ОСОБЕННОСТИ ИММУННОГО РЕАГИРОВАНИЯ ПРИ ВИРУСНЫХ ИНФЕКЦИЯХ

Abstract

The aim of the investigation was to select using cluster analysis and comparatively characterize immune disorders types in acute and chronic viral infections. Patients with acute and chronic viral infections (n = 896) were examined: 77 patients with acute viral hepatitis B, 94 — chronic viral hepatitis B, 119 — chronic hepatitis C, 531 — recurrent herpes, 75 — human papillomavirus infection. Healthy persons (n = 466) were examined as control. The research of blood lymphocyte phenotype was performed by flow cytometry. Four-color immunophenotyping were used in the following panels: Т-lymphocytes (CD3+CD19–CD16/56–CD45+), Т-helpers (CD3+CD4+CD45+), cytotoxic Т-cells (CD3+CD8+CD45+), NKcells (CD3–CD16/56+CD45+), B-lymphocytes (CD3–CD19+CD16/56+CD45+). Absolute values were obtained on a dualplatform technology using the results of haematological analysis. The immunoglobulin concentrations were determined by ELISA. The clustering was performed by a single linkage method. The number of clusters was determined on the basis of calculating the values of the Euclidean distance between the mean group values. It was found that the parameters, characterizing the functional state of the various parts of the immune system in acute and chronic viral infections, considerable diversity values. Custer analysis allows to allocate 6 immunotypes defined different states of innate and adaptive immunity: characterized by activation of the innate (increasing the number of neutrophils and NK-cells) and adaptive immunity humoral response (increasing the concentration of IgG), characterized by hyperreaction of adaptive immunity (a significant increase in the concentration of IgG), discoordinated (multidirectional changes in the values of immunological parameters), immunodeficiency and unresponsiveness (did not differ from the control parameters) immunotypes. It is proved that in patients with viral infections most often determined by the “unresponsiveness” immunotype (40,5%), as well as humoral immunodeficiency (24,9%) and adaptive immune reaction (24,5%). A group of patients with chronic viral hepatitis B and C is allocated separately in which more than 10% of the detected adaptive immunity overreaction that is probably due to the development of chronic hepatitis. These immunotypes can be regarded as different pathogenetic variants of the course of acute and chronic viral infections. Healthy people often had unresponsiveness or immunodeficiency immunotypes, that is their immune system is out of activation. Stratification of patients with viral infections by immunotypes will increase the effectiveness of treatment and implement personalized approaches to diagnosis and treatment of functional disorders of the immune system.