Quantititative Changes of T-Regulatory Cells in Patients With Polipous Rhinosinusitis Treated by Nasal Glucocorticosteroids

Семенов, В. М.; Зурочка, В. А.; Зурочка, А. В.

doi:10.15789/1563-0625-2012-3-233-238

Cited by 3 publications

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“…Колебания иммуно-логических параметров в динамике хроническо-го воспаления отражают степень адекватности реакций иммунной системы на патологический процесс, в связи с чем они имеют большое диа-гностическое и прогностическое значение. [7]. Другая группа авторов указывает на уменьшение уровня абсолютно-го количества Т-хелперов (CD4 + ) и цитотокси-ческих Т-лимфоцитов (CD8 + клеток).…”

Section: клеточный иммунитет при прс Cellular Immunity In Chronic Rhiunclassified

“…В работах ряда авторов отмечалось снижение этой популяции Т-лимфоцитов [7,16]. В другой статье 2016 года не найдено различий уровня Treg между пациентами с ПРС и здоровыми людьми, но отмечено увеличение этих клеток в ткани по-липов [14].…”

Section: клеточный иммунитет при прс Cellular Immunity In Chronic Rhiunclassified

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Characteristics of Cellular Immune Status in the Patients With Chronic Rhinosinusitis With Nasal Polyps

et al. 2017

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Резюме. Хронический полипозный риносинусит (ПРС) -гетерогенное воспалительное заболева-ние полости носа и околоносовых пазух, характеризующееся воспалительной инфильтрацией слизи-стой оболочки с дальнейшим повреждением коллагенового каркаса, что приводит к ремоделированию слизистой и образованию полипов. Механизмы его развития до сих пор остаются невыясненными. Для исследования направления патогенетических механизмов проведен анализ показателей клеточ-ного иммунитета у 20 пациентов с ПРС. Наличие двустороннего полипозного риносинусита было подтверждено эндоскопическим исследованием полости носа и данными компьютерной томографии околоносовых пазух. Для определения фенотипа заболевания было проведено аллергологическое обследование и анкетирование пациентов, на основании которых пациенты с ПРС были разделены на подгруппы: ПРС + бронхиальная астма; ПРС + непереносимость НПВП; ПРС + атопия. В каче-стве показателей контрольной группы были использованы результаты 356 практически здоровых лиц. Методом проточной цитометрии в периферической крови определены CD3 +

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Section: клеточный иммунитет при прс Cellular Immunity In Chronic Rhiunclassified

Characteristics of Cellular Immune Status in the Patients With Chronic Rhinosinusitis With Nasal Polyps

et al. 2017

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“…В соответствии с текущими рекомендациями, для лечения ПРС хорошую доказательную базу имеют только интраназальные кортикостероиды (иГКС), короткие курсы системных глюкокортикостероидов и ирригационная терапия [13]. Контроль проводимой терапии при ПРС измеряется степенью выраженности клинических проявлений, что отражает субъективную характеристику пациентами своего уровня качества жизни, и степенью распространенности полипозного процесса при эндоскопическом осмотре полости носа, который позволяет объективно оценить динамику патологического процесса на фоне медикаментозной терапии [4] [8,14]. Комбинация хирургического вмешательства и фармакотерапии также не всегда в состоянии контролировать прогрессирование заболевания и его симптомы в связи с тем, что ПРС представляет собой целый комплекс патологических процессов, объединенных единым симптомом -наличием полипов в полости носа и ОНП, поэтому единый подход к консервативному и оперативному лечению этого заболевания невозможен [15].…”

Section: Introductionunclassified

“…Тем не менее ПРС является хроническим персистирующим воспалительным заболеванием, что не может не отражаться на состоянии всего организма, в том числе на состоянии системного иммунитета [2]. Также следует иметь в виду, что применение топических кортикостероидов на слизистую носовой полости может изменять параметры иммунной системы крови [8]. Проведя собственные исследования показателей работы системного клеточного иммунитета методом проточной цитометрии, мы выявили увеличение абсолютного и относительного количества NK (CD3 -CD16 + CD56 + ) одновременно с резким повышением числа активированных NK (CD8 + CD3 -) и NKT-клеток (CD16 + CD56 + CD3 + ).…”

Section: Introductionunclassified

Characteristics of Cellular Compartment Changes of Immune System in the Patients With Chronic Polypous Rhinosinusitis Depend on Efficiency of Drug Therapy

