The timely diagnosis and treatment of post-infectious glomerulonephritis (PIGN) is currently limited by the erased and low-symptom nature of the disease, which leads to the search for informative biological markers of the disease, which can be used as immunological indicators of blood and urine. The study was carried out in order to establish the characteristic changes in the immunological parameters of blood and urine in patients with PIGN. The study included 60 patients with PIGN from among the patients, hospitalized in the nephrology department of the Republican Clinical Hospital of Health Care Ministry of the Chuvash Republic in 2015-2018. In addition to the generally accepted research methods, the patients underwent: 1) the determination of indicators of innate and acquired immune response in the blood (CD3+ -, CD3+ CD4+-, CD3+CD8+-, CD4+CD25+-, CD95+-, CD20+-, CD14+CD282+-, CD14+CD284+- cells; levels of IgG, IgA, IgM, circulating immune complexes, C3, C4) and urine (levels of IgG, IgA, IgM, C3, C4); 2) the determination of the levels of cytokines - IL-1β, Ra-IL-1β, IL-2, IL-4, IL-8, IL-10, IL-17A in blood serum and urine. The data obtained were compared with those of the group of healthy individuals. The changes in blood immunological parameters, identified in the group of patients with PIGN, indicate the activation of innate immunity (the increase in the number of CD14+TLR2+- cells) and the humoral component of adaptive immunity (the increase in the number of B-lymphocytes, hyperimmunoglobulinemia - the increase in IgM and IgA levels) against the background of the decrease in the number of T (CD3+) - lymphocytes and regulatory (CD4+CD25high) - cells, hypocomplementemia (decreased levels of C3, C4). The increase in the content of C3, IgG and IgA was found in the urine. The cytokine profile of blood in patients with PIGN was characterized by the increase in the levels of pro- and anti-inflammatory cytokines IL-1β, Ra-IL-1β, IL-2, IL-8, IL-10, IL-17A, with the exception of IL-4, which remained on the levels of healthy individuals. The cytokine profile of urine in patients was characterized by the increase in the levels of pro-inflammatory cytokines IL-1β, IL-2, IL-8, IL-17A and anti-inflammatory cytokine - IL-10, with no changes in the content of Ra-IL-1β and IL-4. The revealed features of the immunological profile of blood and urine in patients with PIGN reflect the immunopathogenetic mechanisms of this disease.
Liver cirrhosis continues to be an acute problem of modern medicine due to the high rates of its prevalence and mortality. The high mortality rate is caused by the development of the number of life–threatening complications in decompensated forms of liver cirrhosis – hepatorenal syndrome, infections and varicose bleeding. Hepatorenal syndrome and infections are the result of immunological shifts occurring during decompensation of liver cirrhosis. Currently available literature data do not allow us to create a complete picture of the functional state of various links of adaptive immunity with decompensated liver cirrhosis. The aim of the research was to study the characteristic features of adaptive immunity in patients with decompensated liver cirrhosis. Material and methods. The prospective cohort study included 136 patients with decompensated liver cirrhosis, who received inpatient treatment in the hepatological department of the multidisciplinary hospital. The cohort of examined patients was divided into two groups, one of which included patients with liver cirrhosis of viral origin (n = 78), the other – patients with alcoholic liver cirrhosis (n = 58). In addition to the generally accepted standard methods, the patient examination program included immunological tests: identification of T- and B-lymphocytes, immunoregulatory and activated subpopulations of T-lymphocytes by the method of immunophenotyping peripheral blood mononuclear cells using monoclonal antibodies. The serum levels of immunoglobulins IgM, IgG, IgA, circulating immune complexes were determined by immunoturbidimetric method. Results. The study of indicators of the humoral link of adaptive immunity revealed an increase in the number of B cells, an increase in IgM, IgG, IgA and circulating immune complexes in patients with decompensated liver cirrhosis. The cellular link of adaptive immunity was characterized by an increase in the relative content of T helper cells, activated T cells against the background of a decrease in the number of immature T cells and T regulatory cells. Conclusions. The distinctive features of adaptive immunity in patients with decompensated liver cirrhosis are simultaneous activation of both humoral and cellular components, which, apparently, supports the systemic inflammatory process and the associated progressive liver fibrosis.
