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Medical Immunology (Russia)

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Vol 21, No 1 (2019)
View or download the full issue PDF (Russian)
https://doi.org/10.15789/1563-0625-2019-1

EDITORIAL

REVIEWS

9-20 8735
Abstract

Thrombocytes keep a leading role in conjugating thrombosis, inflammation and congenital immune responses. The platelets provide stable adhesion and interaction with immune cells. Activated platelets express CD40L (CD154), a membrane glycoprotein of tumor necrosis factor (TNF) family. Hence, the platelets are the main source of sCD40L in blood plasma. Platelet CD154 may interact with CD40 receptor on endothelial cells, causing an inflammatory response, and enhancing production of immunoglobulins by B-lymphocytes. Membrane and soluble CD154 of platelets combined with other signals can induce maturation and activation of dendritic cells (DC). The platelets possess functional receptors, e.g., TLR2, TLR4, TLR7 and TLR9 they also bear Fc-receptors, including FcγRIIA, FcεRI and FcαRIA. FcγRIIA on platelets mediate protection against bacteria. Cross-linking of FcαRI on platelets results in production of prothrombotic and pro-inflammatory mediators such as tissue factor and IL-1β. Activation of platelets via FcεR1 causes release of chemokine RANTES and serotonin, which contribute to the pro-inflammatory response of other immune cells. Platelets possess receptors for activated complement components and its fragments (CR2, CR3, CR4, C1q, C1 inhibitor and factors D and H). Activated platelets trigger the complement system through the release of protein kinases and ATP, and also by phosphorylation of C3 and C3b. α-granules of platelets contain chemokines which represent the most numerous group of antimicrobial proteins of platelets (kinocidins), and there is an antimicrobial protein of the defensin family – hBD-1 in the cytoplasm of platelets. Ligand and receptor of the TNF superfamily (TRAIL and LIGHT), the SDF-1 chemokine (CXCL12), the IL-1βinterleukins, IL-8 and the soluble IL-6 receptor (sRIL-6) are recognized as platelet products belonging to the family of cytokines and their receptors. The HMGB-1 protein classified as an inflammatory cytokine, is expressed by activated platelets and causes formation of the extracellular traps by neutrophils. Platelets produce numerous growth factors, including EGF-α and EGF-β1, EGF-β2, TGF-α and TGF-β1, TGF-β2, PDGF, HGF, FGF-β, IGF, pro- and antiangiogenic factors, e.g., VEGF-F and angiopoietins Ang-1 and Ang-2. Fulfillment of immune functions by the platelets is carried out by their interaction with leukocytes, which are attracted to the site of infection and inflammation and retained during the development of an “immune thrombus” under conditions of high shear stress. Platelets can not only maintain and guide the immune response, but also initiate these events. They are able to present the antigen in the context of MHC class I molecules, and activate naїve CD8+ T lymphocytes. Potential consequences of platelet interaction with neutrophils, monocytes, dendritic cells and lymphocytes are discussed in the review article.

21-38 1841
Abstract

All lymphoid cells are referred to as an innate or adaptive immunity unit in terms of the mechanisms of performing immune reactions. The functional activity of natural killer (NK) cells is not associated with pre-activation processes resulting from contact with antigen, rearrangement of antigen-recognition receptor genes, and clonal proliferation. In this regard, NK cells are traditionally referred to as cells of innate immunity. Previously, it was believed that NK cells represent the only population of innate immunity lymphoid cells, but, more recently, there has been increasing evidence in the literature concerning existence of different populations of these cells, thus serving a basis for isolating a common cluster called Innate Lymphoid Cells (ILC). According to the ILC classification, NK cells are classified as the first group of innate lymphoid cells according to their overall functional characteristics, as well as contribution of the T-bet transcription factor to their differentiation. Complexity, multistage and partially nonlinear character of NK cell differentiation are associated with influence of the cellular microenvironment, consistent expression of transcription factors and activation of various intracellular signaling pathways in NK cells. The review considers positioning of NK cells in the ILC classification, the main transcription factors involved in NK cell differentiation. The authors are seeking for generalization of the major routes of intracellular signal transmission in NK cells depending on their activation by cytokines located in the cellular microenvironment and affecting NK cells. The decidual NK cells during pregnancy represent a special object of NK cell differentiation. Stromal cells, trophoblast cells and macrophages are present in the decidua, in addition to NK cells. The review concerns a special case of microenvironmental effects upon expression of transcription factors and activation of NK intracellular messengers, while considering trophoblast cells an example of such influences. The recently discovered variety of NK cells, induced by the microenvironment in the course of their differentiation, requires further study.

