NON-SPECIFIC IMMUNOLOGICAL RESISTANCE IN DIFFERENT
Tuberculosis (TB) is a socially significant disease for the entire world community. An important challenge in successfully combating this infection is the avalanche increase in the number of drug-resistant tuberculosis. Currently, among the reasons for the development of pulmonary tuberculosis, a complex of etiological and pathogenic factors contributing to the disruption of the immune response to M. tuberculosis and the formation of secondary immunological failure (SIF) accompanying the disease are of particular importance. However, the issues of discoordination of cellular components of the local immune system of the lungs leading to T-cell deficiency, as well as the ineffectiveness of the B-cell link, reduction of lymphocyte proliferative activity and activation of apoptosis, cytokine imbalance and activation of immunosuppression mechanisms are not fully studied and have a scattered nature, which does not allow us to assess the overall picture of violations. The goal: determining the immunophenotype of lymphocyte population in lung tissue biopsy specimens of patients with various forms of secondary tuberculosis depending on resistance in case fibrosecavernous tuberculosis (FCT). The material in the study was pulmonary tissue fragments of 30 patients with the verified diagnosis of FCT, and distributed in 2 main groups: resistant forms of secondary tuberculosis (n = 15) and 15 patients not resistant forms of secondary tuberculosis. The standard histological method was used. Immunohistochemically panel of markers included CD68, CD4, CD8, CD20, CD138. The study was conducted at the Center for the collective use of scientific equipment «Molecular Biology» of the Medical Academy named after S.I. Georgievsky in the framework of the grant № ВГ 09/2019, supported by federal state autonomous educational institution of higher education «V.I. Vernadsky Crimean Federal University». The results of the study have shown that in the conditions of secondary tuberculosis, regardless of resistance, the formation of local immunodeficiency with an immune response along the Th-2 pathway is determined. The prevalence of cytotoxic lymphocytes in the area of specific granulation tissue and the draining bronchus indicated the prolongation of inflammation and its transfer to the latent phase. The increase in the number of T-helpers and activated plasma cells can serve a reliable prognostic and diagnostic marker for the reactivation of the tuberculosis process.