IMMUNE PARAMETERS AND NASAL MICROFLORA IN PATIENTS WITH POLYPOID RHINOSINUSITIS AND ASTHMATIC TRIAD

The article provides a comparative study of immunological parameters and microbiocenosis nasal mucosa in patients with the asthmatic triad (AT) and polypous rhinosinusitis (PRS). Performance evaluation of immunity carried out by flow cytometry and enzyme immunoassay. The study of the microflora of the nasal mucosa was performed by microbiological methods. Analysis of the immune status in the PRS showed an increase of B-lymphocytes, which may indicate the activation of humoral immunity, while reducing the total number of lymphocytes and T-helpers. Also in the group of PRS revealed increased concentration of IgE and decreased sIgA signals the oppression of mucosal immunity. In the group of the PRS found an increase of the total number of white blood cells and cytotoxic cells, and wherein the concentration of circulating immune complexes (CIC) reduced levels of natural killer cells and B-cells. Thus, the asthmatic triad increased levels of T-lymphocytes due to the high content of cytotoxic cells against decrease in NK-cells. In the AT group have low levels of B-lymphocytes, and as a consequence - reducing the concentration of immunoglobulin IgG4 and sIgA. Thus, the immune status with polypous rhinosinusitis is characterized by the activation of B-lymphocytes with a decrease in T-cell immunity, thus to form a deployed asthmatic triad immunogenesis change occurs with the activation of T-lymphocytes, and reduction in humoral immunity. The study of cytokine profile in PRS and AT showed mixed imbalance of cytokine concentration: increasing the concentration of pro-inflammatory (IFNγ, TNFα), anti-inflammatory (IL-4) and a decrease in the concentration of pro-inflammatory (IL-6) cytokines in asthmatic triad compared with a group of polypous rhinosinusitis. Activation, proliferation and differentiation of B-lymphocytes is under the control of IL-2, IL-6 and IL-4, while IL-10 and IFNγ opposite suppress immunoglobulin synthesis. In the study of the microbial landscape of the nasal mucosa showed an increase of the total number of microorganisms and bacteria of the genus Staphylococcus, Streptococcus and Enterobacteriaceae in the both group. In the group of the PRS was found to increase the total amount of bacteria and microorganisms of the genus Staphylococcus, Streptococcus relative to control. Thus, the group revealed AT and PRS increase the total number of conditionally pathogenic microbial flora in the background to reduce the systemic and local immunity.

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