39-48 4195
Abstract

In this review we analyze literature data concerning participation of synovial inflammation, subchondral bone, humoral and cellular immune responses towards various cartilage autoantigens in the initiation and progression of primary osteoarthritis (OA). The vast majority of studies showed that the synovial inaflammation in OA is less pronounced than in RA but is more pronounced than in healthy people. In OA synovial tissue, macrophages and T-cells predominate in the inflammatory infiltrate. Some authors detected mast cells in the OA synovium in quantities higher than in healthy control and significantly higher than in RA patients. Most of researchers found many cytokines related to innate and adaptive immune cells in the OA synovial tissue, while in some studies the cells producing those cytokines were not identified. Among the cytokines there were both pro-inflammatory and anti-inflammatory ones: IL-1b, TNFα, IFNγ, IL-4, IL-2, IL-6, IL-8, IL-10, IL-17, IL-18. In addition, some authors detected IL-5, IL-13, IL-19, IL-21, IL-26, IL-32, and TGFb. A role of adaptive immune response in OA is supported by the presence of autoantibodies against antigen determinants of collagens type II, IX, XI, aggrecan, fibronectin fragments, in the synovial tissue, synovium fluid, and peripheral blood serum. The research data clearly support a role of chronic inflammation and changes in innate and adaptive immune response in the pathogenesis of OA thus justifying the change of the disease name from “osteoarthrosis” to “osteoarthritis”. This novel understanding of OA pathogenesis is paramount as it provides a rationale for modern anti-inflammatory treatments and discovery of new therapeutic targets. We discuss the results of studies evaluating efficacy and safety of some types of anti-inflammatory treatment of OA. Until now, treatment of OA directed on inflammation control was not successful. Thus, clinical trials of anti-TNFα anti-IL-1b strategies for the treatment of OA did not show clinically significant improvement in spite of multiple studies demonstrating elevated concentrations of TNFα and IL-1bin synovial fluid and subchondral bone in OA thus suggesting the role of these cytokines in the OA pathogenesis. On the other side, treatment with IL-1 inhibitor diacerein was found to be effective which can be explained by pleiotropic effects of this drug. It should be stressed out that in order to increase the efficacy of anti-inflammatory treatments of OA they should be initiated at early disease stages, thus necessitating the use of new informative biormarkers of early OA.

ORIGINAL ARTICLES

49-58 1256
Abstract

The role of pregnancy-specific β1-glycoprotein (PSG) in the regulation of molecular genetic factors determining the functional activity of naїve T cells and T cells of immune memory in vitro was studied. Human PSG was isolated with a proprietary immuno-purification method using a biospecific sorbent followed by removing of immunoglobulin contamination with a HiTrapTM Protein G HP column. Physiological concentrations of PSG were used in the experiments. They corresponded to PSG levels in the peripheral blood of pregnant woman: 1, 10 and 100 μg/ml (I, II, III trimester, respectively). The objects of study were monocultures of naїve T cells (CD45RA+) and memory T cells (CD45R0+), obtained by immunomagnetic separation from the peripheral blood of women of reproductive age.

It was established that at the level of naїve T cells (CD45RA+) PSG inhibited the expression of CD28 (1, 10, 100 μg/ml) and CD25 (100 μg/ml), without affecting the interleukin-2 (IL-2) production by these cells. At the same time, PSG in all concentrations studied suppressed the expression of CD25 at the immune memory T-cell (CD45R0+) surface but increased the IL-2 production. Expression of U2af1l4, Gfi1, hnRNPLL genes regulating the alternative splicing of the Ptprc gene encoding CD45 was also evaluated. It was found, that PSG reduced the expression of the Gfi1 (1, 10, 100 μg/ml), hnRNPLL (10, 100 μg/ml) genes, but increased the expression of the U2af1l4 gene (1, 10, 100 μg/ml) in the naїve T cells. It was shown that at the immune memory T-cells’ level the effects were similar, with PSG rendering them in all concentrations used. The revealed changes in the mRNA transcription of U2af1l4, Gfi1 and hnRNPLL genes in the studied T cell subsets may lead to the inhibition of CD45 “mature” isoform formation – CD45R0.

Thus, PSG reduces the functional activity of naїve T cells and immune memory T cells associated with the expression of costimulation/activation molecules CD25 and CD28 and is involved in the regulation of Ptprc gene alternative splicing, which determines the ratio of CD45 molecule variants. Apparently, using these mechanisms, PSG regulates the functional activity of the memory T cell circulating pool, which is potentially capable of carrying out antigen-specific cytotoxic reactions against fetal antigens in vivo. In general, the data obtained broadens the notion of the PSG role in the regulation of molecular-genetic mechanisms of naїve T cells and immune memory T cells differentiation.

