Pavlova Ye. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The problem of chronic heart failure (CHF) continues to be relevant and currently holds a lead-ing position in the structure of morbidity and mortality from cardiovascular disease. CHF – complex circulatory and metabolic reactions arise owing to cardiac dysfunction. Pathogenesis of heart failure is a complex multi-factorial process, resulting impact on the cardiovascular system of etiological factors and mobilizing complex compensatory mechanisms involving the violation of various parts of the immunological reactivity of the or-ganism, which further defines the course and prognosis of CHF. The aim of this work was to study regularities of changes nonspecific cellular and humoral immunological reactivity in patients with chronic heart failure, before and after standard therapy compared to similar patients where, in addition to standard therapy, was carried immunotherapy. We observed two groups of patients with chronic heart failure, which accompanied by moderate hemodynamic disorders. Cause of heart failure was coronary heart disease. For treatment of one group of the patients we used the standard therapy, and the other carried immunocorection in addition to standard therapy. As an immunomodulator, we used immunofan. The study of immunological reactivity was performed twice – before and 10 days after of treatment. Determination of hemolytic complement activity, phagocytic activity of neutrophils in peripheral blood was determined by standardized method. Phagocytic number, phagocytic index and neutrophil bactericidal index was also determined by standardized. Quantitative content of cytokines (TNF-α, IL-1β, IL-4, IL-6) and C-reactive protein examined by ELISA using sets of reagents firm “Protein contour” (St. -Petersburg). Analysis of the results of research which characterize the state nonspecific cellular immunological reactiv-ity in patients with chronic heart failure of moderate severity showed a decrease in the initial protective function of polymorphonuclear leukocytes (рhagocytic number, phagocytic index and neutrophil bactericidal index). Use of immunocorrection in addition to standard therapy, accompanied by an increase functional activity of polymorphonuclear leukocytes, the activity of the complement system. Activation nonspecific cellular and humoral reactivity is adaptive in nature and is aimed at restoring the functional state of the immune system in patients of the study group. At the same time reduction of proinflammatory cytokines TNF-ά, IL-1, IL-6 necessary condition for the realiza-tion the reparative effects of cytokines in the focus their reasonable concentration, which is possible only after the utilization of antigenic material by neutrophils and macrophages. Increased levels in the blood of IL-4 (antiinflam-matory, multifunctional cytokine) actively influences on cell-mediated reactions of late-phase and processes to repair damaged, decrease in the activity of the process during CHF and a whole – reducing the risk of possible com-plications. To restore altered nonspecific cellular and humoral immunological reactivity, which is associated with the severity of chronic heart failure, there is a necessity of using immunomodulators in addition to standard therapy.

chronic cardiac insufficiency, ischemic heart disease, preventive immunocorrection, nonspe-cific cellular and humoral reactivity

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«Bulletin of problems biology and medicine» Issue 2 part 3 (109), 2014 year, 175-178 pages, index UDK 616. 12-008. 46-036. 12-085. 37:612. 017. 1