Comparative Assessment of the Dynamics of Immunological Reactivity in Patients With Postoperative Ventral Hernia

Postoperative Ventral Hernias to this day remain one of the main pathologies of planned and urgent surgical interventions. The purpose of the study is to study the immune response in patients with postoperative ventral hernias who underwent auto and alloplastic hernioplasty methods. The study included 40 patients diagnosed with postoperative ventral hernia, including 25 men (62.25%) and 15 women (37.5%). In men, the average age was 45.6±2.3 years, and in women 57.2±3.2 years. Patients are divided into 2 groups. Group I are patients who underwent autoplastic methods and group II patients who underwent alloplastic hernioplasty methods. The complex of immunological examination included the determination of a subpopulation of lymphocytes with CD3, CD4, CD8, CD20 receptors, interleukin 6, interleukin 10 and immunoglobulins A, M, G. Immunological examination of blood parameters in patients with postoperative ventral hernias revealed the following changes. There is an upward trend in all indicators. In group I, the leukocyte level was increased by +0.2±0.01, and in group II, the indicators were within the normal range. The level of monocytes in patients who underwent alloplasty increased by +1.5±0.2. There was an increase in the concentration of T and B lymphocytes with GD3, CD4, CD8, CD20 receptors on the 7th day after surgery in patients of the first group was +1.85±0.3, +1.6±0.4, +1.6±0.1, +1.5±0.2. And in patients of the second group, the initial level of indicators was lower and increased by +1.2±0.1, +1.4±0.2, +1.67±0.65, +1.03±0.45. The level of IL6 and IL 10 in the postoperative period increased in patients of the first group by +1.55±0.2 and +1±0.9, in the second group it was IL 6 +0.9±1.2, IL 10 +0.8±1.2. The study shows that the indicators of the humoral cell type tended to increase, which shows the result. Conclusions. Patients with postoperative ventral hernias who have undergone autoplastic and alloplastic hernioplasty methods in dynamics, the immunological reactivity indicators significantly increase on the 7th day, in comparison with the initial blood parameters. Namely, in patients who have undergone autoplastic methods of hernioplasty. The use of conventional suture materials in autogernioplasty increases the risk of developing an inflammatory process in the early and long-term postoperative period, in contrast to the use of polypropylene mesh prostheses.

State of Immunological Reactivity of Rat’s Body after Exposure to Different Doses of γ-Radiation in a Long Period and their Offense of the 1st Generation

BACKGROUND: Recently, the problem of changes in immunological reactivity has become important with the growth of immunodeficiency states of a different nature. [4]. High radiosensitivity of the immune system, its stability in time and the irreversibility of some post-radiation changes can contribute to the development of long-term effects of radiation [2,3,6]. One of the tasks of modern medicine and biology is to study the effect of chronic or fractionated ionizing effects on the body's immune system both in the early and late periods of irradiation and their 1st generation descendants [1,2,3,11,12]. Therefore, it is necessary to study the long-term effects of sublethal and fractionated effects of g-radiation on the immunological reactivity of the organism, nonspecific phagocytic resistance and their 1st generation descendants. AIM: The aim of this study was to study the long-term effects of sublethal and fractionated effects of g-radiation on the immunological reactivity of the organism, nonspecific phagocytic resistance and their 1st generation descendants.. METHODS: 7 series of experiments were performed on 105 white outbred sexually mature rats. 1-series intact (n=15), 2nd series - (n = 15) irradiated with a sublethal dose of 6 Gr. (1 month), 3rd series - irradiated with a sublethal dose (3 months, n = 20), 4 - descendants 1 - generations after sublethal dose, 5 series - irradiated with a fractionated dose (1 month), 6 series - irradiated with a fractionated dose (3 months), 7 - descendants of the 1st generation after fractionated -irradiation. Each series used 15 animals. Irradiation of animals 2 - 3 - 4 series was carried out on the Russian radiotherapy device "Agat-RM" -rays 60Co, the dose of sublethal irradiation is 6 Gr. Irradiation of animals of 5-6-7 series was carried out on the Russian radiotherapy device "Agat-RM" with 60Co-rays with topometric and dosimetric preparation of experimental animals, which facilitates the administration of a fractionated dose of 2 Gr. to animals three times within 3 weeks. RESULTS: In the long-term period after fractionated g-irradiation in the T-system of immunity, the following changes occur: against the background of an increase in the total number of lymphocytes, there is a decrease in the pool of CD3 +, CD4 + lymphocytes, immunoregulatory index, normalization of the lymphokine-producing ability of lymphocytes and a decrease in the pool of CD8 + lymphocytes. In the long-term period after fractionated g-irradiation in the humoral link of immunity, an increase in the absolute amount of CD19 + by 3.5 times was noted, which significantly exceeded the indicators of both control and intact animals. The percentage of this pool of cells exceeded the data of intact ones by 1.7 times. In the studied time period, the antibody-producing ability in the spleen increased from 22 ± 1.3 to 45 ± 2.6, without reaching, however, the level of intact animals. At the same time, there was a significant decrease in the suppression index to 13% (P<0.001) and the CIC concentration by 14 times (P<0.001) in the blood serum. The indicators of F/n and NST-test were high by 1.43 and 2.46 times, respectively. So, in the long-term period after exposure to a fractionated dose of g-radiation, the nonspecific phagocytic resistance of the organism is increased. CONCLUSIONS: The tension in the humoral link of immunity is manifested by a decrease in the quantitative and qualitative indicators and an increase in the functional and metabolic activity of neutrophils.

