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THE STATE OF HUMORAL MECHANISMS OF THE IMMUNE SYSTEM IN HEROIN ADDICTS
DOI: http://dx.doi.org/10.20534/ESR-17-5.6-45-46
Sultanov Shokrukh Habibullaevich, Tashkent Institute of Postgraduate Medical Education, PhD in Medicine, department of psychiatry and psychotherapy
E-mail: nazira-48@bk.ru
THE STATE OF HUMORAL MECHANISMS OF THE IMMUNE SYSTEM IN HEROIN ADDICTS
Abstract: The article is devoted to the study of humoral mechanisms of immunity in heroin addiction. It was revealed that the disorganization of immune systems, which are in close relationship with the central nervous system, lead to disruption of homeostasis and aggravate the course of drug abuse.
Keywords: heroin addiction, withdrawal syndrome, activated neutrophils, myeloperoxidase.
In recent years, many investigations indicating immunological failure in drug addicts and the increased interest to study the influence of drugs on the immune system of people [1, 50-52; 3, 3-5]. It is known that among patients with drug abuse infectious and inflammatory diseases are spread much more often than in healthy people [5, 191-193; 6, 198-200]. In this regard, of considerable interest is the study of the immune system of these patients. The results of a clinical assessment of the functional state of the individual components of nonspecific resistance in drug addicts remain to be elucidated [2, 23; 4, 120-122].
The aim of the study was to investigate immunological features of patients with heroin addiction.
Material and methods: 57 heroin addicts. Of these 34 patients aged 19-20 years, 11 patients aged 10-22 years, 8 patients — 2325 years; 43 male, 14 female employees. All patients for the duration of the use ofopium preparations were divided into 2 groups. Duration of drug abuse in group 1 ranged from 4 months to 5 years (31 patients). In the 2nd group duration of drug addiction was more than 5 years (26 patients). All patients were formed on narcotics withdrawal. The analysis of anamnestic data of drug addicts have revealed a tendency to infectious diseases, while prevailing were the so-called blood-contact infection — viral hepatitis and HIV infection. So, 64,0% of the patients were identified antibodies to hepatitis C virus, 14,0% ofboth hepatitis C virus and In and 11,1% ofpatients — to HIV. In addition, most patients complained of frequent (4-5 times per year) respiratory diseases, mostly acute respiratory viral infection.
To the cells, taking an active part in realization of the basic functions of the immune system, as well as key positions in the nonspecific immunological resistance, are dendrite-wide cells, neutro-phils, monocytes/macrophages, esinophils, basophils, mast cells. The main role belongs and refers to neutrophils. Given this fact, in the course of this study that these cells were the main focus in assessing the status of patients who abuse heroin. A series of studies was devoted to the evaluation of the actual phagocytic function of neutrophils (percentage of activated neutrophils) in the peripheral blood of heroin abusers.
For statistical processing of material was used statistical analysis and information delivery SAS (Statistical Analysis System).
Results and discussion: The results of the survey showed that pereditary burdened by alcoholism, drug abuse was detected in 6 patients. All the studied patients abused heroin, which was their main drug. Parallel, but much less from case to case, the patients had used alcohol, cannabis, psychotropic drugs.
As follows from the data, the most pronounced reduction in the proportion of activated neutrophils in peripheral blood were registered in patients of the 2nd group in the withdrawal period taking heroin for over 5 years (Table 1).
The percentage of phagocytic cells was the lowest and amounted to 25,7 ± 2,3% and significantly differed from the value compared to the control. In the future, these indicators at the exit of the withdrawal syndrome and is in remission increased, but did not reach the numbers of the control group.
