Научная статья на тему 'Local status of patients with mixed infections'

Local status of patients with mixed infections Текст научной статьи по специальности «Фундаментальная медицина»

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Ключевые слова
SEXUALLY TRANSMITTED INFECTIONS / MIXED-INFECTIONS / LOCAL IMMUNITY / REPRODUCTIVE HEALTH / ИНФЕКЦИИ / ПЕРЕДАЮЩИЕСЯ ПОЛОВЫМ ПУТЕМ / МИКСТ-ИНФЕКЦИЯ / МЕСТНЫЙ ИММУНИТЕТ / РЕПРОДУКТИВНОЕ ЗДОРОВЬЕ

Аннотация научной статьи по фундаментальной медицине, автор научной работы — Uskenbayeva A.S., Tsoy N.O., Ibraimova Z.O.

This article presents the results of research of local immunity condition in 30 patients with mixed urogenital infections, taking place on treatment in the clinic of the Research Institute for Skin and Venereal Diseases. The analysis showed the existence of immunological shifts in all patients with predominant involvement of cellular link of immunity: reduction of relative and absolute number of general T-lymphocytes; imbalance in subpopulations of T lymphocytes; violation of the functional activity of lymphocytes; decrease in production of cytokines (IL-2).

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Текст научной работы на тему «Local status of patients with mixed infections»

РЕЗЮМЕ

Т.Ж. УМБЕТОВ, Е.Ж. БЕКМУХАМБЕТОВ, А.А. МАМЫРБАЕВ, Т.А. ДЖАРКЕНОВ, А.И. КОРВАТ, А.М. БАСПАКОВА

ВЛИЯНИЕ КОМБИНИРОВАННОГО ВОЗДЕЙСТВИЯ ХРОМА И БОРА НА СПЕРМАТОГЕНЕЗ

Западно-Казахстанский государственный медицинский

университет имени Марата Оспанова, Актобе, Казахстан

Исследование проведено на белых крысах - самцах (10 контрольные, 15 экспериментальные). Для установления генотоксичности комбинированного воздействия соединений хрома и бора подострая интоксикация животных проводилась в течении 5 дней путем внутрижелудочного одновременного введения бихромата калия (доза 10мг/кг) и бората калия (10мг/кг) в водном растворе объемом 2,0 мл. Изучались структуры семенника с определением стадии профазы процентного деления, как в физиологических условиях жизнедеятельности, так и при подострой комбинированной интоксикации. Установленные показатели: достоверное снижение индекса сперматогенеза, расширение диаметра извитых канальцев семенника, увеличение числа канальцев с «пробками», уменьшение количества клеток Лейдега наглядно подтверждают депрессивный характер действия на сперматогенез. Приостановка профазы 1-го деления мейоза свидетельствует об ослаблении процесса развития половых клеток.

Ключевые слова: хром, бор, сперматогенез, генотоксичность.

SUMMARY

T.Zh. UMBETOV, Ye.Zh. BEKMUKHAMBETOV, A.A. MAMYRBAYEV, T.A. JARKENOV, A.I. KORVAT, A.M. BASPAKOVA

THE INFLUENCE OF COMBINED CHROMIUM AND BORON ACTION ON SPERMATOGENESIS

West Kazakhstan Marat Ospanov State Medical University, Aktobe, Kazakhstan

The research was conducted on white male rats (10 control, 15 experimental). In order to establish the genotoxicity of combined action of chromium and boron compounds the subacute intoxication of animals was carried out in 5 days by intragastric simultaneous administration of potassium dichromate (dose 10mg / kg) and potassium borate (10 mg / kg) in an aqueous solution of 2.0 ml. The structure of the testis has been studied with identification prophase stage of percentage division, both in physiological conditions of life, and in subacute combined intoxication. Established indicators: a significant decrease in the index of spermatogenesis, increasing the diameter of the convoluted tubules of the testis, the increase in the number of tubules with "plugs", reducing the number of Leydig's cells clearly confirms the depressive nature of effect on spermatogenesis. Suspension of slit of 1st meiotic division indicates a weakening of the process of development of germ cells.

Key words: chromium, boron, spermatogenesis, genotoxicity.

