Functional condition of the sensitized T-lymphocytes according to RBTL in children with non-rheumatic myocarditis

Abstract

Summary. The increased proportion of non-rheumatic myocarditis in children has recently determined the urgency of this problem in pediatrics. It is known that non-rheumatic myocarditis in children often occurs against the background of viral or bacterial infection under conditions of altered reactivity of the immune system. There is evidence, mainly in rheumatism, that spontaneous and stimulated lymphocyte blatransformation response in such patients reflects the activity of the process, its tendency to chronicity and may serve as a criterion for the adequacy of therapy. Studies on the functional status of T lymphocytes in patients with non-rheumatic myocarditis are mainly related to experimental models. This determines the relevance of this work. The aim was to compare the functional activity of T-lymphocytes in spontaneous and phytohemagglutenin-stimulated lymphocyte blastranformation reactions in children with non-rheumatic myocarditis in acute and chronic course. Materials and methods. Under observation were 42 children aged 4 to 13 years with non-rheumatic myocarditis. A study was made of the functional activity of T-lymphocytes in the reaction of blast transformation using a radioisotope technique with thymidine-3H. Phytohemagglutenin from Reanal was used as a nonspecific stimulant. The reaction was evaluated on an SBS-2 automatic scintillation counter. The functional activity of T-lymphocytes was studied upon admission of children to the cardiology department and after the treatment. As a result of the study of the functional state of T-lymphocytes in the blast transformation reaction using the thymidine-3H radioisotope label in 52 children with acute and chronic non-rheumatic myocarditis, it was shown that during the period of advanced clinical manifestations, high spontaneous stimulation to the nonspecific phytohemagglutenin stimulator was recorded. The complex of generally accepted therapeutic agents leads to the restoration of the functional state of T-lymphocytes in children with an acute course of non-rheumatic myocarditis, and in chronic, despite the positive clinical dynamics, increased spontaneous stimulation of T-lymphocytes is still recorded, and the response to phytohemagglutenin is not fully restored in them. These data make it possible to recommend indicators of the functional activity of T-lymphocytes as criteria for recovery and determining the timing of treatment. Conclusions. The criterion for recovery and determining the duration of treatment of children with non-rheumatic myocarditis should be not only clinical and electrophysiological indicators, but also indicators of functional activity of T-lymphocytes, reflecting the sensitization of the body