Імунокомпетентність лімфоцитарного пулу периферичної крові при гострому гнійному лімфаденіті в дітей

Abstract

Метою роботи було вивчення імунокомпетентності лімфоцитарного пулу периферичної крові при гострому гнійному неодонтогенному поднижньощелепному лімфаденіті в дітей з обтяженою спадковістю. Установлено, що в цієї категорії дітей зменшуються основні популяції лімфоцитів і знижується імунорегуляторний індекс при Т-супресорній спрямованості імунної відповіді, а зміну їх кількості не вдається усунути повною мірою на період клінічного одужання. Не можна відкидати і те, що запальний процес у них може бути спровокований індексними агентами, а сприяє цьому анатомічна або функціональна неповноцінність лімфатичної системи, зумовлена обтяженою спадковістю. Целью работы было изучение иммунокомпетентности лимфоцитарного пула периферической крови при остром гнойном неодонтогенном поднижнечелюстном лимфадените у детей с отягощенной наследственностью. Установлено, что у данной категории детей имеет место снижение основных популяций лимфоцитов и иммунорегуляторного индекса при Т-супрессорной направленности иммунного ответа, а изменение их количества не удается устранить в полной мере на период клинического выздоровления. Нельзя исключить, что воспалительный процесс у них может быть спровоцирован индексными агентами, а способствует этому анатомическая или функциональная неполноценность лимфатической системы, обусловленная отягощенной наследственностью. The substantial prevalence of different nosological forms of lymphadenitis in children is due to morphofunctional immaturity and age-related features of the structural components of the lymph node. The lymphatic system in children under 6 years of age is well developed, however, their immune competence is not perfect. Therefore, most often lymphadenitis of neodontogenic origin occurs at this age when the immune response of the organism to a significant number of bacterial and viral stimuli is insufficient for its reliable protection. The purpose of the work was to study the immunocompetence of the lymphocytic pool of peripheral blood in acute purulent lymphadenitis in children with overburden heredity. Materials and methods of research. A clinical examination and evaluation of the expression of surface markers of peripheral blood lymphocytes in 22 children with acute purulent neonotogenic submandibular lymphadenitis aged from 3 to 7 years was performed. The patients were divided into 2 groups. The first group included 17 persons with this disease, and the second one involved 5 children who have been diagnosed with a history of heredity in their families. The appearance of acute lymphadenitis in children was preceded by acute respiratory viral infection. The general clinical methods of examination included an assessment of the state of the somatic status, the oral cavity and the immediate inflammation cell. Incubation of peripheral blood cells was performed with monoclonal antibodies to CD3+, CD4+, CD4/25+, CD8+, CD16+, and a mechanism for incubation with FITSconjugated goat antibodies to mouse immunoglobulins was used to detect them. The level of expression of surface markers of lymphocytes was determined as a percentage by the method of indirect immunofluorescence. Blood collection was performed at the time of hospitalization and for recovery. Prior to conducting surgical intervention, an ultrasound examination was required. Results of the research and their discussion. It was found out the fact that acute lymphadenitis in children of the second group occurred in the childhood of two grandparents and one grandmother, and later in their daughters, and their 4 sons. In 2 patients (a boy and a girl) it was traced only through the father or mother. In one mother, inflammation is diagnosed twice in the submandibular areas. Her sons had one-sided inflammation of the lymph nodes (right). The ultrasound biolocation, which was conducted with the aim of clarifying the diagnosis, determined the presence of single hypoechoic formations of ordinal form with clear contours of different sizes in all patients. At the time of hospitalization, in the group of children with hereditary imitation in the peripheral blood, it has been determined the fact that a decrease in the total number of CD3+ was in 2,2 times, CD4+ in 1,6 times, CD16+ in 2,5 times, CD4+, CD25+ in 2,1 times, immunoregulatory index in 2,5 times, the number of CD8+ in 1,6 times than in the group of healthy children. This clearly indicates to the presence of more pronounced immunological disorders, namely, in this group of children. At the end of treatment of patients of the second group it was followed a tendency to improve all indexes, however, the number of CD3+, CD4+ and immunoregulatory index values were lower than the control ones in 1,3, 1,4, and 1,6 times, respectively. At that time, the content of CD8+, CD16+, CD4+, CD25+ came close to healthy children. Thus, in acute purulent neodontogenic submandibular lymphadenitis, a decrease in the level of major lymphocyte populations in the immunoregulatory index at the T-suppressor direction of the immune response is observed, as the number of lymphocytes of this type increased by 1,3 times. More significantly, these changes were inherent for a group of children with hereditary imitation, which requires a more careful study of this phenomenon in the corporate participation of clinicians, immunologists, morphologists.