UDC: 616.98-576.8.097.3

A.S. USKENBAYEVA, N.O. TSOY, Z.O. IBRAIMOVA

LOCAL STATUS OF PATIENTS WITH MIXED INFECTIONS

Research Institute for Skin and Venereal Diseases, Almaty, Kazakhstan Uskenbayeva A.S. - candidate of Medical Sciences; Tsoy N.O. - Phd, phone: 8(727) 397-42-10.

its association with other pathogenic and non-pathogenic thereproductive tract microbiocenosis.

members of

Abstract. This article presents the results of research of local immunity condition in 30 patients with mixed urogenital infections, taking place on treatment in the clinic of the Research Institute for Skin and Venereal Diseases. The analysis showed the existence of immunological shifts in all patients with predominant involvement of cellular link of immunity: reduction of relative and absolute number of general T-lymphocytes; imbalance in subpopulations of T lymphocytes; violation of the functional activity of lymphocytes; decrease in production of cytokines (IL-2).

Key words: sexually transmitted infections, mixed-infections,local immunity,reproductive health.

Introduction.The problem of mixed of the high rate of these infections in both of mixed infections depends on the age of urogenital infections is one of the pressing sexes, torpid, subjectively asymptomatic patients, concomitant diseases, epidemic problems of practical medicine, because course of the inflammatory process, and situation, the biological properties of

As a consequence, there are frequent relapses of infections, high risk of pelvic infection and treatment failures[1-3].

Analysis of the current clinical picture of urogenital infections demonstrates the high frequency of mixed infections, the manifestation of which occurs with more severe clinical picture, increasing duration of the disease and increase the incidence of various complications [4]. The frequency

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circulating pathogens and many other reasons. The mixed infection detected in 38.8% of women with sexually transmitted diseases [1,5], which is accompanied by atypical clinical manifestations, the character of which is determined by the role of fellow members-associates, colonizing the same ecological niche, and the type of interaction between different agents [6].

Great importance is the problem of mixed infections resistant to a wide range of specific tools used in therapy. Inappropriate treatment, including self-medication, leads to the chronicity of the process that gives rise to complications of varying severity, increasing the frequency of male and female infertility [7].Many years of experience in treating patients with mixed urogenital infections showed that therapy should be predominantly integrated and should begin after the obligatory assessment of the state of the immune system.

Research objective. Study of the local immunity state in patients with mixed urogenital infections.

Materials and Methods. 30 patients aged 19 - 45 years (15malesand 15 females) with verified diagnose - mixed urogenital infections - were followed up in the clinic of the Research Institute for Skin and Venereal Diseaseswithin 3 months.

For investigation of peculiarities of immune disorders in patients with mixed urogenital infections was conducted the complex research of immunological parameters. In the group of healthy individuals (immunological control) were included 30 donors of the same age.

The study of local immunity factors in patients conducted based on data from smears from the vagina and urethra. For assessing of cellular immunity the reaction with the culture of phagocytosis of Staphylococcus was carried out with the calculation of indicators of phagocytic activity (PA), phagocytic number after 30 and 120 minutes (FCH30 and FCH120) and the index of completeness of phagocytosis.As a control, 30 healthy men of reproductive age were examined, without complaints; in the vaginal and urethral swabs was determined normal

microbiocenosis on microscopy and microbiological study.

To evaluate the results of the study were used methods of variation statistics with the calculation of conformity criterion (chi-square). (Figure 1.)

Mixed infection was represented by a large variety of etiologic agents; the analysis of the frequency of occurrence using the chi-square test revealed a nonrandom distribution of some sexually transmissible agents in the sample, ie, the existence of typical associations (Figure 1).So, at the lower boundary of reliability registered trichomonas+chlamydia mixed-infection (Chi-square = 4,56; p <0,05). For the rest of polymicrobial associations reliable values of chi-square test was revealed.

In all patients with mixed STIsthe immunological changes were detected. The analysis of cellular immunity showed a significant reduction of relative and absolute number of general T-lymphocytes (CD3+) compared to healthy individuals. The relative number of CD3 + was reduced to 42,9±1,8 (p<0,01), the absolute amount up to 1010±61 cells/ul (p <0,05) compared with values of healthy donors - 69,0 ±1,6 and 1398±87 cells/mm, respectively.