59-68 3995
Abstract

Inhibitory receptors CTLA-4 and PD-1 (immune checkpoints) play a key role in regulation of immune reactions. They suppress excessive immune response against pathogenic microbes and prevent autoimmune reactions. The immune checkpoints are targets of the modern effective therapy based on human and humanized monoclonal antibodies (ipilimumab and nivolumab, tremelimumab, pembrolizumab, etc). However, despite its high efficiency compared to standard chemotherapy, the therapy based on blocking immune check points is facing several problems, i.e., high therapy cost and severe negative autoimmune-related side effects. Unfortunately, this therapy helps to minority of the patients. Hence, further studies are required to improve its efficiency and safety, as well as to search for selection criteria of the patients who would benefit from the therapy. An appealing approach to reduce negative side effects from immune checkpoint inhibition is application of the blocking antibodies, aiming for ex vivo generation of patients’ activated immune cells for cancer therapy, thus avoiding systemic drug administration. Our aim was to elucidate influence of immune checkpoint blocking antibodies on the expression of CTLA-4 and PD-1 in such an in vitro model. First of all, we have determined quantities of lymphocyte receptors in peripheral blood of healthy volunteers, or cancer patients with disseminated melanoma. Moreover, we defined effect from the addition of antibodies against immune checkpoints on proportions of cells expressing CTLA-4 and PD-1 in the population of phytohemagglutininactivated lymphocytes. Our study demonstrated that, in presence of antibodies to either of the two checkpoints during in vitro cell activation, the blockade of specific target receptor is accompanied by reduced number of cells positive for another checkpoint. Hence, the antibodies directed against PD-1 or CTLA-4 seem to suppress both negative signal cascades at once, if tested under such experimental conditions. Noteworthy, the response to blocking antibodies for different immune checkpoints varied for different donors. Our data may be used for development of effective combinations of lymphocyte activators and immune check-point inhibitors, for in vitro generation of activated lymphocytes applied for adoptive cancer therapy, as well as for prediction of possible responses to antibodies against CTLA-4 or PD-1, aiming to select the best personalized cancer immunotherapy.

69-76 3130
Abstract

Psoriatic arthritis is a chronic progressive systemic inflammatory disease of joints and spine, which leads to the development of erosive arthritis, bone resorbtion, multiple enthesitis and spondylitis. Severe clinical course, resistance to therapy, high prevalence of disability, increased mortality of patients determine a need for further study of the disease. Psoriatic arthritis is a multifactorial disease including immune pathogenic factors representing a complex process of interaction between cellular and humoral components of immune system. The most important way of activating epidermal cells and synovial membrane proliferation in psoriatic arthritis is an imbalance of proinflammatory and anti-inflammatory cytokines. It is noted that the features of clinical course in psoriasis are age-dependent. The study of immune response indices in different age groups allows to reveal distinct progression features of the psoriatic pathology.

The purpose of this study was to compare concentrations of proinflammatory and anti-inflammatory cytokines, cellular and humoral immunity, and to conduct a comparative analysis in young and adult patients with psoriatic arthritis.

The study included a group of patients with psoriatic arthritis (n = 101) who were divided by their age: group 1, from 18 to 44 years (n = 43); group 2, over 44 years (n = 58). The control groups (3 and 4) included virtually healthy people (n = 103) matched for sex and age with the patients. Populational and subpopulation profiling of blood lymphocytes was performed by flow-cytometry using monoclonal antibodies to CD3, CD4, CD8, CD16, CD19 (LLC “Sorbent”, Moscow, Russia). Phagocytic activity of peripheral blood neutrophils was assessed microscopically by uptake of latex particles. Concentrations of IgA, IgM, and IgG immunoglobulins, circulating immune complexes, cytokines (IL-4, IL-6, IL-10, TNFα) in blood serum was determined by enzyme-linked immunosorbent assay. Statistical evaluation of the results obtained was performed using applied “Statistica 6.0” software.

In all the age subgroups of patients with psoriatic arthritis, we have revealedstatistically significant differences against controls, i.e., increased relative and absolute number of CD3-CD16+ lymphocytes in peripheral blood, higher concentration of CIC-C1q, with decreased concentrations of IgA, IgM, IgG in blood serum. The analysis of the main cellular and humoral indicators of immunity in psoriatic arthritis patients revealed a statistically significant differences for psoriatic arthritis in young and adulthood. E.g., the serum concentration of IL- 10 was statistically significantly lower in psoriatic arthritis at a young age in comparison with adult psoriatic arthritis. Phagocytic number and IgG concentration in serum were statistically significantly lower in adults with psoriatic arthritis adulthood than in young patients.

In conclusion, The revealed changes in immunological indices in psoriatic arthritis in young and adult patients indicate to differences against healthy controls, as well as intergroup differences. Previous studies have not revealed statistically any significant differences in immunological parameters between young and adult patients with psoriatic arthritis in, thus suggesting a presence of immune disorders associated with psoriatic pathology, but not with the age of patients. However, changes of immunological reactivity are observed with increasing age of patients with psoriatic arthritis and development of severe clinical forms, and they can be considered as markers of psoriatic disease progression, such as increased concentrations of IL-10 and lower IgG amounts in blood serum, a decreased phagocytic number.