Effect of ozonotherapy on clinical and immunological indicators in children with allergic rhinitis

Objective. To determine the effect of ozonotherapy on the clinical indicators and immunological reactivity state in children with a moderate course of persisting allergic rhinitis. Materials and methods. Children aged 510 years with a moderate persisting allergic rhinitis were under observation. They were divided into two groups depending on the therapy applied. Group I of allergic rhinitis patients received a complex generally accepted therapy, group II of allergic rhinitis patients a complex therapy associated with ozonotherapy. Clinical indices and immunological reactivity parameters were studied during exacerbation and clinical remission in allergic rhinitis children. Results. Ozonotherapy, included into a complex treatment of group II patients, was established to promote a faster occurrence of full clinical remission and normalization of most parameters of immunological reactivity. Duration of a full clinical remission in the group of allergic rhinitis patients, who received a complex therapy associated with ozonotherapy, more than twofold exceeded its duration in the group of allergic rhinitis patients receiving a complex generally accepted therapy. Conclusions. The data obtained indicate high clinical, immunomodulating and antirelapsing effect of ozonotherapy that allows recommending its wide use in complex of medical measures among children with persisting allergic rhinitis.

FEATURES OF IMMUNOLOGICAL REACTIVITY OF PATIENTS WITH LICHEN PLANUS OF THE ORAL MUCOSA

Lichen planus is considered as a multifactorial disease. Various factors play a role in the development of lichen planus of the oral mucosa: genetic, dental materials that are used for restoration, prosthetics of teeth, Helicobacter pylori, viruses, psychological stress, somatic pathology and others. The pathogenesis of oral lichen planus is based on an autoimmune process. The aim of the study was to determine the immunological reactivity in patients with various clinical forms of lichen planus of the oral mucosa. The study carried out clinical, laboratory examination of 75 female patients aged 29 to 75 years old with red lichen planus of the oral mucosa. All patients were divided into three groups depending on the clinical form of the disease. The control group consisted of 30 women aged 39 to 70 years old without red lichen planus of the oral mucosa. The phagocytic activity of neutrophils, the level of immunoglobulins of classes A, M, G and circulating immune complexes in the blood serum were evaluated. The humoral link of immunity in patients with exudative-hyperemic form of OLP was characterized by hyperimmunoglobulinemia of classes A, M, G, an increase in circulating immune complexes, in patients with erosive-ulcerative form of hyperimmunoglobulinemia of class M against the background of hypoimmunoglobulinemia A, G and an increase in circulating immune complexes. In patients with a typical form of OLP, only an increase in the level of circulating immune complexes was noted. When assessing the immune reactivity in patients with OLP, the relationship between the manifestations of the "dysphagocytosis" syndrome, disorders in the humoral immunity system with various clinical forms of the disease was established. This fact allows us to conclude about the pathogenetic role of an imbalance in the system of mechanisms that ensure the elimination of pathogens, including infectious nature in the occurrence of a disease with the formation of an autoimmune component.

BODY IMMUNOLOGICAL REACTIVITY IN OPIOMANIA

Due to the general trend of changes in reactivity in many exogenous and endogenous diseases, more and more attention is currently being paid to changes in immunological reactivity in drug addiction. The expediency of assessing the state of immune mechanisms in opioid addiction is determined by the need to predict their course and outcome. The aim of the study was to study the immunological reactivity of the body in patients with opium addiction in a stage of abstinence. For this purpose, clinical and immunological studies were conducted in 80 patients who use opioid drugs. The duration of the disease ranged from 0.5-19 years. Of these, the disease duration is up to 3 years – 28 patients (group I), and over 3 years – 52 patients (group II). The number of subjects in the control group was n = 50. Authors carried out the assessment of the mental, narcological, somatic, and neurological status. In addition, they have studied the general clinical, biochemical and immunological parameters As a result of this study, it was found, that patients of group I had more pronounced T-lymphocytopenia. A persistent increase in the value of serum IgM was revealed both in the dynamics of abstinence and depending on the duration of the disease, which may indicate a strain on the humoral link of immunity in opium addiction. In addition, as the duration of chronic narcotization increases, there is a tendency to increase the relative number of B-lymphocytes. Thus, at the patients with opium addiction in a state of abstinence develop T-lymphocytopenia. Moreover, with an increase in the duration of the disease, an increase in the level of IgM by 2-2.6 times. The revealed changes in the immunological reactivity of the organism suggest the need to include immunocorrective therapy in the complex of therapeutic measures for opium addiction.