There were significant changes in the indicators T-lymphocyte subpopulations: T-helpers-inductors (CD4+) and cytotoxic

Results of research

T-lymphocytes (CD8+) as compared to healthy donors.A significant reduction in the relative number of CD4+ to 23,6±1,8 (p<0,01) were registered at a norm rate of 39,7 ± 0,4, and the absolute values were not significantly different from that of healthy individuals.Indicators of cytotoxic T-lymphocytes (CD8 +) had a tendency to authentically significant increase in both the relative (23,2 ±1,5%) and the absolute content of 318 ± 50 cells / mm (p <0,05) at a norm rate of, respectively, 19,8 ± 1,7% and 246±36 cells / mm.At the same time, due to changes in the ratio of CD4+/CD8+, immune regulatory index (IRI) at a rate of 2,01 ± 0,2 decreased to 1,02 ± 0,6.Decrease in the number CD3+, CD4+-cells led to a decrease of the activated lymphocytes content, expressing the receptors for IL-2 (CD25 +), because CD4 + lymphocytes are the main producer of IL-2 synthesis. The number of CD25+ decreased authentically to 2,7±1,9% (p<0,05) compared to healthy individuals 5,2±1,2%.

Reduced production of IL-2 is one of the mechanisms of immune deficiency. This is reflected also in the reduction of functional activity of NK-cells by reducing the number of CD16 + to 9,7±2,1% at a rate of 13,6±2,5%.This imbalance is caused by violations of receptor system cells due to the pathogenetic action of sexually transmissible agents.

4,56

x1

3,1

3,4

3,6

1

7

1 - trichomonas+chlamydia, 2 -trichomonas+mycoplasma, 3 - candida+chlamydia, 4 -ureaplasma+chlamydia, 5 -candida+trichomonas, 6 -ureaplasma+trichomonas, 7 -ureaplasma+mycoplasma, 8 -candida+mycoplasma, 9 -candida+gardnerella

Figure 1. Typical combinations of sexually transmissible agents

The functional activity of lymphocytes identified through application reaction of inhibition of migration of lymphocytes with lymphocytic mitogen in patients with mixed STI has been broken, and there was a sensitization to the antigen, which amounted to 0,75 ± 0,06 for the values of healthy individuals 0,85 ± 0,09.

In humoral immunity, which was less subject to change, the absolute and relative abundance of mature B-lymphocytes (CD20 +) in patients with mixed STI was not significantly different (p>0,05) from that of healthy individuals. There was a slight increase in the content of serum immunoglobulins G, M, A, without significant differences, with the same values of healthy donors.

For patients with mixed STI more pronounced changes were identified in the assessment of functional and metabolic activity of neutrophils. In the spontaneous nitrobluetetrazolium test the percentage of NBT-reducing neutrophils was reduced to 11,9±5,17 (p <0,05) compared with healthy individuals 16,6 ± 2,35.The inducing effect pyrogenal on the reactive in NBT-test amount of neutrophils in patients was reduced to 29,62 ± 4,3% at a normal rate of 38,12 ± 5,83%. These changes, probably, should be considered as one of the causes of treatment failure and the presence of recurrence of the disease.

Comparison of local immunity indicators to the values of healthy individuals showed that in the absence of significant differences between the treatment groups on indicators, characterizing the humoral link (secretory IgA), showed a decrease of activity (54,67 ± 6,52%) and intensity of phagocytosis (phagocytic number 1, 99 ± 0,44) in patients with mixed STI compared with controls (70,04 ± 4,79% and 3,48 ± 0,87) respectively.

Discussion.The problem of studying of local immunity of the urogenital tract, in recent years has attracted particular attention of experts - venereologists in connection with the possibility of using received data to improve methods of diagnosis, treatment and prevention of

diseases of the reproductive system.Thus, in the course of researches have been established following changes: reducing the rate of immune responses and the prevalence of immunopathological response of normal protective reactions. [8] Some authors point to the suppression of humoral, while other researchers have concluded in violation of basic cellular level and phagocytosis [9].

Notion of mixed infection emphasizes the main peculiarity of the infectious process caused by the combined effect on the host organism of two or more etiological factors that lead to disturbances in the immune system and contribute to the development of chronic inflammatory process. Localimmunopathological reactions

observed at urogenital infections, lead to the formation of lymphoid-histiocytic lesions in the mucosa with the formation of adhesions in the pelvic organs, fallopian tubes, prostate, access to which is limited to antibacterial drugs.