77-88 1716
Abstract

The aim of the study was to investigate a dependence of respiratory burst state in neutrophils on activities of their intracellular enzymes in patients with acute destructive pancreatitis (ADP) of different severity. The study included 50 patients with ADP of moderate (17 cases) and severe degree (33 cases). A group of 47 healthy people was examined as controls. The respiratory burst state was examined in neutrophilic granulocytes by means of chemiluminescence assays. A study of NAD(P)-dependent dehydrogenases activity in blood neutrophils was performed using bioluminescent analysis. We have revealed that a decrease in spontaneous and induced synthesis of superoxide radical by neutrophils was detected in ADP patients, independently of the disease severity. Kinetics of primary ROS synthesis was also impaired in patients with severe ADP. In patients with moderate disorder, the level of secondary ROS synthesis by neutrophils proved to be increased, whereas, in cases of severe disease, a disturbed kinetics of secondary ROS synthesis by neutrophils was detected at a resting state, showing increased synthetic level upon additional induction by zymosan. Metabolism of neutrophils in patients with ADP is characterized by activation of plastic processes (due to the products of the pentose phosphate cycle) and aerobic energy (increased substrate flow intensity in the cycle of tricarboxylic acids). However, NADPH neutrophilic pool in patients with moderate disorder could be additionally supported by enzymatic malic enzyme reactions and NADP-dependent glutamate dehydrogenase. Activation of peroxidation events in patients with severe ADP is revealed, which needs NADPH compensation. The state of energy processes in blood neutrophils in patients with ADP is characterized by lacking changes in glycolytic activity, and increased intensity of substrate flux along tricarboxylic acids cycle. Activity of aerobic processes in patients with moderate disease is maintained by the products of amino acid metabolism (via glutamate dehydrogenase), whereas, in severe ADP it may be provided by products of lipid catabolism. Using correlation analysis, a dependence of respiratory burst of neutrophils on the state of their metabolism was studied. We have found that intensity and kinetics of respiratory burst in the neutrophils of controls depends only on the activity of NADP-dependent dehydrogenases. The changes in cellular metabolic activity in the patients with moderate ADP led to disturbances of their regulatory effect upon the state of neutrophil respiratory burst. In patients with severe disorder, the degree a neutrophil respiratory burst is stimulated by reductive amination of α-ketoglutarate, being, however, inhibited by intracellular peroxidation processes.

89-98 2488
Abstract

Chronic obstructive pulmonary disease (COPD) is socially significant disease. COPD is based on chronic inflammatory process of respiratory tract, which determines steady progression of the bronchial obstruction. Studies of the role of cytokines in immune pathogenesis of COPD are of crucial importance. The biological mediators determine local, systemic inflammation, and pathophysiological effects of extra-systemic pathological manifestations. In this work, we studied spontaneous and induced production of IL-4, IL-6, IL-8, IL-10 cytokines by blood leukocytes from the patients with moderate and severe chronic obstructive pulmonary disease, beyond the exacerbation phase. It is shown that the evident role in formation of the inflammatory process in COPD belongs to the IL-6, IL-8. We have found a significant increase in both spontaneous and induced production of IL-6 and IL-8 (p < 0.05) in the patients. Induced production of cytokines strongly suggests the reserve capabilities of immunocompetent cells in response to the pathogenic factor. Neutrophilic type of inflammation, manifesting as activation of granulocytes, mostly, neutrophils, in response to toxic agents (in particular, smoking) and bacterial pathogens, is primarily associated with IL-6 and IL-8. These results reflect the type and intensity of respiratory tract inflammation in patients with chronic obstructive pulmonary disease and its persistent course.

High levels of the studied cytokines confirm their role in bronchial remodeling and contribute to irreversibility of bronchial obstruction in this disorder. The relationship between spontaneous and induced production of the studied cytokines and the clinical indices of the disease course has been shown. Statistically significant increase between frequency of COPD recurrences (more than 2 times pro year, p < 0.05), and low FEV1 values (p < 0.05) were observed in patients with high values of spontaneous and induced production of IL-6 and IL-8. It may be associated with persistent course of neutrophilic inflammation of respiratory tract and progressive bronchial obstruction. IL-6 and IL-8 significantly contribute to pathogenetic mechanisms, determining the clinical course of COPD and may serve as markers of severity in this disorder. Certainly, the immune mechanisms of pathological inflammation in COPD are complex and multifaceted. Studies of clinical significance of induced cytokine production will help the physician when determining type and duration of treatment. Personalized approach to the therapy of patients with COPD depends on the phenotype of pathology, pattern, severity and intensity of inflammation.

99-106 1102
Abstract

At the present time, the role of innate immunity in pathogenesis of bronchial asthma (BA) is actively studied, in particular, significance of TLRs and cytokines. The study included 42 patients with severe bronchial asthma (from 3 to 12 years old), and 67 healthy children at the same age. Expression of TLR2, TLR4, and TLR9 genes was evaluated by PCR-RT from the scrapings of nasal mucosa; cytokines (IL-33, TSLP, IL-4, TGF-β1 and IL-28B) were assayed in nasal swabs by ELISA technique. The main results were as follows: an increased gene expression of TLR2, TLR4, TLR9 genes was revealed in the nasal mucosa scraps from the patients with bronchial asthma as compared to healthy children. We have also measured the contents of important cytokines secreted by the respiratory epithelium in the course of TLRs activation. The study of IL-33, TSLP, IL-4 in nasal samples revealed significantly increased concentrations of these cytokines in the patients with severe BA against the control group. A study of TGF-βlevels in nasal cavity swabs revealed a significant decrease of this regulatory cytokine in the group of pediatric patients with asthma. Worth of note, evaluation of antiviral IL-28B cytokine in the group of patients with severe BA showed a significant downward trend, in comparison to the control indexes. Hence, one may conclude on some disturbances of local innate immunity system in the patients with severe BA which manifest as hyperexpression of TLRs genes, increased production of proinflammatory and epithelial cytokines, decreased production of antiviral IL-28B cytokine, and TGF-β1.

