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Navruzova Shakar Istamovna, MD, professor, Head of Department of Childhood Diseases and Neonatology of the Bukhara State Medical Institute, Sa'dulloeva Iroda Kurbonovna, Senior scientific employee-researcher, assistent of Department of Childhood Diseases and Neonatology of the Bukhara State Medical Institute, Suleymanova Gulrukh Suleyman qizi, student of Medical and Pediatric Faculty of the Bukhara State Medical Institute, Bukhara, Uzbekistan E-mail: ss-1961@mail.ru
CORRELATION INTERRELATION OF IMMUNOLOGICAL AND HORMONAL INDICES IN CHILDREN WITH CONGENITAL HEART DISEASES
Abstract: The authors studied the relationship between immunological and hormonal parameters of blood in congenital heart diseases. At the same time, an increase in the acute process of antibody formation with the acceleration of the processes of energy release from the body's stores by increasing catabolism was revealed. A cytokine profile shows an increase in the processes of apoptosis of cardiomyocytes due to the enhancement of oxygen exchange with the formation of a free radical of oxygen and nitrogen oxide and a reduction in the inflammatory process against a background of hypothyroidism.
Keywords: correlation, children congenital heart disease, immune system, hormonal, immunocompetent cells, immunoglobulins, cytokines, lymphocyte, hypothyroidism.
The interrelation of immunological parameters is the basis the Institute of Immunology of the Ministry of Health of the
for the methods of parametric quantitative assessment of the Russian Federation, SPC Sorbent (Moscow), were used by
functional state of the organism, which allows to identify and indirect resetting.
evaluate quantitatively the trends in the analytical state, to predict The content of immunoglobulins was determined by the
both the subsequent disease, and possible deviations [1; 2; 5]. method of radial immunodiffusion in G. Mancini et al. (1965)
The study of the influence of endocrine gland hormones with the use of monospecific sera against immunoglobulins
on the reactivity of the body is one of the urgent problems G, A and M from the Moscow Institute of Microbiology and
of modern medicine. Meanwhile, the materials accumulated Epidemiology. The phagocytic activity of leukocytes (PhAL)
in the library for studying the effect on the immune system was determined by the method of I. Todorov (1963). Blood
of thyroid hormones have not yet gained access to analytical tests for thyroid (T3, T4, TTG) and corticoid status (cortisol)
thinking, although their influence on the reactivity of the or- were performed by ELISA on STATFAX 303 (USA, 2010))
ganism is of great interest [3; 4]. using the standard set of VECTOR-BEST AO (International
The purpose of the work: to study the correlation rela- certificates ISO 9001 and ISO 13485, Russia). Blood tests
tionship between immunological and endocrine parameters were taken early in the morning on an empty stomach and
of congenital heart defects (CHD) in children. before morning cleansing.
Materials and methods. Clinical-laboratory examina- IBM Excel-97. Information about the reliability provided
tion of 116 children with CHD was carried out. The control that t > 2, and P < 0.05. Correlation analysis was carried out by
group consisted of 30 healthy children. The criteria for exclu- the method of Pearson (Pearson). In organizing and conducting
sion were immunological and endocrine diseases, CHD with scientific research on the principles ofevidence-based medicine.
chromosomal diseases. Results and discussion. At birth and depending on the
To determine the main populations of human lympho- order in which you enter the body. Feedback between T-lym-
cytes, monoclonal antibodies of the LT series, developed at phocytes and free T4(r = -0.288). The main actions of free
Section 7. Medicine
T4 is the enhancement of catabolism, that is, the acceleration of processes that take place with the release of energy from body stores. Overcoming the level of T-lymphocytes is compensated for the free T4 stock, while the tissue energy requirement is covered by increased catabolism.
The analysis showed the presence ofa directaverage relationship between T-helpers, total T3(r = 0.590), free T4(r = 0.524), and an inverse relationship with free T3(r = -0.472). It is known that the hormone T3 is a free intake in oxygen metabolism and its assimilation cells. Overcome all the difficulties associated with improving the level of security.
