ANTIGENPRESENTING SUBSETS OF NEUTROPHILIC GRANULOCYTES AS A DIAGNOSTIC MARKER OF THE DYNAMICS OF CLINICAL EFFECTIVENESS OF IMMUNOMODULATORY THERAPY WITH SYNTHETIC THYMIC HEXAPEPTIDE IN CHILDREN WITH ACUTE HEMATOGENOUS OSTEOMYELITIS

The multifunctionality of neutrophilic granulocytes (NG) is associated with the presence of various subsets and phenotypes. Previously, in children with severe purulent inflammatory diseases, a correlation was found between the severity of disease and the number of CD66b⁺CD16⁺CD33⁺HLA-DR⁺NG (APC-NG) subset. Thus, the determination of the APC-NG subset can serve as a valuable diagnostic tool and an indicator of the effectiveness of complex therapy in severe purulent-inflammatory diseases.

Goal: to assess the dynamic changes in APC-NG level in children with AHO in comparison with the dynamics of indicators of clinical effectiveness during immunomodulatory therapy with a synthetic thymic hexapeptide (HP).

Materials and methods. The study group (SG) included children aged 10-15 years with AHO (n=15), the comparison group (CG) consisted of 13 conditionally healthy children. In the peripheral blood (PB) of children, the content of NG expressing CD66b, CD16, CD33, HLA-DR (FC500, Beckman Coulter) and the expression density of these molecules was evaluated. The PB was collected before surgery, on the 10th day of therapy, and before discharge. The immunological parameters of children with CG were studied once.

Results: It was found that the amount of APC-NG, which was increased by 18 times in SG before treatment, decreased by 1,9 times on the 10th day after the beginning of treatment and by 3,8 times by the time of discharge (20-25th day). However, the content of APC-NG after treatment did not reach the CG indicators. In addition, a decrease in the number of APC-NG correlated with positive clinical dynamics: there was an earlier regression of general and local symptoms. A delay in the positive changes of APC-NG was observed in the absence of clinical effectiveness, which required a revision of therapeutic tactics and the need to change antibacterial therapy.

Conclusion: The study demonstrated the high clinical efficacy of HP in the complex treatment of children with AHO and the possibility of using the content of the APC-NG subset as a diagnostic marker for monitoring efficacy of postoperative treatment of children with AHO. This marker can also serve as a tool that allows for timely adjustment of the treatment of patients with AHO.

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