107-120 8391
Abstract

The work presents data on forty-one patients with chronic hepatitis C (HCV, genotype 1), at different liver fibrosis stages. The studies were performed in the course of interferon-containing treatment regimens, i.e., pegylated interferon combined with ribavirin and pegylated interferon; ribavirin together with NS3/4A inhibitor of HCV serine protease. Concentrations of cytokines/chemokines (TNFα, CCL2/MCP-1, CCL20/MIP-3α, CXCL9/MIG, CXCL10/IP-10, CXCL11/ITAC) were measured in blood plasma samples, using xMAP multiplex analysis. Flow cytometry studies were also performed in order to reveal cells with CCR6 and CXCR3 receptors in lymphocyte populations. The obtained results were analyzed using a statistical program package R. Results: 36 out of 41 patients achieved virological response, while 5 patients did not respond to the therapy. The responders were split into two groups, as follows: (1) liver fibrosis-free; (2) patients with fibrosis stages 1, 2 and 3. In the group of fibrosis-free patients, the decrease of CXCL11/ITAC concentration and the increase of TNFαwere observed, as well as increase of CTL CXCR3+ content by the 12th week of therapy and an increase of NK CXCR3+ by the end of treatment. In addition, this group exhibited a decrease in the CXCR3+ B lymphocyte contents at this timepoint. Concentrations of CCL2/MCP-1 during treatment were increased in the patients with different stages of liver fibrosis, as compared to baseline. By the end of therapy, an increase in the relative content of NK CXCR3+and TNK CCR6+ was also detected. The study confirmed a potential role of cytokines/chemokines TNFα, CCL2/MCP-1 and CXCL11/ITAC in activation of the cell-mediated immunity and elimination of the hepatitis C virus from the body. The results indicate that activation of T cellmediated immunity in both groups of the patients and reduction of B cells with CXCR3 receptor in the patients of first group is a positive prognostic factor showing efficiency of interferon therapy. Two of studied cytokines/ chemokines (TNFαand CCL20/MIP3α) differed in the groups of responders and non-responders at the start of therapy. Statistical evaluation of pre-treatment results has shown a tendency for differing concentration of TNFα, and CCL20/MIP3αamounts were significantly different for the patients of these groups. The plasma concentrations of CCL20/MIP3αin non-responders were > 4-fold higher than in responders to the therapy. Hence, the present study allowed us to propose the chemokine CCL20/MIP3α as a potential predictor of treatment outcomes in HCV infection.

121-128 1194
Abstract

We compared clinical efficacy and safety of simvastatin (40 mg daily) for 12 weeks (n = 33, group 1) vs fenofibrate (145 mg daily) for 12 weeks (n = 33, group 2) in patients with active RA taking stable doses of DMARDs. Changes in the Disease Activity Score (DAS28) with 28 joints count was the primary endpoint. Both simvastatin and fenofibrate treatment resulted in statistically significant decrease in DAS28 scores, the patients taking fenofibrate developed moderate EULAR and ACR20 responses 1.5 times more frequently than the patients taking simvastatin. There were no serious adverse events in either group. Clinical response was associated with pleiotropic effects, both in simvastatin- and fenofibrate-treated groups. Both drugs resulted in decrease of atherosclerosis immunological markers (CRP and IL-6 levels). At the end of treatment, we observed a decrease in serum IL-17 in patients taking simvastatin. No changes in serum IL-8, TNFα, and IFNγ were observed in both groups. The total cholesterol concentrations did not change, whereas simvastatin treatment resulted in decreased serum LDL cholesterol, while increasing serum HDL cholesterol levels. There was a decrease of triglyceride concentrations in patients taking fenofibrate. In conclusion, simvastatin and fenofibrate can be considered as drugs of choice in RA patients with high risk of atherosclerosis who do not respond to conventional DMARDs. There is a need for larger comparative studies, in order to define detailed guidelines for their use.

129-136 810
Abstract

The aim of this study was to assess optimizing effects of antistress neurotechnologies on the clinical course of acute pulmonary tuberculosis. The study was performed in three steps: upon admission before treatment, followed by repeated examination at 2 and 4 months. The patients before study were divided into the two groups: (1) 33 patients received standard antituberculosis drug therapy (SDT) and (2) 35 cases after standard antituberculosis drug therapy accompanied by neurothechnological anti-stress therapy (NAT). Patients from the NAT group received a regular audio-visual-vibrotactile stimulation as additional therapy (2 to 3 30-min sessions per week during 4 months). By the time of hospitalization, the groups did not differ in their general immune state. The percentages of CD3+ , CD4+ , CD8+ , CD16+ , CD19+ as well as indexes of phagocyte activity showed some changes after 2 and 4 months of therapy. The patients from both groups before treatment exhibited lymphocytosis, decreased phagocyte activity, when compared to healthy individuals. By the end of therapy (4 months), the patients from the NAT group showed increased phagocytosis by monocytes (p < 0.01) and granulocytes (p < 0.05) which approached values of healthy control. The study demonstrated also that efficiency of combined therapy was higher in the NAT vs. SDT group: closure of lung destruction cavities was observed in 90.5% of patients from the NAT group vs 45% of patients from the STD group. The results present evidence for combined implementation of neurothechnological anti-stress therapies as a supplementary method for the standard specific drug therapy in primary infiltrative lung tuberculosis.

