EXPRESSION OF ACTIVATION AND APOPTOSIS MARKERS ON PERIPHERAL BLOOD LYMPHOCYTES IN DIFFERENT STAGES OF PURULENT-INFLAMMATORY PROCESS DEVELOPMENT IN ABDOMINAL CATIVITY ORGANS

Akimova V. M., Lapovets N. E., Lapovets L. E.

PATHOMORPHOLOGY

Scentific article

The clinic has an urgent differential diagnosis of acute abdominal diseases that require conservative or urgent surgical treatment. An analysis of the activation profile of blood lymphocytes can be used to assess the state of the immune system and the intensity of the immune response. Objective. To investigate the expression of activation markers on peripheral blood lymphocytes in patients with acute inflammation of the abdominal cavity. Object and methods. We conducted a study on the expression of early activation CD25+ marker, functional activation CD23+ marker and late activation CD95+ marker on peripheral blood lymphocytes in 68 patients with destructive forms of acute appendicitis, 20 patients with appendicular infiltrate, 21 patients with acute catarrhal appendicitis (ACA), and in 30 virtually healthy persons by the method of indirect immuno-fluorescence. Results and discussion. We have shown that in patients with acute phlegmonous appendicitis (APA), the absolute number of lymphocytes (LC) of blood is reduced by 10%, and in the group with appendicular infiltrate by 14.5% compared with the control (p <0,05). In complicated and destructive forms of acute appendicitis, T-cell immunodeficiency is expressed in the group with APA and appendicular infiltrate (AI), where the level of T-lymphocytes is lower by 37% compared with control. There also reduced the absolute number of circulating T-helper cells by 46% in the APA, 33% in those with acute gangrenous appendicitis (AGA), 47% in the group with AI (p <0.05). At the same time, the activation of humoral immunity is manifested in the increase of B-lymphocytes number. In the group with ACA, the number of circulating B-lymphocytes is 48.5% higher and in the AGA group 57% greater than control. The activity of the effector unit is expressed in an increase of NK-cells number in 2.9 times relative to control in the group with ACA; in 2.7 times in the group with APA, 3 times in the group with AGA, 2.5 times in the group with AI (p <0.05). The analysis of activation processes shows an increase in the level of peripheral blood of lymphocytes expressing early activation CD25 + marker (1.6 times for AGA and 1.3 times for APA), while at AI level is higher 2 times, and with ACA 2.2 times compared with control. An analysis of the expression CD95+ level on blood lymphocytes showed that an increase in gangrenous and phlegmonous form of inflammation and in AI was more than 3 times compared with the control of the number of CD95 + lymphocytes. In the group with ACA, CD95+ lymphocytes were 19.36 ± 1.58% of all lymphocytes, which was 2.7 times more than control (7.0 ± 0.42%). In acute destructive abdominal inflammatory processes, with the complication of acute appendicitis appendicular infiltrate, high levels of CD23+ lymphocytes are found that exceed the norm more than 3 times, which may be evidence of the presence of an allergic component in abdominal inflammation. Conclusion. It was established that in the destructive forms of acute appendicitis, the formation of the T-cell immunodeficiency state and activation of the humoral and killer units of immunity and increased expression of CD23+ on peripheral blood lymphocytes are observed. This indicates the development of hypersensitivity Type I. In patients with destructive forms of acute appendicitis processes of activation of apoptosis over the proliferation of lymphocytes prevail. This is evidenced by the predominance of CD95+ expression on the expression of CD25+ compared with the control group and with unchanged appendix.

acute phlegmonous appendicitis, acute gangrenous appendicitis, CD25+, CD23+, CD95+, lymphocytes

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«Bulletin of problems biology and medicine» Issue 4 Part 3 (141), 2017 year, 328-331 pages, index UDK 616.1/.4-003.96-08

10.29254/2077–4214–2017–4–3–141–328-331