Characteristics of cellular and humoral immunity parameters in patients with mechanical jaundice, caused by cholangiocarcinoma
In the modern world, obstructive jaundice caused by developing a malignant disease - cholangiocarcinoma, poses a significant medical and social problem in economically developed and in developing countries. The aim of this study was to examine parameters of cellular and humoral immunity in patients with obstructive jaundice caused by cholangiocarcinoma before and after surgical intervention. There were enrolled 56 patients with obstructive jaundice caused by cholangiocarcinoma (stages T2-3N0-1M0) and 90 age-matched apparently healthy volunteers. Cellular immunity parameters were studied by using an FC500 flow cytometer (Beckman Coulter, USA). The parameters of humoral immunity were assessed by measuring level of serum immunoglobulins A, M, G, E by using enzyme-linked immunosorbent assay kits manufactured by Vector-Best (Russia). The results were statistically analyzed using the Statistica v. 12.0 software (StatSoft Inc., USA). According to the study results, in patients with obstructive jaundice caused by cholangiocarcinoma, there was revealed activation of humoral immunity due to increased serum level of IgA, IgG, IgE with a profoundly depressed some arms of cellular immunity contributing to the imbalanced work of the entire immune system. The imbalance in the cellular arm of immune system was manifested by decreased count of T helper and increased cytotoxic T cell subsets as well as decline in the CD4+/CD8+ T cell ratio. An increased count of cytotoxic T lymphocytes points at lowered T cell immunity and existence of a cytotoxic effect at the cellular level. A decrease in the count of pan-marker-positive T lymphocytes indicates about generally reduced activity of the T cell arm due to altered T cell function and, as a result, affected antigen-presenting function in immune cells. The development of T cell immunodeficiency due to T-cell apoptosis confirms upregulated expression of immunomarkers CD38+, CD95+. An increased serum level for some immunoglobulins suggests developing imbalance in the humoral immunity, whereas rise in the circulating immune complexes indicates about pronounced body intoxication caused by obstructive jaundice due to hyperbilirubinemia and disintegration of tumor cells. Application of surgical correction of obstructive jaundice contributed to normalizing parameters of cellular and humoral immunity, resulting in immunocorrective effect.