If T-lymphocytes-helpers strengthen the immune response, suppressors, on the contrary, are suppressed. Moreover, these cells do not suit the sabotage of immune processes, but simply regulate the strength of the immune response. This allows the immune system to respond with restraint and with moderate strength to stimuli. When T-suppressors die, they release a lot of ATP. Usually, ATP helps to supply the body with energy, but the dying Tregs quickly convert ATP into adenosine. Adenosine then targets T-lymphocytes and changes their functional activity [6].
A direct relationship between T-suppressors and concentrations of total T3(r = 0.282) and total T4(r = 0.396) in the blood of patients with CHD was established. The average inverse relationship is noted between T suppressors with SVT3 (r = -0.681) and cortisol (r = -0.504). All this shows the physiological connectivity of the hypothalamic-pituitary-thyroid and hypothalamic-pituitary-adrenal systems, which take part in pathogenesis and determine the course of CHD.
Consequently, an increase in the level of T-suppressors against the background ofhyperthyroidism contributes to a decrease in oxygen tissue needs and suppression of adrenal function, which is manifested by an increase in hypocortisolemia.
A significant proportion of T-killers in children with AMS was found to correlate inversely with a reduced level of T4(r = --0.430) and T3(r = -0.388). The high content of T-killers in the blood with AMS indicates the presence of cells with virus-specific antigens infected with the virus. Therefore, in the case of CHD, the antiviral immune response is directed at enhancing cytotoxic reactions, which is accompanied by suppression of the processes of energy release from body stores and oxygen exchange.
The high content of CD20 cells in children with AMS as a result of repeated infections was directly related to the indicators of total T3 (r = 0.348) and cortisol (r = 0.309), and is inversely related to the total T4 (r = -0.376). Although the established relationships were of a weak nature, it can
be concluded that a decrease in the level of total T in CHD
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against the background of an increase in the level of CD20-lymphocytes in the blood can be the result of a violation of protein-energy metabolism and a reduction in the delivery of oxygen to all tissues (especially with blue defects), as well as the development of hypothyroidism [7].
Today, the level of immunoregulatory index (IRI) is assessed in comparison with the phase of the immune response. In the period of the height and stagnation of clinical manifestations IRI reaches high values due to a high percentage of T-helpers (CD4 + T cells). During the period of convalescence, the value of the indicator decreases, due to the increase in the level of CD8 + T cells (killers). Violation of this pattern indicates an inadequate immune response and the possibility of chronic infection, due to incomplete eradication of the pathogen.
In our studies, the indices of IRI in children with CHD directly correlated with the concentrations of total T3(r = +0.456), free T4(r = 0.449) and cortisol (r = 0.533), which confirms the reliability of the results obtained on the relationship of T-helpers to thyroid hormones and adrenal glands. An increase in both humoral and cellular immunity in children with CHD has been established. This is confirmed by the presence of the IgM bond with the level of free T4 (r = 0.441) in this case.
Analysis of the correlation matrix of immunological indices allowed to establish that the cytokine status of children with CHD has correlative interrelations with thyroid hormones and cortisol. Among the cytokines studied, only TNFa directly correlates with the levels of St. T3(r = 0.779) and cortisol (r = 0.444), and is correlated with the level of total T3(r = -0.366).
The special effect of TNFa is cytotoxic. It causes cell death, stimulating the formation in the cell membrane of superoxide radicals, reactive oxygen species and nitrogen oxide.
From the obtained data it follows that the cytokine status in children with CHD is characterized by the intensification of apoptosis-cardiomyocyte processes due to the enhancement of oxygen exchange with the formation of a free oxygen radical and nitrogen oxide and a decrease in the inflammatory process against hypothyroidism.
Thus, the analysis of communication revealed the presence of a high degree of integration of immunological and hormonal parameters included in the correlation structure, which may indicate a violation of the mechanisms of internal regulation of immunity and the hormonal system in children with CHD.
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