Summarizing the results of our research, we should recognize that the complex treatment of mixed urogenital infections should include new, effective and safe methods aimed at restoring the broken links and increasing the functional activity of the immune system with simultaneousstimulation of antibiotic therapy and reduction in the frequency of adverse events occurring during its use.

Conclusion. During the research of patients with mixed sexually transmitted infections shifts in the parameters of local immunity (non-specific immunity and cellular link) were found. Analysis of cellular immunity showed a significant reduction in the relative and absolute number of total T-lymphocytes shifts in subpopulations of T-lymphocytes. Pronounced changes were found in the functional-metabolic activity of neutrophils.

Reference list:

1. Li LX, McSorley SJ. A re-evaluation of the role of B cells in protective immunity to Chlamydia infection. Immunol Lett. 2015 Apr;164(2):88-93.

2. Versteeg B, Himschoot M, van den Broek IV, Bom RJ, Speksnijder AG, Schim

van der Loeff MF, Bruisten SM. Urogenital Chlamydia trachomatis strain types, defined by high-resolution multilocus sequence typing, in relation to ethnicity and urogenital symptoms among a young screening population in Amsterdam, The Netherlands.SexTransm Infect. 2015 Feb 16. pii: sextrans-2014-051790. doi: 10.1136/sextrans-2014-051790.

3. Wira CR, Fahey JV, Rodriguez-Garcia M, Shen Z, Patel MV. Regulation of mucosal immunity in the female reproductive tract: the role of sex hormones in immune protection against sexually transmitted pathogens. Am J Reprodlmmunol. 2014 Aug;72(2):236-58.

4. Skripkin J.K., Sharapova G.Y., Tarasova G.D. Sexually transmitted infections. MED press inform; 2001.

5. Johnson LF, Dorrington RE, Bradshaw D. The role of immunity in the epidemiology of gonorrhoea, chlamydial infection and trichomoniasis: insights from a mathematical model.Epidemiol Infect. 2011 Dec;139(12):1875-83.

6. Batkaev E.A., Rumin D.V. Urogenital trichomoniasis. The attending physician. 2002; 12: 64-70.

7. Shamin G.E., Rodionov V.A. Orungal in the complex therapy of urogenital chlamydia and mycoplasma. Journal of Dermatology and Venereology. 2005; 2: 57-58.

8. Padrul M.M., Olin A.A., Pirozhnikova N.M., Padrul V.M.. Immunotherapy of sexually transmitted infections (manual)/ - Perm:Medical University, 2006. - 82 p.

9. Anchupane J.S. Mixed chlamydial infections and immunotherapy//Vestn. dermatol. and venerol. - 2000. - № 1. - S. 28-30.

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TYMIH

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А.С. УСКЕНБАЕВА, Н.О. ЦОИ, З.О. ИБРАИМОВА

МИКСТ-Ж¥КПАЯЫ НАУКАСТАРДЬЩ ЖЕРПЛ1КТ1 АХУАЛЫ

Теривенерологиялык, ^лыми-зерттеу институты, Алматы, К,азак,стан

Жумысымыздын мак,саты - аралас несеп-жыныс жукпалы аурулары бар емделуштердщ жергiлiктi иммунитетшщ жаfдайын зерттеу болып табылады.

К,уралдар мен эдктер. ТВГЗИ клиникасында Yш ай шшде 19-45 жас аралыfындаfы 30 наук,ас верифицирленген аралас несеп-жыныс жукпаларымен жэне осы жас шамасындаfы 30 сау наук,ас бак,ылауда болды. Наук,астарда™ жергЫкт иммунитеттщ себепкер шарттарын оку к,ынап пенуретрадан алынfан жак,палардьщ ^рсе^ши-ерш^ непзше сYЙелдi. Иммунитеттщ жасушалык, бeлiмiн баfалау Yшiн стафилококк культурасымен фагацитарлык, белсендЫпн, фагоцитарлык сандарын 30 жэне 120 минуттардан кейiн жэне фагоцитоздын аяк,талуынын индексiн анык,тауымен крйылды. К,орытындылар мен талк,ылаулар. ЖYPгiзiлген талдау барлык зерттелген наукастарда иммунологиялык, eзгерiстiн барлыfы непзшде иммунитеттiн жасушалык бeлiмiнiн катысуымен болfанын, яfни: жалпы Т-лимфоциттiн абсолюттiк жэне салыстырмалык, сандарынын тeмендеуiн, Т-лимфоцит субпопуляциясынын дисбалансын, лимфациттердiн функционалдык, белсендiлiгiнiн бузылуын, цитокин eнiмiнiн (ИЛ-2) тeмендеуiн гарсе™.

