CYTOMETRIC FEATURES OF THE CELLULAR COMPARTMENT OF THE IMMUNE SYSTEM OF PARTICIPANTS IN MODERN MILITARY CONFLICTS

Abstract

Staying in a combat zone is associated with a high risk of developing mental disorders. A significant amount of knowledge has been accumulated about the mechanisms of immune-mediated reactions in the development of neuropsychiatric pathology, in particular post-traumatic stress disorder (PTSD). Activated T-regulatory cells play an important role in the development of neuroinflammation under stress.

Purpose of the study: to study the indicators of the blood system, cytometric features of the cellular compartment of the immune system in participants in modern military conflicts with the presence of adaptation disorders associated with stress.

Materials and methods. We examined 97 veterans - participants in modern military conflicts, males from 35 to 55 years old, of which 35 were veterans of a special military operation in Ukraine (SVO) - the main group, 42 veterans of the second Chechen military campaign (comparison group), 20 people - healthy military personnel (control group. All patients underwent pathopsychological examination in accordance with clinical recommendations. 12% of Northern Military District veterans were diagnosed with PTSD, 77% had various types of neurotic, stress-related and somatoform disorders. In the comparison group, 2% of combatants were diagnosed with chronic personality change. A complete blood count was performed using a standardized method on a hematology analyzer. Immunophenotyping of lymphocytes using a Navios flow cytometer (Beckman Coulter, USA).

Results and discussion. In the group of SVO veterans, a decrease in the degree of dispersion of erythrocytes in volume, an indicator of heterogeneity and the average volume of platelets, lymphopenia, and monocytosis was noted, which reflects the multidirectional effect of hematopoietic cell regulators on individual lines of differentiation of mononuclear cells. Cytometric analysis of the composition of lymphocytes showed a decrease in T-helper cells and mature NK cells in the group of SVO veterans, which explains the presence of lymphopenia and may indicate a deficiency of the adaptive and innate compartments of immune defense in conditions of a prolonged response to stress. An increase in the number of TNK and T-regulatory lymphocytes, which prevent the transition of the immune response to an autoimmune reaction, has been established. Under stress, the transcription factor Foxp3 is involved in the upregulation of the glucocorticoid-induced TNF receptor in the T-regulatory cell line, potentiating the proliferative activity of the latter. A decrease in the number of T-helpers and T-regulatory cells with markers of early and late positive activation has been shown, limiting the development of both autoimmune reactions and the development of stress-induced neuroinflammation. There were practically no differences between the control group and the indicators of the comparison group, which indicates that the severity of stress-induced neuroimmune reactions leveled out over time.

Conclusion. Hematopoiesis induced by stress mediators and changes in the quantitative spectrum of lymphocyte subpopulations mediated by neuroimmune influences are a consequence of a complex multi-level neuropsychodynamic process of the central nervous system associated with clinical forms of adaptation disorders.

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