Imbalance of acquired immunity factors in newborns with cytomegaloviral infection depending on the severity of the disease
Objective: to assess the imbalance of the parameters of the immune status at the time of manifestation of CMVI in newborns in order to predict the development of a severe form of the disease. Methods: 133 newborns with CMVI were examined. Depending on the severity of the condition, all children were divided into two groups: 1 - CMVI, severe form - 60 people (45.1%); 2 - CMVI, moderate form - 73 people (54.9%). An immunological examination was carried out, including the determination of T and B lymphocytes, as well as intercellular interaction between them. Using the “classification trees” method, we compared two differentiated approaches to the prediction of severe CMVI: based on a study of the relationships between T-lymphocytes (CD3+), T-helpers (CD4+), the content of cytotoxic lymphocytes (CD8+) and B lymphocytes (CD20+) and by studying the interaction of co-stimulation molecules CD28, CD3 + CD28 +, CD3-CD28 +, CD3 + CD28-. Results. In this study, it was demonstrated that the “standard immunogram”, limited to the definition of CD3+, CD4+, CD8+, CD20+ lymphocytes, shows less information in predicting the development of a severe form of the disease in this patient population than the combination of markers, including CD3 + CD28-, CD20 + CD40 +. Findings. A model for predicting a severe form of cytomegalovirus infection in newborns based on the analysis of the content of CD 28 costimulation molecules has a higher information content, which makes it possible to start specific therapy on time.