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Section 6. Medical science
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Temirova Saodat Yorovna, Senior scientific assistant, applicant of SRI of Epidemiology, microbiology and infectious diseases of the MHC of the RUz.
E-mail: [email protected]
The values of cell-mediated immunity and antigen-conjugating lymphocytes in patients with Herpes viral injure of organ of vision
Abstract: The achieved results of the immunologic study of 54 patients with Herpes viral injure of eyes, among which there were 25 (46.3%) patients with primary apply because of pathology of organ of vision and 29 (53.7%) patients with chronic progressing of the disease, show the presence of deep secondary immune deficiency state with expressed misbalance of immune regulatory sub populations of lymphocytes and deep destructive alterations in the tissues of eyes. And that was indicated by high values of antigen-conjugating lymphocytes to tissue antigens of cornea, vascular membrane, crystalline lens and corpus vitreous.
Keywords: herpetic injuries of eyes, immunologic status.
Topicality. For health care system ophthalmic Herpes presents a serious problem not only because of its prevalence, but also as a result of severe complications. Clinical manifestations of eye Herpes are not studied well yet. In relation to this in many cases, on the basis of only clinical data without laboratory confirmation, that diagnosis can be stated just approximately [2; 5].
The necessity of herpetic infection diagnostics appears if there is no dermal or mucous syndromes. At the present time according to international standards three levels of diagnostics are used: I — definition G class antibodies, and if it is a new-born baby — immunoglobulin M (total) in umbilical blood in case of suspicion ofvertical transmission; II — definition of specific antibodies class M and cytologic test of the scrape; III — chain polymerase reaction method for definition of DNA of viruses in various bio substrates (blood, tear, cerebral-spinal liquor, amniotic water, bioptates) [4].
Like in other chronic diseases with persistence of virus, in cases of herpetic infection there is development of immune deficiency states conditioned by failure of various parts of immune system and its inability to eliminate the virus from an organism. Though virus neutralizing antibodies preserved for the whole life, sometimes in quite high titers, interfere the spread of infection, but do not prevent appearance of relapses [1]. With the progressing of immune suppression activation of the virus becomes more often.
According to literature and our own patients' follow up data herpetic injures of eyes differ by severe stable recurrent progress, often causing significant impairments of optic functions, reflection of which are immunologic disorders, for the restoration of which we need long-lasting and complex courses of therapy [3].
The objective of the study was definition of the character of organism's immune reaction dynamics and expression of pathologic alterations in the tissues of eye in ophthalmic Herpes.
Materials and methods. Immunologic studies were held in 54 patients with herpetic injures of eyes. 25 (46.3%) patients out of
the total number applied to a doctor with pathologies of organ ofvi-sion for the first time, the rest 29 (53.7%) patients had chronic progressing of the disease. 21 (72.4%) out of 29 patients with chronic progression of the disease had exacerbation of the disease 2-5 times within a year, and the rest 8 (27.6%) patients had 6-8 times of ophthalmic diseases exacerbations for the same period.
Assessment of immunologic status was performed in compliance with the recommendations of R. M. Khaitov (1996) and 1 level tests for T-cellular immunity according to the following values: amount of circulating T-lymphocytes and its main immune regulatory subpopulations of T-helpers and T-cytotoxic cells. phenotyp-ing of lymphocytes in peripheral blood was performed by means of indirect rosette-formation in compliance with the method of F. U. Garib et al. (1995). In the work we used commercial conjugates of MCAT produced by SRI of Immunology of the MHC of Russia (Moscow, "Sorbent" Ltd.): CD3, CD4, CD8 and CD20 (common pull of T-lymphocytes, T-helpers/inductors, T-cytotoxic cells and B-lymphocytes, respectively). We also calculated immune regulatory index (IRI) of CD4/CD8 correlation. Blood lymphocytes served to be material for the research.
Besides that, for the definition of the depth of eye injure we performed the study of antigen-conjugating lymphocytes specially sensitized for tissue antigens of cornea, crystalline lens, corpus vitreous and vascular membrane of the eye in the same patients.
Results and discussion. Comparative analysis of the cellmediated immunity dynamics in the patients with primary and recurrent ophthalmic Herpes showed the absence of significant differences between the values in these groups, correspondingly staying very reliably low in comparison with the control values. so, the patients with primary apply had 1.2 fold decrease of the total pull of T-lymphocytes (CD3+ lymphocytes), B -lymphocytes (CD20+ lymphocytes) and 1,4 fold decrease of IRI (immune
Application of the new diagnostic complex of biomarkers in patients with Alzheimer's disease and vascular dementia
regulatory index CD4+/CD8+) by means of expressed decrease of helper line of immunity, testifying suppressor character of immune response. Identical picture was observed in the patients with chronic herpetic injure of eyes. So there was 1.2 fold decrease of CD3+ lymphocytes, 1.1 fold CD20+ lymphocytes, and 1.3 fold decrease ofIRI (CD4+/CD8+). As a result ofthe performed therapy patients with primary episode of the disease with ophthalmic Herpes had some positive dynamics (1.03 fold rise of CD3+ and CD20+- lymphocytes, 1.2 fold increase of IRI level by means of significant increase of helper subpopulation of T-lymphocytes, while in cases of relapse of chronic disease we observed its absence (CD4+ lymphocytes — 19.37±0.37 before and 19.37±0.31 after the therapy) or even negative dynamics of some values of cell-mediated immunity (CD8+- lymphocytes -18.44±0.49% before and 17.89±0.34% after the therapy). In relation to that there is notable reliable increase of immune regulatory index in the primary episode (0.98±0.04 before and 1.13±0.03 after the therapy) and absence of IRI dynamics in relapse cases (1.07±0.03 before and after the therapy — 1.09±0.03).
