The values of cell-mediated and humoral immunity in infants of the first year of life with a history of haemolytic disease of the newborn
The objective. To assess the dynamics of the values of cell-mediated and humoral immunity in children with a history of haemolytic disease of the newborn during the first year of life. Patients and methods. A clinico-immunological examination included 32 children with Rh D haemolytic disease of the newborn, of whom 16 received conservative treatment (group 1), and 16 underwent exchange blood transfusion (group 2). The control group comprised 32 full-term newborns who did not have haemolytic disease. Immunological examinations (immunophenotypic analysis of peripheral blood lymphocytes, assessment of humoral immunity) were performed in the first hour of life before exchange blood transfusion, then at 6 and 12 months (but not earlier than 1 month after preventive inoculations). Results. In newborns of group 2, an increase of an absolute NK cell count at birth (CD16.56 - 0.81 ± 0.65 vs 0.5 ± 0.33 in the control group), and of the number of lymphocyte pools CD54+ (1.38 ± 1.22 vs 1.0 ± 0.49, respectively) and CD95+ (1.83 ± 1.94 vs 0.5 ± 0.66 in the control group) was recorded. At 6 months, patients of this group had lower levels of IgM (to -0.53 ± 0.29 vs -0.99 ± 0.51 g/l in the control group) and a higher complement haemolytic activity. The specificities of immune responses in children of group 1 were: a higher lymphocyte readiness to undergo apoptosis, a higher complement haemolytic activity during the first 6 months, and also activation of cell-mediated immunity (CD95+ - 1.48 ± 1.06 vs 0.64 ± 0.94 in the control group; CD3+CD95+ - 0.67 ± 0.49 vs 0.24 ± 0.24; CD54+ - 2.24 ± 0.48 vs 1.61 ± 0.75). At 6 months of life, children of this group had lower levels of IgA (0.1 ± 0.11 vs 0.21 ± 0.21 g/l in the control group), IgM (0.53 ± 0.29 vs 0.99 ± 0.51 g/l) and IgG (3.02 ± 0.8 vs 4.88 ± 2.03 g/l) along with enhanced levels of IgE ( 33.19 ± 27.45 vs 4.88 ± 2.03 g/l in the control group and 4.08 ± 1.44 g/l in group 1). At 12 months, patients who received conservative treatment had decreased amounts of major lymphocyte subpopulations and lower levels of activation marker expression. Conclusion. The revealed changes of immune indices in children who had a history of Rh D haemolytic disease of the newborn and received conservative treatment are indicative of a prolonged postnatal course of rhesus conflict, enhanced infectious and allergic morbidity.