epithelial keratitis (57.8 %) and keratoconjunctivitis (26.3 %). The results of immunological monitoring of blood serum at the time of the initial visit to the ophthalmologist showed that all patients had IRI changes, while most of them (73.6 % of people) had secondary immune insufficiency, 5 people (26.4 %) had autoimmune disorders. The obtained data substantiate the expediency of using immunomodulators in pathogenetic treatment of this category of patients. Carrying out complex therapy, including the regulatory peptide Imunofan, led to a significant reduction in the symptoms of inflammation by the 7th–10th day of treatment, the timing of complete relief of the inflammatory process was reduced by almost two times. Conclusions. The occurrence of postcovid inflammation of the eye surface with disorders of the immune system is caused by pathogenetic relationships of SARS-CoV-2 infections, and developing by the type of secondary immune insufficiency (73.6 %), or autoimmune disorders (26.4 %). The use of Imunofan in the complex therapy of patients with an inflammatory process of the eye surface after a SARS-CoV-2 infection reduces the time of its relief by two times. Keywords: SARS-CoV-2 infection, inflammatory process of the eye surface, immunomodulator Imunofan