Background:Primary immunodeficiency diseases (PID) occur on average with a frequency of 1: 100 000 of the population. In accordance with the classification of PIDS of the International Union of Immunological Societies (IUIS) 9 different groups of innate errors of immunity are distinguished [1]. The polymorphism of the clinical picture, difficulties in recognizing PID cause their late diagnosis and the associated development of irreversible organ damage, complications and high mortality. According to the traditional view, the clinical marker of PID is an infectious syndrome. However, in some cases, PID is detected as a rheumatologic disease.Objectives:The aim of the study is to analyze the frequency of rheumatologic diseases in adult patients with PID living in one of the subjects of Russia –Chuvashia.Methods:The material of the study was patient data obtained during a retrospective analysis of 49 outpatient records included in the Republican Register of PID. Diagnosis of various forms of PIDS was carried out in accordance with the criteria developed by the IUIS [1].Results:During the period from 1993 to January 2020, 49 cases of PID were registered in the adult population of Chuvashia. According to the frequency of PID, сommon variable immunodeficiency (CVID) is the most common in Chuvashia (26 people). In the second place there is selective IgA deficiency (10 people); in third place there are X-linked agammaglobulinemia (4 people) and hereditary angioedema (4 people). The remaining forms of PID account for 5 cases: 2 cases of Louis-Bar syndrome, 1 case of DiGeorge syndrome, 1 case of Wiskott-Aldrich syndrome and 1 case of Hyper IgE syndrome. The main symptom of PID in 35 (71.4%) patients was heightened susceptibility to infection. In 14 (28.6%) patients, the clinical picture was dominated by non-infectious presentations (autoimmune, lymphoproliferative and oncological diseases). In 9 patients (18.3%), it was manifested by rheumatologic diseases (rheumatoid arthritis, psoriatic arthritis, scleroderma-like syndrome). These symptoms were more characteristic of CVID. With selective IgA deficiency and X-linked agammaglobulinemia, rheumatic symptoms were observed only in isolated cases. CVID debuted in 2 cases as rheumatoid arthritis, resulting in the delay in the diagnosis of an average of 5.2 years. Only the detailed immunological and genetic study made it possible to diagnose PID and prescribe adequate treatment – replacement immunoglobulin therapy. This treatment reduced the frequency of infectious manifestations of the disease and it did not significantly improve the course of rheumatological diseases. Therefore, the use of methotrexate and targeted therapy was continued.Conclusion:In the clinical picture of PID, rheumatic symptoms predominate in 28.6% of cases, which requires a thorough immunological and genetic examination of patients with rheumatic diseases in order to diagnose PID in a timely manner.References:[1]Picard C, Bobby Gaspar H, Al-Herz W, et al. J Clin Immunol. 2018;38(1):96-128.Disclosure of Interests:None declared
The purpose of this study is to evaluate the effectiveness of the treatment of juvenile idiopathic arthritis with systemic manifestations with interleukin-1 (IL-1) inhibitors. Material and methods. A prospective analysis of the course of systemic juvenile idiopathic arthritis was performed in a 15-year-old patient; she was examined using laboratory and instrumental methods before and after therapy with the interleukin-1 (IL-1) inhibitor canakinumab. Laboratory examination included general and biochemical blood tests, determination of rheumatoid factor, C-reactive protein, lactate dehydrogenase, procalcitonin, antinuclear antibodies, anti-citrullinated peptide (ACCP) antibody titer, antistreptolysin-O titer. The patient underwent ECG, echocardiography (EchoCG), ultrasound examination of the pleural cavities, abdominal organs, kidneys, knee joints, radiography of the chest cavity organs and radiography of the hand, computed tomography of the chest and abdominal cavities. Results. Examination of the patient revealed: synovitis of the knee joints, bilateral pleurisy and pericarditis, positive markers of the inflammatory process, characteristic of juvenile idiopathic arthritis with systemic manifestations. The patient was diagnosed with leukocytosis up to 20.3×109/l with a stab shift of leukocytes up to 18%, an increase in the erythrocyte sedimentation rate of 55 mm/h, an increase in C-reactive protein up to 288 mg/l, lactate dehydrogenase up to 500 units/l, in the analyzes urine revealed moderate hematuria and proteinuria. X-ray examination revealed structural changes in the knee and interphalangeal joints. We observed the effectiveness of canakinumab therapy. During therapy with canakinumab, after the second injection, positive dynamics was noted: leukocytes 5.1 × 109/l, ESR 6 mm/h, CRP 12 mg/l, relief of symptoms of the disease. Conclusions. During therapy with canakinumab, the patient showed positive clinical and laboratory dynamics of the disease. The study demonstrated the effectiveness of interleukin-1 (IL-1) inhibitors, canakinumab, in achieving remission of the disease.
Objective. The main purpose of the research was to develop a coefficient of cardiorespiratory system status, which will take into account both frequency and power characteristics of external respiration and hemodynamics activity. Compare an informativeness of this coefficient with a universally accepted Hildebrandt one. Materials and Methods. 154 apparently healthy young people of both sexes were examined. On a bicycle ergometer with a pedaling rhythm of 40 per minute, five standard stages of short-term physical exercise load ranging from negligible to moderate were provided. Spirography, tonometry and pulsometry were carried out before loading, at its peak and after it. The parameters specified were recorded for each subject simultaneously. Systolic volume was calculated using Starr formula with subsequent defining cardiac minute output. Statistical analysis was performed using Statistica ® 7.0 package (StatSoft Inc., USA). Assessment of results’ significance was calculated using Student's t-test and sign test. Results. In the case of low short-term physical exercises pulmonary ventilation is increased due to greater reactivity of external breathing amplitude and to a lesser extent due to change in the frequency of respiratory movements. This type of reactions of the respiratory component in cardiorespiratory interaction is more efficient. In the given conditions, body’s adaptation is ensured by breathing component dominance, while responses of systemic arterial pressure and pulse turn out to be less pronounced, less stabile. Taking into account greater adaptive importance in power characteristics changes of respiratory and cardiovascular activity, a coefficient of cardiorespiratory system status is proposed – MBV/RMV (ratio of minute blood flow volume to respiratory minute volume). The given factor is demonstrated to have significantly greater informative value and sensitivity to generally recognized Hildebrandt coefficient.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.