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Comparative analysis of the immune system at often and chronically patients preschool children
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Juraeva Zuhra Yorievna, PhD, Associate Professor of the Department of Hospital of Pediatrics Tashkent Pediatric Medical Institute, Tashkent Uzbekistan E-mail: [email protected]
Comparative analysis of the immune system at often and chronically patients preschool children
Abstract: The article is devoted to the study of the immune system (IS) and cytokine sta-tus in frequently ill children (FIC) in the acute phase and remission in comparison with that rare-ly ill with children (RIC). The sample of 158 preschool children (PC) with abnormalities of the upper respiratory tract. Revealed at FIC features of cellular and humoral immunity, as well as an imbalance in the cytokine status indicate stress the IS and the possible depletion of the reserves of antiresistance in this group of children as a result of a long and massive antigenic effects on the child.
Keywords: children, immune system, cytokine status, respiratory diseases, immune cells.
There are two main points ofview on the causes of repeated and so frequent respiratory infections in FIC. The first — a violation of the IS manifested in adverse environmental impacts. The second — a genetic predisposition as implemented under the influence of adverse environ-mental conditions. It is possible that both of these factors play a role in the occurrence of fre-quent incidence of acute respiratory disease in FIC. But in recent years, special attention is paid to the researchers of the IS in FIC.
In the formation of the immune response involved a complex of interacting immune cells, resulting in the production of IS mediators involved in intercellular relationships, body resistance to various exogenous and endogenous factors [1; 2].
In connection with the above, the purpose of research is to study the IS and often have long ill PC in comparing them with those suffering from RIC.
Material and methods. We carried out a study on the state of the IS in the examinees: 90 — FIC, 40 — RIC and 28 healthy children of the same age in the control group.
Immunological studies were performed at the Institute of Immunology of the Academy of Sciences of Uzbekistan. The main parameters of cellular and humoral immunity was determined by identifying the cell surface cluster of differentiation of CD3, CD4, CD8,
CD16, CD19 with monoclonal antibodies series LT (LLC "Sorbent Service", Russia). The study of the concentra-tion of serum immunoglobulin A, M, G in peripheral blood was performed according to the me-thod Mancini G. et al (1965). Levels of cytokines (IL-1b, IL-4 and TNFa), IgE and sIgA in nasal washes were determined by ELISA (cytokines produced by "cytokine", St.-Petersburg). Statistical analysis of the data obtained by the methods of variation statistics, Fischer-Student.
Results and discussion. The study of cellular immunity showed a manifestation of im-mune deficiency with symptoms of chronic intoxication in a group FIC. When analyzing the re-lative performance of T-lymphocytes, showed a significant decrease in activity CD3+-cells (48.2 ± 1.3% vs 55.6 ± 1.4% in controls, p<0.05); group RIC also showed a reduction, but the values are not statistically reliable (53.8 ± 1.5%). A similar pattern was observed in the dynamics of the level of CD4+ (29.6 ± 1.5% in group FIC vs. 37.8 ± 1.3% in healthy children, p<0.05), and RIC — 34.2 ± 1.2%.
A significant decrease in the value of cytotoxic T lymphocytes (19.2 ± 1.3% at FIC and 20.4 ± 1.3% at RIC versus the control group — 21.3 ± 1.1%, p<0.05) impact on the immunoregu-lato-ry index (IRI). So, he is RIC averaged 1.68 ± 0.03, while in the group of sickly level IRI was significantly reduced — 1.54 ± 0.01 (p<0.05)
Section 7. Medical science
versus 1.72 ± 0.06 in the control group. In general, these changes contribute to the longer immunograms antigenemia, unfinished process of phago-cytosis, more protracted clinical course with the basic pathology later readjustment of the body. Nonspecific factors represented by the number of NK cells (CD16+-cells) and phagocytic acti-vity (PhA) of neutrophils, were changed depending on the status of children. At FIC in the peripheral blood of 12 or 20% of the relative number of CD16+— 16.2 ± 1.2%, which was significantly higher than the values of the indicator in the group RIC and healthy children (12.9 ± 1.1% and 11.5 ± 0.9%) (p<0.01).
In general, these changes contribute to the longer immuno-grams antigenemia, unfinished process of phagocytosis, more protracted clinical course with the basic pathology later readjust-tment of the body. Nonspecific factors representted by the number of NK cells (CD16+-cells) and PhA of neutrophils, were changed depending on the status of children. At FIC in the peripheral blood of 12 or 20% of the relative number of CD16+ 16.2 ± 1.2%, which was significantly higher than the values of the indicator in the group RIC and healthy children (12.9 ± 1.1% and 11.5 ± 0.9%) (p<0.01).
