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Mirrahimova Nargiza Mirzahidovna, Research Institute of Epidemiology, Microbiology and Infectious Diseases Ministry of Health of the Republic of Uzbekistan, Tashkent
E-mail: Saodat.us@mail.ru
Akhmedova Khalida Yuldashevna, Research Institute of Epidemiology, Microbiology and Infectious Diseases, doctor of medical sciences
Abdushukurov Abdurashid Abdurahimovich, Research Institute of Epidemiology, Microbiology and Infectious Diseases, candidate of Medical Science
Antigen-binding lymphocytes for diagnosis organopathology in brucellosis
Abstract: The essential diagnostic method for determining the value of lymphocyte antigen to tissue antigens is its high sensitivity and specificity: ASL content reaches diagnostic levels in the early stages and creates the possibility of preventive treatment of organ damage in brucellosis.
Keywords: brucellosis, antigenbinding lymphocytes, tissue antigens, organopathology.
Brucellosis — a contagious, anthroponotic disease characterized by severe, often chronic course, the possibility of the propagation of the epidemic spread and classified as particularly dangerous infections. The diagnosis of brucellosis is set in the presence of clinical manifestations, epidemiological assumptions, confirmed by laboratory studies [3; 7; 8; 11].
Brucellas are characterized by a high capacity for invasion and intracellular parasitism. When the destruction of their, its released endotoxin. Brucella penetrates through the skin or mucous membranes and lymphatic enter the lymph nodes, where they can be stored for a long time and lead to a restructuring of the body's immune. In most cases, the immune response does not provide sanitation of the organism from the pathogen. Brucella long remain in metastatic lesions from which the re-repeated dissemination of the pathogen in the body with the development of reactive changes and chronic allergic process. It is possible resorption of inflammatory formations or formations persistent irreversible scarring of the affected organs and tissues. The main pathogenetic changes during brucellosis reduced to a non-specific inflammatory and degenerative processes in organs and tissues, hyperergic reaction, cirrhotic changes in organs and tissues [3; 7; 11].
The causative agent of brucellosis, having a high infectivity, causes changes in almost all organs and tissues. First of all, it is the nervous, lymphatic, cardiovascular system and connective tissue [1; 2; 9; 10; 12; 13; 14].
Pathological changes in the brucellosis are found in many organs. In the acute stage in parenchymatous organs found serous inflammation with the subsequent development of degenerative processes. It is develop infectious-reactive reticuloendotheliosis, panangiitis. The defeat ofvessels is the morphological substrate organopathology
when brucellosis. In the lymph nodes, liver and other parenchymal organs observed hyperplasia of reticular cells [2; 3; 10].
In the sub-acute stage of the disease are detected productive inflammatory processes, combined with degenerative processes and changes in infectious-allergic. In chronic brucellosis is prevail proliferative and inflammatory changes of granulomatous character with the formation of granulomas. In the thick connective tissue accumulates a significant amount of serous fluid, there is a loosening and destruction of the fibrous substance. Inflammation completed development of sclerotic tissue. The allergic nature of the systemic nature of the inflammation causes morphopathoge-netic changes.
However, it should be noted that clinically significant signs of organ damage are rare. At the same time, it is necessary to take into account the possibility of "masking" of clinical symptoms other manifestations of disease, typical for brucellosis as neurological and bone and joint pain [1].
The overwhelming number of patients (up to 80 %) increased liver and spleen. In the acute phase may develop specific focal pneumonia, bronchitis sometimes brucellosis.
The defeat of the urinary organs manifests moderate albuminuria, microscopic haematuria, the advent of single cylinders, renal epithelial cells. Rarely develop glomerulonephritis, sometimes with nephrotic component.
In subacute form of brucellosis (suspended after 3 months from the beginning of the disease) in addition to the symptoms of intoxication detected focal lesions in the form of arthritis, neuritis, plexitis and ets.
Conventionally, after 6 months from the onset of the disease is considered chronic brucellosis. For chronic brucellosis is
Antigen-binding lymphocytes for diagnosis organopathology in brucellosis
characterized by involvement in the pathological process of new organs and systems. In the clinical symptoms is predominate expressed focal lesions and effects of intoxication on the back burner. Temperature usually normal or low-grade, low-grade fever is sometimes installed thrust. It is typically relapsing course of the disease.
