BLOOD LEUKOCYTES PHENOTYPING BY HEMATOFLOW METHOD IN PATIENTS WITH ONYCHOMYCOSIS
The aim of the investigation was to evaluate the information content of Hematoflow method in the pathogenetic significance in determining the violations of the cellular responses of innate and adaptive immunity, as well as the decision on the appointment of immunotropic treatment of patients with onychomycosis. The study involved 42 patients with onychomycosis feet and hands/feet at the age of 20-45 years before the appointment of a systemic antifungal therapy. The diagnosis of mycosis, onychomycosis was confirmed by microscopic examination of the fragments of the damaged nail plate. The growth of the fungus culture on special media was observed in 64% of patients. 24 healthy persons were examined as controls. A study of the phenotype of white blood cells was performed on a dual-platform technology hematology analyzer and flow cytometry using a set of antibodies Cytodiff: CD36-FITC, CD2-PE, CD294(CRTH2)-PE, CD19-ECD, CD16-PC5 и CD45-PC7. The phenotypic composition evaluation of the white blood cells by the Hematoflow method allowed to establish in patients with onychomycosis the violation cellular innate and adaptive immunity. Minor changes were detected in the population composition of granule cells in the peripheral blood of patients manifested to an increase in the content of the young and segmented granulocytes. When monotsitopeniya patients with onychomycosis increases the content of the «classic» monocytes and decreases the level of «non-classical» monocytes. Changes in the composition of blood monocytes subpopulation identified in patients with the infection lasting up to 3 years and stored in the course of the disease. The most pronounced changes were found in patients with onychomycosis by the performance of adaptive immunity. Lymphopenia in these patients is realized by reducing the number of immature and mature B-cell, but by increasing the content of T-lymphocytes. Moreover, if the content of immature B-cells have decreased in patients with a duration of infection of up to 3 years, the change in the number of mature T- and B-lymphocytes detected during disease duration 3-10 and 10 years. These changes in the content of T- and B-lymphocytes reflect immunopathogenetic processes and determine the importance of T- and B-cell immunity in onychomycosis. In general, the Hematoflow method is informative in assessing violations the cell of innate and adaptive immunity. It allows to evaluate the severity of the immunopathological process mechanism and the level of damage to the immune system, can recommend its use for a personalized approach to the appointment immunotropic treatment.