Characterization of cellular immunity in patients with obstructive jaundice caused by cholelithiasis

Abstract

Introduction. Obstructive jaundice is currently a life-threatening organ dysfunction, accompanied by a dysregulatory immune response to obstruction, hyperbilirubinemia, and an infectious process. The prognosis of the disease depends on the changing cellular responses of innate and adaptive immunity. There is evidence of quantitative changes in T- and B-lymphocytes in obstructive jaundice, however, studies of their use as predictors of the development of an unfavorable prognosis are insufficient.

The aim of the study - estimation of the parameters of the cellular part of adaptive immunity in patients with obstructive jaundice caused by cholelithiasis in dynamics after surgical treatment.

Material and methods. The data of a prospective study of the cells of the immune system of 40 patients with obstructive jaundice due to cholelithiasis and 30 practically healthy volunteers are shown. Blood sampling from patients was carried out in the first 24 hours after admission to the hospital and the establishment of the diagnosis «obstructive jaundice» and on the 7th day after surgery. Evaluation of the level of T-, NK- and B-lymphocytes (CD3+CD19-, CD3CD16/56+, CD3CD19+), subpopulations of T-lymphocytes (CD3+CD4+, CD3+CD8+, CD3+CD4+CD25+) was carried out by the method of flow cytometry using monoclonal antibodies. Determination of the number of Th1- and Th2 cells was assessed indirectly by the presence of cytokines IFN-γ and IL-4 in plasma, which were determined using enzyme-linked immunosorbent assay and a set of monoclonal antibodies produced by ZAO Vector Best (Russia).

Results. On admission, patients with obstructive jaundice showed lymphopenia, a decrease in total T-lymphocytes and their supopulations, a decrease in the number of NK cells, an increase in Treg and IL-4 (p < 0.05). After surgical treatment, the patients retained T-cell immunosuppression, while Treg and cytokines were normalized (p < 0.05).

Conclusion. Significant changes in the adaptive immunity cells were revealed in patients with obstructive jaundice caused by cholelithiasis before surgery, manifested by a decrease in the content of T-lymphocytes and their subpopulations, an imbalance of T-helpers towards Th2 cells, an increase in Treg. In the postoperative period, the suppression of the cellular immunity is preserved due to the additional antigenic load from the surgical intervention itself, while the stabilization of pro-inflammatory and anti-inflammatory cytokines, the normalization of the ratio of Th1/Th2-cells and the number of Treg. Quantification of Treg cells can be a predictor of poor prognosis in these patients.

Keywords:cell cytometry; T-lymphocytes; B-lymphocytes; NK cells; obstructive jaundice, cholelithiasis

For citation: Smirnova O.V, Elmanova N.G. Characterization of cellular immunity in patients with obstructive jaundice caused by cholelithiasis. Immunologiya. 2021; 42 (6): 655-61. DOI: https://doi.org/10.33029/0206-4952-2021-42-6-655-661 (in Russian)

Funding. The study was carried out at the expense of the state task of the SRI MPN FRC KSC SB RAS «Study of molecular genetic and regulatory metabolic mechanisms of the functional activity of cells of the immune system in health and immunopathological conditions» No. 121022600088-4 of 24.02.2021.

Conflict of interests. The authors declare no conflict of interests.

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