2019

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Despite numerous attempts to control the course of chronic rhinosinusitis with nasal polyps (CRSwNP) by means of pharmacological treatment and new surgical approaches, the majority of patients experience lifelong persistence of this disorder, at recurrence rates of 50-60% within 18 months after surgical treatment. Since CRSwNP is a chronic persistent inflammatory process, it affects the entire body condition, including the state of systemic immune response. An elevation of NK (CD3-CD16+CD56+), activated NK (CD8+CD3-), NKT cells (CD16+CD56+CD3+), Treg (CD4+CD25brightCD127low to neg) cells and activated T-lymphocytes (CD3+CD25+) was revealed elsewhere among all the patients with CRSwNP, using a flow ytometry method. There was no difference between various disease phenotypes. We analyzed the status of cellular component of systemic immunity, dependent on clinical course of the disease and efficiency of the administered therapy of CRSwNP. The patients were divided into three subgroups. The follow-up period was 1 year. The first group comprised the patients who showed positive dynamics after conservative therapy, resulting into regression of nasal polyps and their grade than a year ago. The second group included the patients in whom the size of polyps remained the same. The third group included the patients with higher incidence of nasal polyps than a year ago.We have shown a decrease of Treg, NKT cells, NK and activated NK, cytotoxic T-lymphocytes (CD3+CD8+), activated T-cell numbers in clinical group 3 with aggressive growth of polyps and low effect of standard therapy, which may cause deterioration of the immune system cellular populations, accompanied by presence of persistent productive inflammatory process of nasal cavity and paranasal sinuses. In the second group, a significant elevation of total lymphocyte number, total and activated T cells, T helpers (CD3+CD4+), cytotoxic T lymphocytes, NK and NKT cells was shown. Meanwhile, a decrease in absolute number of activated NK was observed despite the NK growth. Therefore, we can assume that the mechanism of their activation was disturbed and compensated by production of NKT cells and cytotoxic T lymphocytes. Moreover, we have shown in this group that the absolute number of Treg cells is increased; and these cells had a suppressive influence on effector cells of adaptive immune response, thus inducing incomplete elimination of infectious agents, which contribute to permanent incomplete course of inflammatory process. Chronic inflammatory process in CRSwNP affects systemic cellular immunity depending on the morbidity characteristics in the course of pathological process. The maximal intensity of systemic cellular immunity is observed in the group of patients that require permanent basic drug therapy. In case of aggressive CRSwNP and failure of standard drug therapy, we observed a decrease in absolute numbers of effector cells, along with decreased Treg lymphocyte numbers which may explain inefficient immune regulation of inflammatory process and medical interventions in this group of patients.

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Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

Savlevich,

Lyubimova,

Zurochka

et al. 2023

Med. immunol.

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The issues of recurrencies in chronic rhinosinusitis with nasal polyps (CRSwNP) still remain unresolved. Therefore, detection patients with uncontrolled clinical course of CRSwNP is required.The aim of the present study was to assess cytokine profile in nasal polyps as well as clinical characteristics of patients with CRSwNP at varying levels of therapeutic control.The study included 99 patients with chronic rhinosinusitis. The contents of interferon IFNγ, interleukin IL- 1β, IL-4, IL-5, IL-13, tumor necrosis factor TNFα, transforming growth factors TGF-β1, TGF-β2, TGF-β3 were measured in polyp tissue samples by means of multiplex analysis. The patients were treated according to a stepwise СRSwNP therapeutic algorithm [9]. Following observation for 5 years, all patients were divided into groups, as based on medical control degree. Group 1 included patients with mild CRSwNP, who mainly received stage I and II treatment for the entire observation period. Group 2 was presented by moderate- severity CRSwNP, with stage II or III therapy according to the referred algorithm. Group 3 included the patients with severe CRSwNP who received one or more stage IV courses. The patients underwent repeated SNOT-22 questionnaire, endoscopic examination, clinical assessment. In case of bronchial asthma (BA), ACQ-7 was repeated. Initial cytokine profile of nasal polyps was analyzed by the mentioned clinical groups.Results:After 5 years of observations in group 1 (mild CRSwNP), we found a minimal decrease in quality of life (SNOT-22), severity of nasal congestion, or smell impairment. Bronchial asthma duration in these patients was significantly lower compared to group 3, the patients had better asthma control level. Cytokine profile of nasal polyps was characterized by the highest IL-4 concentration, average values IL-1β, TNFα, IFNγ and minimal TGF-β1 values.In group 2 (moderate CRSwNP), we noted more pronouced impairment of smell, nasal congestion and quality of life. Bronchial asthma was less controlled than in group 1. The maximal concentrations of IFNγ, IL-1β, TNFα, IL-5, TGF-β1, TGF-β2 were registered.In group 3 with poor CRSwNP control, the highest SNOT-22 scores, severity of difficulty in nasal breathing, impaired sense of smell were revealed. Duration of bronchial asthma was longer, with lowest levels of medical control. In nasal polyps, minimal levels of IFNγ, IL-1β, TNFα, IL-4, IL-5, TGF-β2, TGF-β3 were noted.Treatment of patients depending on the clinical phenotypes of CRSwNP in the presence/absence of allergic rhinitis or bronchial asthma may improve control and reduce incidence of relapses in CRSwNP.

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Quantititative Changes of T-Regulatory Cells in Patients With Polipous Rhinosinusitis Treated by Nasal Glucocorticosteroids

Cited by 3 publications

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Characteristics of Cellular Immune Status in the Patients With Chronic Rhinosinusitis With Nasal Polyps

Characteristics of Cellular Immune Status in the Patients With Chronic Rhinosinusitis With Nasal Polyps

Characteristics of Cellular Compartment Changes of Immune System in the Patients With Chronic Polypous Rhinosinusitis Depend on Efficiency of Drug Therapy

Cytokine profile of nasal polyps and clinical characteristics of patients with polypous rhinosinisitis at different degree of therapeutic control and disease severity

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