With the advent of focal changes in locomotor apparatus and nervous system of patients with the condition worsens. Prevalent lesions of the locomotor apparatus, manifested in a variety of combinations manifested in various combinations, i. e. the defeat of bones and joints, muscles and ligamentous apparatus. On palpation of the body found painful compaction, fibrositis and cellulite (nodules or cords). Patients complain of myalgia, arthralgia. The pains are transient "volatile" nature. If brucellosis it is affects not only large joints (shoulder, elbow, hip, knee and ankle), but small one. Brucellosis arthritis is prolonged for months. As a result of chronic inflammation of the joints configuration change is limited to their function. Subsequently, developing ankylosis, contractures, muscles atrophy. It is frequent bursitis, tenosynovitis. The bone X-ray examination revealed arthrosis arthritis, osteoporosis areas, narrowing ofjoint cracks, and hardening. Characterized by pain, stiffness and limitation ofmotion, deformation (spondylosis) of the various parts of the spine [3].
The defeat of the genital organs: orchitis, epididymitis lead to a decrease in sexual function and impotence. Women may develop mastitis, salpingitis, oophoritis, metritis, endometritis, which lead to amenorrhea, dysmenorrhea, spontaneous abortions, infertility [3; 8; 9].
In a number of infectious diseases, including brucellosis and, established involvement in the pathological process of the cardiovascular system [12; 13].
With the defeat of different genesis of a body or in its cells are a violation of intracellular processes and the development of dystrophy. Increasing the degree of dystrophy causes destruction and necrosis of cells. Enter into the internal environment of the molecule or fragments of structural and functional proteins with organ specificity. Tissue proteins and molecules, "alien" to the internal environment, acquire the status of tissue antigens (TA) started an immune reaction aimed at their neutralization and elimination. In the presence of TA in the internal environment of an organ differentiated and circulate in the blood lymphocyte antigen (BLA) capable of specifically binding to TA only of the body. The level of BLA to the TA reflects the intensity of destruction and necrosis of structures in the body: the increase in the dynamics ofABL indicates an increase and a decrease in BLA — on the fading intensity of these processes, which allows us to estimate the extent of organ involvement, as well as the effectiveness of the therapy [4; 5].
The method for determining the value ofABL to TA is its high sensitivity and specificity: the content of ABL to TA reaches diagnostic levels in the early stages and long before the appearance of clinical signs of the body, which creates the possibility of early prediction of the risk of organ failure. Setting response ABL to TA several organs can detect multiple organ destruction of the body in the development of pathology.
The purpose of this study was to evaluate the importance of indicators ABL to TA various organs to identify the degree of destruction of brain tissue, liver, kidney, joint capsule, endometrial and ovarian in acute, subacute and chronic forms of brucellosis.
In patients with brucellosis multiple organ defeat may have the most diverse range. Therefore, for a comprehensive treatment, including causal treatment and therapy aimed at relief of the pathological process in the affected organs, it is necessary for each individual patient to determine the nature multiple organ defeat. To assess multiple organ defeat the most informative and promising is the
determination of blood lymphocyte antigen (BLA) specifically sensitized with respect to specifically sensitized with respect to tissue antigens (TA) of organs [4; 5].
The principle of the method to determine the BLA to TA is as follows. Sensitized lymphocytes patient tissue antigen specifically binds their surface receptors. The used human erythrocytes of blood group O (1), on which the membrane using 3.0 % solution of CrCl3 loaded with tissue antigens, derived from tissue of human organs. Incubation of lymphocytes suspension of the subject with red blood cells loaded with TA, the formation of rosettes, consisting of centrally located lymphocyte and red blood attached there to TA erythrocytes on the membrane. Under the microscope with an immersion lens is made counting the percentage of rosette-lymphocytes to the total pool of lymphocytes [4].
To account for the interaction of nonspecific lymphocyte antigen reaction is carried out parallel to the rosette with red blood cells loaded with human serum albumin. To determine the multiple organs lesions determined the level of antigen-binding lymphocytes specifically sensitized to the antigens of the tissue of the brain, liver, kidney, shells joint bags in all patients, ovary, endometrium and myometrium in women.
The results of the study showed that patients with acute brucellosis most common pathological process were exposed to liver tissue (100 % of patients), and the joint capsule (at 96.7 % of sick). The average degree of increase the ABL to TA liver was 5.14 ± 0.16 %, rising to a maximum of 9 %. The average degree of increase the TA to BLA shells joint capsule was 4.60 ± 0.15 %, rising as much as possible, in some cases up to 10 %. Deviations higher than normal levels was also observed in terms of BLA to TA kidneys in 75.6 % of patients, with an average of 3.82 ± 0.11 %, the level of the maximum values in up to 7 %. In 53.3 % of patients it was showed improvement of ABL to brain TA, with an average of 3.75 ± 0.16 %, reaching in some patients up to 6 % (Table 1).