SHORT COMMUNICATIONS

137-140 992
Abstract

Apoptosis is defined as a highly regulated form of programmed cell death with typical morphological and biochemical features. A variety of factors, including heavy metals, may influence the intensity of programmed cell death. The aim of the work was to simulate apoptosis in an in vitrosystem under the conditions of stable strontium exposure. The children’s population consuming drinking water with high strontium (Sr2+) content (n = 49) was observed. The level of lymphocyte apoptosis was determined with flow cytometry technique, by means of labeled annexin V-FITC conjugate (AnnV-FITC) and propidium iodide (PI) staining. AnnV-FITC+PI- cells were regarded as early apoptotic forms, whereas late apoptotic and/or necrotic cells were AnnV-FITC+PI+. The isolated leukocytes were incubated with Sr2+ at a concentration of 7.0 mg/l, the maximal permitted concentration (MPC) for water of aqueous objects, for 4 hours at 37 ºC. Expression of CD95 and p53 apoptosis markers was performed by flow cytometry using labeled monoclonal antibodies.In vitroexposure to strontium was associated with significantly decreased expression of apoptosisregulating factors, i.e., membrane marker CD95 and intracellular transcription protein p53, 1.56- and 1.68-fold, respectively. Meanwhile, we revealed a significantly (4.68-fold) decreased amounts of AnnV-FITC+PI--cells, as well as a statistically significant (1.35-fold) increase of the AnnV-FITC+PI+-cells. Moreover, the amounts of AnnV-FITC+ PI--lymphocytes in all samples were below the physiological ranges and control values. The number of samples with higher contents of AnnV-FITC+PI+-lymphocyte exceeding the established standards and control values, was 30.8%. Thus, it has been experimentally proven that strontium, at a concentration corresponding to MPC for water objects may significantly inhibit cell death along apoptotic pathways, with switching to necrotic cell death mechanisms, according to phosphatidylserine contents, as detected by annexin V binding test. The data have revealed an ability of strontium to have a significant effect upon the parameters of regulation and maintenance of cellular homeostasis, by influencing the apoptosis intensity, due to shifting a balance towards necrosis and reducing expression of apoptosis-regulating factors. The results of this study may be used in order to identify some marker indexes of immune disorders potentially induced by external influence of strontium upon human health under specific environmental factors.

141-148 914
Abstract

The aim of the present study was a search for associations between the polymorphic allelic variants 3954 C>T (rs1143644) and -511C>T (rs16944) of IL1B gene in the patients with sensory predominant chronic inflammatory demyelinating polyneuropathies (SP-CIDP) from Krasnoyarsk Region and the Sakha (Yakutia) Republic. A total of 95 people were examined, having been divided into 2 groups according to their residence. The first group consisted of 42 patients living in the Sakha (Yakutia) Republic. The second group included 53 patients living in the Krasnoyarsk Region. It was revealed that the carriers of homozygous CC genotype in the 3954C>T locus were more often detected in patients from the Sakha (Yakutia) Republic, and the carriage of TT genotype is found exclusively in the patients from Krasnoyarsk Region. When comparing the different genotype frequencies in the -511CT locus, we did not reveal any statistically significant differences between the two groups of patients. Presence of the CC genotype of the 3954C>T locus was associated with a significantly increased risk of disease in the patients from Sakha (Yakutia) Republic, while carrying CT and TT genotypes at the locus 3954C>T and the TT genotype at the locus -511C>T, is associated with increased risk disorder among patients of the Krasnoyarsk Region. The frequency of carriage of various genotypes in the 3954C>T and -511C>T loci of the IL1B gene was prevalent among the patients from the Sakha (Yakutia) Republic, the association of genotypes of CC/CT prevailed in patients from the Krasnoyarsk Region (p = 0.005), as well as prevalence of CC/CC and CC/CT (p = 0.023). However, there was no statistically significant difference in occurrence of individual genotypes between the two study groups. When analyzing the carrier frequency of high-producing alleles of 3954C and -511C in patients with SP-CIDP, it was shown that they were significantly more common among patients from the Sakha (Yakutia) Republic and patients from the Krasnoyarsk Region than the low-producing 3954T and -511T alleles. Moreover, the 3954C allele was more often found in the Yakut group (p = 0.001), and in the -511C allele for the Krasnoyarsk group of patients (p = 0.05). The presence of 3954C and -511C alleles increases the risk of SP-CIDP development in patients from the Sakha (Yakutia) Republic, as well as carriage of 3954T allele in patients from the Krasnoyarsk Region.

