Zhelezniakova N. M.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

For today the role of the immune system in the development of both acute and chronic inflammatory processes, is a proven and undeniable. It is generally admitted that any chronic disease leads to excessive load on the immune system, and, in the end induces formation of secondary immunodeficiency and reduces the effectiveness of immunological response reactions. The aim of the present study was to estimate the state of humoral immunity in the comorbidity of chronic obstructive pulmonary disease (COPD) and chronic pancreatitis (CP). Materials and methods. 122 patients with COPD were under monitoring, chronic pancreatitis was diagnosed in 79 of them, who composed the main group. A comparison group presented with 43 patients with isolated COPD. Indicators of norm were obtained after having examined 20 healthy patients. Concentrations of immunoglobulins of different classes – A, M, G, E were determined by the method of radial immunodiffusion in gel by Mancini et al. In determining the immunoglobulin E we used method of sedimentation by rivanol. State of the complement system was assessed by the method of 50 % hemolysis with recalculation by a standard schedule. Circulating immune complexes (CIC) in serum of patients were determined by a method based on the ability of polyethyleneglycol with a molecular weight of 6000 Da at low concentrations precipitate immune complexes. Assessment of the excretory function of the pancreas was performed by determining the elastase-1 in feces. Statistical analysis of the results was perfomed using PC with licensed programs «Microsoft Excel» and «Statistica 6.0». Results and discussion. In patients with isolated chronic obstructive pulmonary disease observed changes in the concentration of immunoglobulin of main classes: reduction of immunoglobulin M and A against the increase of immunoglobulin G and E. At the same time there is a decrease of the total complement activity and concentration of its fragments, with high content of the circulating immune complexes. In case of comorbidity of chronic obstructive pulmonary disease and chronic pancreatitis the redistribution of emphasis in indicators of humoral immunity, which is manifested by increased content of circulating immune complexes and immunoglobulins all classes, with simultaneous hyperactivation of the complement system. Such deviations in the formation of humoral response in terms of comorbidity can initiate the development of autoimmune reactions and the accumulation of antibodies to target organs with subsequent formation of the relevant complications. It was also shown that the depth of pathological changes in parameters of humoral immunity is dependent on the degree of the excretory pancreatic insufficiency. Conclusions. Active phase of COPD is accompanied by changes in concentrations of main immunoglobulin classes: reduction of immunoglobulins M and A against the increase of immunoglobulin G and E. Simultaneously there is a decrease of the total complement activity and concentration of its fragments, with elevated levels of CIC. In conditions of comorbidity directionality of humoral immunity indicators has its own feature: activation of the complement system, elevation of main immunoglobulins classes levels and CIC. And, these changes depended on the degree of the excretory pancreatic insufficiency. Such changes may initiate the development of autoimmune processes and the accumulation of antibodies to target organs with subsequent formation of the relevant complications, which allows considering this pathological tandem as prognostically unfavorable.

COPD, chronic pancreatitis, excretory insufficiency, complement system, immunoglobulins, CIC

«Bulletin of problems biology and medicine» Issue 3 part 3 (112), 2014 year, 104-108 pages, index UDK 616. 24-007. 272-036. 12-07-037:616. 37-002-036:12