Analysis of the obtained data showed the highest values of ACL to TAG of cornea and vascular membrane both in the primary episode and relapse of chronic ophthalmic Herpes (7.00±0.50%; 7.44±0.35%; 6.03±0.35% and 7.48±0.41%, respec-
tively), reliably different from the normal values. Less expressed pathologic disorders were also observed in crystalline lens and corpus vitreous of eyes both in primary episode (3.76±0.18% and 3.28±0.21%, respectively), and recurrent ophthalmic Herpes (3.48±0.20% and 3.83±0.22%, respectively). Values change ratio in relation to the values before the therapy showed that more expressed dynamics of recovery of pathologic impairments was noted in the primary episode (1.4 fold to ACL to TAG of cornea, 1.3 ACL to TAG of crystalline lens and vascular membrane) in comparison with the relapse (1.2 fold to ACL to TAG of cornea and vascular membrane, 1.1 fold ACL to TAG of crystalline lens).
Conclusion. Thus, the obtained results show the presence of deep secondary immune deficiency status with expressed misbal-ance of immune regulatory subpopulations of lymphocytes (CD4+ and CD8+- lymphocytes), with expressed decrease of IRI indicating suppressive character of immune reaction of an organism and deep destructive alterations in the tissues of eyes, confirmed by high values of ACL to TAG of cornea, vascular membrane, crystalline lens and corpus vitreous. After the performed common pathogenetic therapeutic measures the more expressed dynamics of the recovery of pathologic impairments was noted in the primary episode of ophthalmic Herpes, then in chronic recurrent forms of the disease.
References:
1. Dolgikh T. I. Immunologic characteristics of first time herpetic infection./Dolgikh T. I., Yershov A. V., Minakova Y. U., Zapariy N. S.//Infectious diseases, 2010; 8 (1): 25-28.
2. Isakov V. A. Herpes viral infection./Isakov V. A., Romantsev M. T., Ribalkin S. B.//Recommendations for doctors. — St.Petersburg, 2006; 95.
3. Kuskova T. K. Family of herpes viral at the modern stage./Kuskova T. K. Belova Y. G.//MSMSU, Moscow, GP. 2004; 5: 48-58.
4. Makarova T. Y. Herpetic infection. Clinic, diagnostics, therapy/Khabarovsk, 2007; 112.
5. Khodjayeva A. S. Herpes-viral infections, variants of clinical manifestations, diagnostics and therapy//Med. Jour. Uzbekistan. 2010; 1: 50-54.
Tolibov Dilshod Sirojovich, Tashkent Medical Academy, postgraduate student, assistant of Department of Neurology E-mail: [email protected] Rakhimbaeva Gulnora Sattarovna, Tashkent Medical Academy, PhD, doctor of medical science, head of Department of Neurology E-mail: [email protected]
Application of the new diagnostic complex of biomarkers in patients with Alzheimer's disease and vascular dementia
Abstract: The article presents data on new methods of diagnostics ofAlzheimer's disease in a comparative perspective with using the ischemic scale of Khachinsky. In this regard, we studied 147 patients, who were divided into 3 groups. In the research we found that the use of our diagnostic method increases the diagnostic value of using ischemic scale of Hachinski.
Keywords: Alzheimer's disease, scale of Khachinsky, beta-amyloid protein, apolipoprotein E4, dehydroepianderosteron sulfate.
Alzheimer's disease is a progressive neurodegenerative lesion with individual characteristics of the course and severity of symptoms, as well as multiple converging etiopathogenetic mechanisms. The etiology of this lesion is not fully understood. Some researchers suggest that the convergence of such risk factors as advanced age, presence of epsilon 4 genotype lipoprotein E, obesity, insulin resistance, vascular factors, dyslipidemia, hypertension and inflam-
matory markers [1, 475-481] launches pathophysiologic cascade which lead to pathology of Alzheimer's type and developing of dementia [2, 1364-1370]. Modern understanding of Alzheimer's disease is based on the gradual biological changes that occur, apparently, decades before the first symptoms. Today, great importance is given to potential biomarkers that can detect biological changes [3, 49-70]. Nowadays there is no biomarker which for self-use in clinic