149-156 1553
Abstract

In the present time, incidence of pulmonary tuberculosis (TB) becomes broader, due to spreading resistance of Mycobacterium tuberculosis (MBT) to anti-tuberculosis drugs and infection with highly virulent strains of M. tuberculosis. The MBT antigens can cause dysfunction of the receptors and modulate the cytokine secreting function of immunocompetent cells. Polymorphic genes of pro-inflammatory cytokines involved in the mechanisms of defense responses of innate immunity, determine the degree of resistance to individual mycobacterial infection, as well as severity and duration of the disease in cases of clinical manifestations. The aim of the study was to investigate the connections between allelic polymorphisms of IL2, IFNG and TNFA genes and changes in secretion of the corresponding pro-inflammatory cytokines IL-2, IFNγ, and TNFα in vitro in patients with the newly diagnosed pulmonary tuberculosis (TB), depending on the clinical form of the disease.

A total of 334 patients (220 men and 114 women) aged 23 to 50 years with newly diagnosed infiltrative and disseminated TB were enrolled into the study. The control group consisted of 183 healthy donors (130 men and 53 women) of corresponding age. The material of the research included DNA extracted from the whole blood and supernatants of culture suspensions of mononuclear leukocytes isolated from venous blood in healthy volunteers and patients with TB. The evaluation of cytokines secretion was performed by measuring their concentration in the blood mononuclear cell culture supernatants. using enzyme-linked immunosorbent assay (ELISA). To study polymorphic regions of cytokine genes, a polymerase chain reaction (PCR) was applied. Analysis of the obtained data was carried out by means of the program Statistica for Windows Version 6.0 (StatSoft Inc., USA).

It was found that the imbalance of secretion of pro-inflammatory cytokines in TB patients was associated with the polymorphic variants of genes of these cytokines. It was found that the hypo-secretion of IL-2 is determined by the carriage of the G allele and genotype GG (T-330G) of the IL2 gene in both the control group and in patients with TB, regardless of the clinical form. In patients with DTB carriers of the homozygous genotype TT (T-330G) of the IL2gene, increased protein secretion was established. The maximum secretion of TNFб was recorded in patients with the AA genotype (G-308A) of the TNFA gene in the control group and in ITB patients; the minimum concentration of TNFα was associated with the carrier of the homozygous GG genotype (G-308A) of the TNFA gene in all the examined groups. In patients with ITB and DTB, an increase in IFNγ secretion by mononuclear blood leukocytes is not associated with the carrier of polymorphism +874A/T of the IFNG gene.

Reduced secretion of IL-2 and TNFα in TB patients is associated with polymorphisms of their genes – (T-330G) of IL2 gene and (G-308A) of TNFA gene, respectively. The polymorphism (+874A/T) of the IFNG gene does not have a modulatory effect on the secretion of IFNγ in patients with TB, regardless of clinical form of the disease.

157-164 944
Abstract

Colorectal cancer is one of the most common malignant diseases in Russia worldwide making up 5-6% of all human malignant tumors. Neutrophilic granulocytes are actively involved in development of antitumor response. A key role in tumor regression is assigned to active forms of oxygen produced by neutrophils. In connection with these pre-requisites, our goal was to study functional characteristics of spontaneous and induced chemiluminescent activity of neutrophil granulocytes in patients with rectal cancer before starting pathogenetic therapy and in subsequent dynamics. The paper presents some laboratory results, i.e., functional indices of neutrophilic granulocytes’ activity in 36 patients with rectal cancer being at different stages of oncological process. The control group consisted of 112 practically healthy volunteers, comparable in sex and age to the group of patients under study. To perform the study venous blood was taken from patients to vacuum test tubes with lithium heparin in the morning time before surgical treatment, and on day 7 after the surgical intervention. Evaluation of spontaneous and induced chemiluminescence was performed for 90 minutes in a 36-channel “CL 3606” chemiluminescence analyzer (Russia). The following characteristics were determined: time of the curve transition to maximal chemiluminescence intensity (Tmax), maximal value of chemiluminescence intensity (Imax), integral area under the chemiluminescence curve (S). Luminol was used as the chemiluminescence enhancer. Opsonized zymosan was used to induce the respiratory explosion. Chemiluminescence amplification induced by opsonized zymosan was evaluated by the ratio of induced-tospontaneous chemiluminescence (Sind/spont) designated as an activation index.

Analysis of chemiluminescence activity in neutrophilic granulocytes showed a significant increase in spontaneous chemiluminescence activity at the stages III and IV of the disease. The production of active oxygen forms induced in neutrophilic granulocytes by opsonized zymosan increased in all the study groups, relative to control parameters. The area under the curves of spontaneous and induced chemiluminescence in patients with colorectal cancer at all stages of the oncological process is less, as compared to the control group, which, despite high indices of maximal chemiluminescence activity, may indicate insufficient total production of reactive oxygen species. The time-to-peak values of the chemiluminescence curves in patients with rectal cancer at all stages of the disease did not show statistically significant differences from the control group.