In subacute brucellosis in 100 % of patients have elevated levels ofABL to liver TA an average of 5.23 ± 0.26 % and the BLA to the TA joint capsule shells to 5.00 ± 0.21 %, ranging from 3 to 8 %, at 65.7 % of the patients showed an increase in BLA to brain TA an average of 3.03 ± 0.24 % and 48.6 % of patients improving to ABL to kidney TA an average of 2.97 ± 0.23 %, the maximum values were 6-7 % (Tab. 1).
Analysis of the results to the BLA parameters studied TA of the secondary-chronic brucellosis found that the increase in performance BLA specifically sensitized to the TA of the liver was observed in 86.4 % of patients, kidneys in 60.6 %, and in 34.8 % of patients to the brain TA and in 100 % of patients in the joint capsule TA shells, respectively, with an average of 4.37 ± 0.19 %, 3.80 ± 0.14 %, 4.00 ± 0.17 % and 4.83 ± 0.12 %. The maximum values ofABL to the joint capsule TA of the liver is 7 %, and the kidneys and the brain of 6 %, whereas in acute brucellosis they rise to 9-10 % (Table 1).
Frequent manifestations of infection are a syndrome of general intoxication and fever, accompanied by functional (transient) impaired kidney and liver. Febrile body temperature can lead to violations of water-electrolyte metabolism, which also affects the kidney function [1]. This apparently explains the more frequent liver, kidneys and brain in acute brucellosis compared with secondary chronic form of the disease.
In acute and chronic secondary we studied as indicators of BLA to TA ovary, endometrium and myometrium (Table 1). Comparative analysis of the results showed a significant increase in all indicators in the norm (3.35 ± 0.34 %, 2.29 ± 0.19 % and 1.71 ± 0.19 %, respectively in acute; 0.20 % ± 4.47, 2.73 ± 0.08 % and 2.07 ± 0.03 % respectively, with a secondary-chronic; in healthy women, the figures were respectively 2.32 ± 0.13 %, 1.74 ± 0.15 % and 1.37 ± 0.11 %.
Table 1. - Lymphocyte antigen display in various forms to treat brucellosis
АВД to ТАГ Norm n = 23 Brucellosis
Acute n = 90 Under acute n = 35 Secondary chronic n = 66
Brain 2.2б t Q.13 3.75 t 0.16* 3.91 t 0.18* 4.00 t 0.17
Liver 1.б4 t Q.13 5.14 t 0.16* 5.23 t 0.26* 4.37 t 0.19* '**
Kidney 1.93 t Q.13 3.82 t Q.11* 4.06 t 0.28* 3.80 t 0.14*
Joint capsule 2.Q4 t Q.21 4.60 t Q.15* 5.00 t 0.21* 4.75 t 0.30*
n = 19 n = 17 n = 15
Ovary 2.32 t Q.13 3.35 t 0.34* - 4.47 t 0.20* ,**
Endometritis 1.74 t Q.15 2.29 t 0.19* - 2.73 t 0.08* '**
Myometrium 1.37 t Q.11 2.07 t 0.03* - 2.07 t 0.03*
Note: * — P < 0.05 with respect to the accuracy of performance standards; ** — P < 0.05 with respect to the accuracy of the indicators of the acute form.
Comparative analysis between the studied forms ofbrucellosis organs. So BLA performance to allow the TA of different organs to showed significantly higher values in ABL to TA ovarian and endo- evaluate the nature, frequency and degree of involvement ofvarious metrial secondary chronic brucellosis. Based on what we can assume organs in the disease process when brucellosis, allowing clinicians to that in chronic processes occur deeper destructive changes in these spend in addition to causal treatment Organotropic specific therapy.
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Mirsaidova Munisa Abdushukurovna, Republican Specialized scientific-practical medical Centre of Dermatology and Venereology of the Health Ministry of the Republic of Uzbekistan, Tashkent
E-mail: munisa876@mail.ru
Colposcopic features of cervical mucus associated with certain urogenital infections
Abstract: There conducted a colposcopy study of women in sexually transmitted infections and reproductive health department of RSSPMC D and V and identified certain changes in the cervical mucus which had the combination of ureaplasma, chlamydia and HPV, characterized by atypical colposcopic picture.
Keywords: sexually transmitted infections, colposcopy, cervix of uteri.