Нег'зг'! свздер: жыныстык, жолмен жугатын аурулар, микст-жукпалар, жергiлiктi иммунитет, репродуктивт'1 денсаулык,.

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РЕЗЮМЕ

А.С. УСКЕНБАЕВА, Н.О. ЦОЙ, З.О. ИБРАИМОВА МЕСТНЫЙ СТАТУС У ПАЦИЕНТОВ С МИКСТ-ИНФЕКЦИЯМИ

Научно-исследовательский кожно-венерологический институт, Алматы, Казахстан

Целью настоящего исследования явилось изучение состояния местного иммунитета у пациентов со смешанными урогенитальными инфекциями. Материалы и методы. Под наблюдением в клинике НИКВИ в течение трехмесячного срока находились 30 пациентов в возрасте 19-45 лет с верифицированными смешанными урогенитальными инфекциями и 30 здоровых лиц того же возраста. Изучение факторов местного иммунитета у пациентов проводилось на основании данных мазков из влагалища и уретры. Для оценки клеточного звена иммунитета ставили реакцию фагоцитоза с культурой стафилококка с вычислением показателей фагоцитарной активности, фагоцитарного числа через 30 и 120 минут и индекса завершенности фагоцитоза. Результаты и обсуждения. проведенный анализ показал наличие иммунологических сдвигов у всех обследованных пациентов с преимущественным вовлечением клеточного звена иммунитета: снижение относительного и абсолютного количества общих Т-лимфоцитов; дисбаланс в субпопуляциях Т-лимфоцитов; нарушение функциональной активности лимфоцитов; снижение продукции цитокинов (ИЛ-2).

Ключевые слова: инфекции, передающиеся половым путем, микст-инфекция, местный иммунитет, репродуктивное здоровье.

УДК: 612.017.34:597/599.16.574.4

Н.Н. ШЕВЛЮК1, Д.А. БОКОВ1, Е.В. БЛИНОВА1, Л.Л. ДЁМИНА2, О.А. МЕШКОВА2

ОСОБЕННОСТИ АДАПТИВНЫХ И РЕАКТИВНЫХ ПЕРЕСТРОЕК ОРГАНОВ РЕПРОДУКТИВНОЙ СИСТЕМЫ МЛЕКОПИТАЮЩИХ В УСЛОВИЯХ ВЛИЯНИЯ НЕГАТИВНЫХ ФАКТОРОВ СРЕДЫ ОБИТАНИЯ (ОПЫТ ЭКОЛОГО-МОРФОЛОГИЧЕСКОГО МОНИТОРИНГА)

Оренбургский государственный медицинский университет1, Оренбург, Россия, Оренбургский государственный педагогический университет2, Оренбург, Россия

Шевлюк Н.Н. - д.б.н., профессор кафедры гистологии, цитологии и эмбриологии, Тел.: 8 (3532) 77-22-75, E-mail:k [email protected].

Аннотация. С использованием обзорных гистологических, гистохимических, иммуноцитохимических и морфометрических методов исследованы органы репродуктивной системы половозрелых особей 7 видов мелких млекопитающих из популяций, испытывающих постоянное негативное техногенное воздействие. Выявлено, что в условиях негативного влияния техногенных производств на фоне активизации репродукции в гонадах выявлен комплекс адаптивных и реактивных изменений. В семенниках возрастает доля канальцев с деструкцией

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Актуальность.

органов

млекопитающих, в

Состояние репродуктивной системы обитающих антропогенно изменённых является одним из

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экосистемах, объективных и значимых критериев для оценки воздействия негативных техногенных факторов на окружающую среду [2 - 6, 9 - 10]. Несмотря на большое число работ, посвященных

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