165-170 822
Abstract

The studies in the organism adaptation for the conditions of technogenic environmental changes, especially in child population, will allow to design a set of diagnostic markers for assessing the health status and early detection of pathological trends for development of hypersensitivity to environmental substances and improve efficiency of therapeutic and preventive measures. Metals are capable to alter functional activity of immune system by producing both immunostimulating and suppressive effects on immune reactivity, dependent on the properties of the given metal, its environmental concentration, source and duration of exposure. The aim of the present study was to investigate the features of hypersensitivity markers in children under the conditions of external exposure to aluminum. We have conducted a survey of the schoolchildren aged from 7 to 11 y.o. (a mean of 8.82±0.11 years), permanently inhabiting the territory of active industrial exposure associated with environmental contamination with aluminum compounds. The comparison group consisted of children from a “conventionally clean” area, with acceptable parameters of environmental quality. Specific features of sensitization developing to aluminum were evaluated, including both reactive and alternative mediator mechanisms (leukotrienes and prostaglandins), as well as participation of the cytokines in evolving sensitivity to the metal in the ex vivo experiments. We have shown a 1.43-fold increased level of metal in peripheral blood of the observation group, than in comparison group (respectively, observation group, 0.020±0.005 μg/ml; comparison group 0.014±0.003 μg/ml). Enhanced levels of IgE antibodies were found to be 2.13-fold higher compared to the reference values (213.55±88.10 IU/ml against normal rates of < 100.0 IU/ml) accompanied by increased specific IgG antibodies to aluminum (1.55-fold relative to the controls, i.e., 0.157±0.054 cu in observation group versus 0.101±0.041 cu for the comparison group), as well as a 2.09-fold increased spontaneous production of leukotrienes C4/D4/E4 (80.60±19.44 pg/ml for observation group; 38.51±2.40 pg/ml in the comparison group), which was 1.67-fold enhanced by experimental aluminum stimulation. Prostaglandin F2α levels among the children from observation group were increased 1.9-fold (observation group, 892.62±97.20 pg/ml; comparison group, 457.11±132.99 pg/ml, p < 0.05). Under the ex vivo experimental conditions, we observed mostly suppressive effects of aluminum upon the cytokine production. E.g., IL-4 production was inhibited by 2.13-fold, as compared with control values (observation group, 0.64±0.23 pg/ml; comparison group, 1.36±0.09 pg/ml); the suppression for IL-17 was 1.90 times (observation group, 1.08±0.27 pg/ ml; comparison group, 2.05±0.37 pg/ml, p < 0.05). The parameters studied may be used as aluminum hypersensitivity markers and used for monitoring and predictions in public health care.

CHRONICLE

171-188 1236
Abstract

A review article is an aftermath of the 11th International Congress on Autoimmunity and First Academy of Autoimmunity, happened 14th to 20th May, 2018 in Lisbon. The first part of paper discusses the formation, main problems and prospects for the development of Autoimmunology as a new integral branch of fundamental and clinical Medicine engaged in the research, diagnosis, treatment and prevention of autoimmune diseases of various organs and systems, totally circa 90 of them. A summary of all lectures conducted during the Academy of Autoimmunity is given, including a discussion of the newest and controversial aspects of the development of the modern concepts of the immune system, autoimmunity and autoimmune pathology. Article reviews data on the current problems of Immunology associated with the use of large databases of clinical and laboratory findings and extrapolation of animal experimentation data to humans. The newest ideas about congenital immunity, including the populations of innate lymphoid cells, on the role of various groups of receptors of the innate immunity system, on the participation of the mechanisms of innate immunity in pathogenesis of autoimmune disorders are highlighted. Modern concepts of antigen presentation are offered, including classification of dendritic cells, alternative pathways of macrophage activation, as well as on costimulatory and inhibitory interactions of ligands and receptors of lymphocytes and antigen-presenting cells. The latest data about the subpopulations of T lymphocytes and their role, including the functions of Tfh cells and the relationships of these subpopulations with various immune responses are highlighted. Influence of microbiota on T cell subpopulations is discussed. The main regularities of the phenomenon of immunological memory are formulated. The questions of antibody production and B lymphocyte functions are considered taking into account recently discovered mechanisms of intracellular penetration of immunoglobulins and details of affinity maturation of lymphoid clones. The new therapeutic approaches in the treatment of autoimmune diseases associated with influences on B and T lymphocytes are described. Mechanisms of central and peripheral autotolerance have been highlighted, taking into account data on the function of the AIRE gene and T regulators. The role of T regulators in placentation is considered. The role of interleukin-2 and its recombinant analogues in immune interactions is interpreted in a new way, taking into account not only their immunostimulating, but, under certain conditions, immunosuppressive potential also. Considerable attention has been paid to the inhibitory receptors of T lymphocytes and to immuno-biotherapeutic effects on them. The history and current status of Oncoimmunology and the use of blockers of inhibitory T lymphocyte receptors in Oncology, including the side effects of treatment with check-point inhibitors, are briefly discussed. Information was given on the held on 21-23 September 2018 2nd Academy of Autoimmunity in St. Petersburg.

ANNIVERSARY

 
189-190 436


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