Hematological and biochemical features with tuberculosis and bacterial lymphadenitis in children

Objective — to improve approaches to differential diagnosis of lymphadenitis by identifying features of hematological and biochemical parameters of blood of children with nonspecific bacterial and specific tuberculous lymphadenitis. Materials and methods. Under our supervision were 45 children aged 1 to 5 years with an increase in lymph nodes (LN), who were treated in the surgical department of the Odessa Regional Children’s Clinical Hospital for the period from 2017 to 2018. Patients were assessed for general condition and affected lymph node lesions, as well as blood sampling for general and biochemical studies. Additionally, the calculation of integrated hematological indices of immunological tolerance of the organism was performed, namely the index of neutrophils to lymphocytes ratio (NLR); lymphocyte to monocyte ratio (LMR); neutrophil to monocyte ratio (NMR); lymphocyte to eosinophil ratio (LER). For comparison with the norm used the data of these indicators, established in healthy children. Results and discussion. All patients were divided into 2 clinical groups. The first group (СG-1) included 25 children with lymphadenitis caused by BCG vaccination, the second (СG-2) — 20 patients with acute purulent lymphadenitis. The study found that the condition of most children (75 %) of the second group was more severe compared with patients with CG-1, which was manifested by more pronounced manifestations of intoxication and local condition of the affected LN.Evaluation of a general blood test showed that the average number of leukocytes with specific lymphadenitis in most (80.8 %) patients was within normal limits, with purulent; on the contrary, in 71.4 % of children there was a tendency to increase. The calculations of hematological indices revealed a decrease in NLR, and, with BCG lymphadenitis, it decreased by half (to 0.96) compared with bacterial lymphade­nit (to 1.88), which indicates an increase in specific immunological reactivity in children of CG-1. ISNM in most patients with lymphadenit remained low throughout the course of the disease. This indicates the timely activation of the macrophage defense system of the body. LMR with tuberculous lymphadenit grew, while with bacterial lymphadenit, on the contrary, it decreased by half, which indicates earlier mobilization of lymphocytes as an effector immunity in children with BCG lymphadenitis. LER in all forms of the disease tended to increase, which indicates the predominance of a delayed-type hypersensitivity reaction in children of both groups.Analysis of blood biochemical parameters in patients of both clinical groups did not reveal clear differences in children with bacterial and tuberculous lymphadenitis. Conclusions. At specific defeat of LN unlike nonspecific, the clinical and laboratory picture with lack of expressive leukocytes reaction is noted. Determining the indices of the ratio of blood leukocytes makes it possible to more deeply assess the level of immunological reactivity and the general condition of the child, which increases the informative value of clinical blood tests. Analysis of blood biochemical parameters in patients with specific and nonspecific lymphadenitis, although it has no specific differential diagnostic value, however, is an important component of assessing the quality of treatment and the patient’s condition as a whole.

Evaluation of the anti-inflammatory activity of melatonin in a model of experimental arthritis

The epiphyseal hormone melatonin (1 and 5 mg/kg) significantly limited locomotor and psychoemotional disorders, indicators of inflammation and immunological reactivity in rats with experimental adjuvant arthritis.

Particularities of immunological reactivity, nitric oxide and its metabolities production in patients with pulmonary tuberculosis in association with covid-19 infection

The study included 24 patients, which formed the baseline group — 12 patients with pulmonary tuberculosis in combination with COVID-19 infection and the control group — 12 patients with pulmonary tuberculosis. There were studied the leukocyte formula, the content of CD3, CD4, CD8 lymphocytes, the content of NO2-+NO3- total and its metabolites. The obtained results showed that in patients with pulmonary tuberculosis and COVID-19 there is a pronounced decrease of lymphocytes and an unexpressed shift of the leukocyte formula to the left. The lymphocyte content decreases due to CD3 lymphocytes and their subpopulation of CD4 (helper) lymphocytes. The CD4/CD8 immunoregulatory index demonstrates a stimulation of immunological reactivity in patients with pulmonary tuberculosis and depression of immunological reactivity in patients with pulmonary tuberculosis in combination with COVID-19 infection and a pronounced suppression of the production content of NO2-+NO3- total and its metabolites (NO2- and NO3-).

Immunological Reactivity of the Body to Implanted Retic Endoprosthesis Used for Hernias of the Anterior Abdominal Wall

The article analyzes the review of the literature of foreign authors and authors of the CIS countries on the immunological response to the used mesh endoprostheses in patients after alloplastic methods of hernioplasty with hernias of the anterior abdominal wall. Currently, it is possible to monitor the course of the wound process in patients operated on for hernia using the immunological method. The correlation dependence of the nature of complications in the wound with indicators of additional research methods has not been sufficiently studied, which requires further study of this issue.