Immune Status Disorder in Children with Recurrent ENT-Infections
Purpose. To study the changes in the immune system in children with recurrent infections of ENT organs. Materials and methods. We examined 25 children with frequent episodes of ENT infections (sinusitis, otitis) We studied the leukocyte immune phenotype based on monoclonal antibodies to СD3 (FITC), CD4 (FITC, PE), CD8 (PC-5, PE), CD56+16 (PE), CD11A (PE), CD14 (FITC), CD18 (FITC), CD19 (FITC), CD22 (FITC), CD25 (PC-5), CD28 (PC-5), CD40 (PE), CD45 (FITC, PC-5), CD71 (FITC), CD95 (PE), CD154 (PE), HLA-DR (PC-5); the IgG, IgM, IgA, IgE, C3, and C4 components of complement; the level of circulating immune complexes were also determined. Results. The state of remission in children with recurrent infections of the upper respiratory tract is characterized by the increase of the level of activation processes, manifested by a significant increase of CD3+CD8+CD28+ activated T-lymphocytes and the increase of the CD3-CD8+ subpopulation. A decreased lipopolysaccharide-binding capacity of B-lymphocytes was also revealed. Increase of the level of neutrophils carrying adhesion receptors CD11a+ and CD18+ was noted, which indicates the presence of persistent migration activity of leukocytes in the tissue (persistence of the inflammatory process) even during the period of clinical well-being (without exacerbation of the underlying disease). Conclusions. The state of remission in children with a high incidence of infections of the ENT organs is characterized by various changes in the immune status. Increase of the level of activation processes indicates the presence of persisting activation of the immune system even during the period of clinical well-being, which can lead to disruption of functional capabilities of the immune system and the formation of chronic pathology. A significantly reduced lipopolysaccharide-binding capacity of B-lymphocytes was revealed, which indicates the role of receptors for lipopolysaccharides of the bacterial cell wall in the pathogenesis of the formation of the risk of complicated clinical forms of recurrent respiratory infections.