Table 1. - The state fraction of activated neutrophils in the peripheral blood of heroin addicts with different duration of the disease
Groups The proportion of activated neutrophils in the withdrawal period The proportion of activated neutrophils after treatment The proportion of activated neutrophils in remission
I group 34,8 ± 3,2%* 38,5 ± 3,8% 39,8 ± 3,6%
II group 25,7 ± 2,3% * 29,8 ± 2,8% 30,7 ± 3,3%*
Control group 41 ± 3,9% 41 ± 3,9% 41 ± 3,9%
* significantly compared to control group (p < 0,05)
Pronounced changes in the functional state of phagocytic cells was recorded also at the duration of taking the drug up to 5 years in patients of the 1st group. Patients who use heroin has a direct moderate correlation between duration of intake of drugs and the proportion of activated neutrophils (r = 0,56, p < 0,05), while the propor-
tion of activated neutrophils and phagocytic number also correlate among themselves.
The fraction of lymphocytes in peripheral blood were assessed according to the magnitude of the phagocytic number (Table 2).
Section 4. Medical science
Table 2. - The state of phagocytic numbers in the blood of heroin addicts with different duration of the disease
Currently, it is well known that the metabolism of phagocytes is mediated by the presence in their lysosomes of a number of enzymes including acid hydrolases, neutral proteases, bactericidal enzymes (myeloperoxidase, lysozyme) as well as lactoferrin and others. Ofparticular importance is the activation of these enzymes during phagocytosis and other effects of oxidative metabolism. When this occurs, activation of the oxidase to the cell membrane, which restores the O2 to superoxide ion O2 accumulated in phagosome and becoming partly in H2O2 in an acidic environment.
In the next phase of this study, we evaluated the extent to which heroin use is reflected in this component. The bactericidal effect of the mentioned substances is enhanced by myeloperoxidase. The entire set of enzymes of phagocytes can act not only within cells
Table 3. - The content of myeloperoxidase in serum
As can be seen from the Table 3, the use of heroin leads to a decrease in the level of myeloperoxidase in blood serum of examined patients at all stages of the disease. Depending on the duration of drug abuse value of myeloperoxidase were detected reliably at a lower level than in the control group (p< 0,05). Failure of the phagocytic systems in heroin addicts is clinically manifested in the form of infectious-inflammatory processes in internal organs. Given information, determine the relevance of a comprehensive study of acquired defects of phagocytosis, to determine the feasibility of establishing new ways to study the functional activity of neutrophils and development of pathogenetic methods of their prevention.
but also released into surrounding tissues and the blood, forming, thereby, along with other biologically active-governmental substances (complement, lysozyme, 3-lysine, lymphokines, monokini, etc.), the humoral component of the immune system. In this connection seemed interesting to assess in conditions of chronic heroin intoxication this side of the functioning of phagocytes.
We determinated serum concentration of myeloperoxidase, a key enzyme of oxygen-dependent metabolism of phagocytes. The results of the studies in this direction showed that in the acute period of the disease the concentration of this enzyme in the blood serum of the examined patients was significantly lower than the control (Table 3).
heroin addicts with different duration of the disease
Conclusions:
Thus, on the basis of a comprehensive study of the phagocytic activity of neutrophils in heroin addicts, we have determined that heroin addiction is accompanied by pronounced changes in cell-humoral system of human. Drugs have a suppressive effect on immunocompetent cells. Disruption of the immune system leads to the violation of cellular and humoral homeostasis and exacerbates the course of addiction. The comprehensive study of the functional activity of neutrophils extends pathogenetic interpretation of the clinical manifestations of addiction and helps the development of additional methods of correction of ongoing therapeutic interventions.
Groups Withdrawal period After treatment Remission
I group 8,8 ± 0,76 9,0 ± 0,55 9,1 ± 0,72
II group 7,8 ± 0,56* 8,6 ± 0,66 8,9 ± 0,88*
Control group 9,5 ± 0,78 9,5 ± 0,78 9,5 ± 0,78
*significantly compared to control group (p<0,05)
of
Groups Withdrawal period After treatment Remission
I group 220,7 ± 10,75* 229,4 ± 12,55 239,8 ± 20,76
II group 208,7 ± 10,73* 215,7 ± 7,19 225,7 ± 4,53*
Control group 252,5 ± 3,19 252,5 ± 3,19 252,5 ± 3,19
*significantly compared to control group (p < 0,05)
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