Due to its non-specificity of the PhA ofhighly labile, so quickly and visibly reacts to different pathogens even before the detailed characteristics of the disease [4; 5]. The quantitative study of the PhA showed that in the blood of healthy children are between 52% to 62% of phagocytic cells — 57.8 ± 1.4%. In RIC PhA was slightly reduced — 53.8 ±1.3%. And FIC figure was 1.3 times lower than the control values and averaged 45.4 ± 1.2% (p<0.05). Consequently, the FIC showed significant inhibition of neutrophil PhA by an increase in the number of natural killer cells.
During the immune response of B-lymphocytes differentiate into plasma cells that sec-rete antibodies. In the system presented in our studies, the quantitative content of CD20+ and the level of IgG, IgA and IgM. Exacerbation of a chronic process often accompanied by increase in the proportion of activated cells in the peripheral circulation, including CD20+. In the group FIC relative content of B-lymphocytes was 29.5 ± 1.1% (p<0.01), in the group RIC — 23.7 ± 1.4% (p<0.05), which significantly higher against the values of the control group — 22.6 ± 1.3%. Integral indicator of the functional activity of B-lymphocytes is the content of the main classes of IgG, IgA, IgM. The study of the concentration of Ig in the serum of healthy children showed that IgG is synthesized from 860 to 1320 mg% with an average 1090.7 ± 31 mg%. At RIC IgG concentration was slightly reduced, while SC — compared with FIC — significantly increased — 1320.6 ± 47,4 mg% with a range from 1080 to 1550 mg% (p<0,05).
The children of the control group IgA levels in the serum of 110 to 170 mg%, on average — 145.3 ± 6.4 mg%. In peripheral blood serum IgA concentration RIC slightly reduced, while SC — significantly reduced and averaged 97.3 ± 7.3 mg/% (p<0.01).
The most important from the point of view of the state of the local immunity is the full production sIgA on the mucosal surface. As it turned out, the process is in a group FIC signi-ficantly disrupted, which can cause frequent erosive and ulcerative lesions of the mucous in these children (312 ± 10 mg% in FIC and 502 ± 20 mg% at RIC, p<0,05 against values of the control group — 589 ± 0.07 mg%).
All the children in the group frequently and chronically ill was an increase in the number of IgE (3.29 ± 0.47 pcg/ml — in the study group; 1.15 ± 0.23 pcg/ml- in the control group, p<0.001), the there is a lack of mucosal immunity. Thus remains unclear what comes first: dys-biosis mucosa or impaired immunity. Definitely have to reckon with the fact that the relationship between the immune system and infectious agents are interdependent.
We conducted a study to determine the levels of IL-1fi production as an important neurotransmitter, which is one of the most versatile regulators of immunity and inflammatory reactions with a wide range of biological effects, which include the proliferation of T- and B- cells, antibody, induction of synthesis of other cytokines. Our results showed significantly higher values of IL-1fi in the group FIC compared to RIC (22.9 ± 1.6 pcg/ml vs 16.6 ± 1.12 pcg/ml.
p<0.01. A very important immunoregulatory cytokine is IL-4. It is believed that its main biological role is to suppress IFN-y. According to our data, the level of production of IL-4 in-creased in sickly children by almost 1.5 times compared to those suffering from rare children (p<0.001).
TNF-a is aimed at recognition and elimination of foreign genetic information and is an important mediator of immunity, which allows it to be attributed to the family of regulatory cy-tokines. Our results show that the main group of children TNF-a level in almost two times the value of comparison group (4.42 ± 0.3 pcg/ml vs 2.34 ± 0.25 pcg/ml), (p<0.001).
These facts underscore the multidimensionality of the structural and functional organi-zation of the IS, we studied the example of FIC otorhinolaryngology type.
Conclusions:
1. In the study of the IS in a FIC sinus pathology observed decrease in the total pool of T- lymphocytes, T-helper cells and PhA of neutrophils from 1.15 to 1.3 times. At this level of CD16+-cells, B-cells and IgG were significantly elevated 1.3-1.4 fold.
2. The study of humoral immunity IgE — shows a significant increase of 2.9 times, and the suppression of secretion of sIgA — 1.8 times, indicating a reduction of local immunity and inc-rease sensitization by prolonged antigenemia.
3. In the study of cytokine status of children surveyed showed a sharp increase in the lo-cal concentration of IL-1p by 1.4 times, IL-4-1.7 times, TNF-a — 2.1 times in RIC compared with FIC.
References:
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