Immune system condition - the part of pathogenesis of obstetrical and perinatal complications in syphilis (literature review)
Contemporary research data about the state of immune system in syphilis have been presented in literature review, which were characterized by development of malfunction of innate immunity with supressed functions of complement system and phagocytosis. Treponema pallidum are capable to direct binding of big regulatory proteins of complement system such as FH, FHL-1, C4b-binding protein (C4bp) and C1 esterase inhibitor (C1-Inh) and cause the suppression of complement activity. Circulatory immune complex and macrophages, proinflammational cytokines and IFN-γ from Th1 have been observed in mucosal and dermal elements and injured vases in early syphilis. Treponema pallidum immunogenity is caused by presence in its outer membrane immunogenal lipoproteins. Treponema pallidum coacts with the host through superfacial lipoproteins, lipopolysacharids (LPS) and glicolipids, in the mean, of external membrane. Lipoproneins are presence in diff erent cell components: in external membrane, extracellulary and in periplasmatical space. Proinfectional lipoproteins of Treponema pallidum are located lower of the cell surface and do not coact directly with host immune system. This calls a weak immune response and contributes to replication of spyrochetes in organism of patients. Only destraction and involvement of Treponema pallidum free lipoproteins initiates their coaction with receptors on immune cells with following immune system activation. Spirochetal lipiproteins have two opposite actions on immune system: activate immune system and other lipoproteins suppress it, avade the reaction of immune system. Human syphilis is a multistage disease, with diverse and wide-ranging manifestations caused by Treponema pallidum. Cell-mediated immune response takes part in the course of syphilis. Treponema pallidum often manages to evade host immunity and, in untreated individuals, may trigger chronic infection. In patients with syphilis lymphopenia has been discovered which testifies the development of immune system malfunction with inhibition of adaptive immunity. Lymphopenia also are observed in untreated pregnants and treated pregnants with syphilis. Leukocytosis with the leukocyte formula disposition to the left has also been observed in untreated pregnants. This testifies the malfunction of the immune system in pregnants with syphilis and refers them to the risk group of infection in pregnancy, intrauterine infection and preterminal pregnancy interruption. Lymphocyte-leukocytal placenta infiltration is the morphological indicator of placental unsuffi ency (placental malfunction).