LOCAL AND SYSTEMIC IMMUNITY DEFICIENCY IN PATIENTS WITH ACUTE PHLEGMONOUS APPENDICITIS DURING EXACERBATION

Kuyun L. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Objective. The purpose of this research was to study the systemic and local immune disorders in patients with acute phlegmonous appendicitis during exacerbation (post-surgery peritonitis) to discover the most efficient specific treatment method. Object and methods. Materials used in the research were obtained from 50 acute phlegmonous appendicitis patients during the exacerbation stage (peritonitis). There were 48 healthy individuals in the control group (without peritoneal pathologies and infections in other systems). Analysis of the serum levels of immunoglobulins (Ig) A, M, and G was conducted using an immunoturbidimetric method. The population and subpopulations of the immune cells were identified using an immunofluorescence flow cytometry method. The same method was used to evaluate phagocytic activity of monocytes in the peripheral blood. The data obtained during the research was statistically processed. Results and their discussion. Analysis of the material taken from 50 post-surgical peritonitis patients with acute phlegmonous appendicitis (APA) during exacerbation showed certain changes in immunocompetent cells of the peripheral blood. The results were compared against those obtained from a control group (48 healthy individuals in the control group without peritoneal pathologies and infections in other systems). There was a significant increase in B-lymphocytes (CD19+) in APA patients (18,0±0,9%) compared to the control group samples (12,6±0,23%, р<0,001). Activated T-helper cells (CD3+CD4+HLA-DR+) in APA patients decreased significantly (4,7±0,891) in the peripheral blood, compared to the numbers in the control group (10,8±0,37, р<0,001). Similarly, the content of NK cells (CD3- CD16/56+) in those same patients was also lower comparing to the control group (in APA peritonitis patients the percentage of NK cells was (10,9±0,9%), the control group (14,5±0,45% NK клітин, p<0,001). Studying the local immune response using immunohystochemical analysis of the IC cells of the appendix walls in APA patients showed increased numbers of B-lymphocytes (CD20+) and peritoneal macrophages (CD68+) when compared to the content of the same populations of immune cells in the control group. Significance of the research. The systemic and local immune response have certain differences that need to be accounted for in order to achieve success in treating peritonitis patients. Individual approach in treatment will help to dramatically decrease the number of deaths due to peritonitis as a complication of acute phlegmonous appendicitis.

acute phlegmonous appendicitis, peritonitis, exacerbation, local and systemic immunity, proinflammatory cytokines.

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«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 132-135 pages, index UDK 616.346.2-002.36-06:616.381-002]-097

10.29254/2077-4214-2019-2-2-151-132-135