medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2022-16-19-162-166medsovet-7188Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLСравнительная характеристика показателей гуморального иммунитета и их взаимосвязь с хелаторной терапией при талассемииComparative characteristics of humoral immunity indicators and their relationship with chelation therapy in thalassemiaРахмановаУ. У.RakhmanovaU. U.

Рахманова Умида Улугбековна, к.м.н., доцент кафедры военно-полевой терапии и гематологии 

220100, Узбекистан, Хорезмская область, Ургенч, ул. Аль-Хорезмий, д. 28 

Umida U. Rakhmanova, Cand. Sci. (Med.), Associate Professor of the Department of Military Field Therapy and Hematology

28, Al-Khorezmiy St., Urgench, Khorezm Region, 220100, Uzbekistan 

raxmanovaumidahon@gmail.comУргенчский филиал Ташкентской медицинской академииУзбекистанUrgench Branch of Tashkent Medical AcademyUzbekistan202216112022019162166Copyright © Рахманова У.У., 20222022Рахманова У.У.Rakhmanova U.U.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7188

Введение. Данные о повышенной восприимчивости больных талассемией к инфекциям вызывают большой интерес к изучению различных аспектов иммунного статуса больных.Цель. Изучить показатели гуморального звена иммунитета и их взаимосвязь с хелаторной терапией у больных талассемией.Материалы и методы. Настоящее исследование проведено в Республиканском специализированном научно-практическом медицинском центре гематологии с 2015 по 2020 г. Материалом исследования явилась периферическая венозная кровь больных талассемией. При определении иммунологического статуса больных β-талассемией нами были исследованы 74 школьника в возрасте 8–12 лет. Статистическая обработка клинического материала была произведена при помощи статистического пакета прикладных программ «STATISTICA 10.0».Результаты и обсуждение. Результаты изучения содержания сывороточных иммуноглобулинов в крови больных детей показали сниженный синтез IgA (р < 0,001). При этом уровень IgМ был достоверно повышен у больных β-талассемией по сравнению с контролем (р < 0,001), что говорит о наличии острого воспаления в организме. Также результаты наших исследований показали, что наблюдается некоторая тенденция к повышению уровня IgG (11,2 ± 0,41 пг/мл в контроле против 16,13 ± 0,58 пг/мл), наблюдалось достоверное повышение синтеза этого иммуноглобулина (р < 0,001), это позволяет утверждать об аутоиммунном процессе. В группе больных β-талассемией детей уровень С-реактивного белка был в 4 раза выше значений контрольной группы (3,8 ± 0,1 нг/мг в контроле против 15,33 ± 0,17 нг/мг, p < 0,001). Уровень лактоферрина у больных детей был снижен в 4,2 раза по сравнению с данными контрольной группы. Наблюдается дисрегуляция факторов белков острой фазы: С-реактивного белка и лактоферрина. Для β-талассемии характерно резкое повышение уровня провоспалительных цитокинов – уровень IL-6 повышен в 2,9 раза, а уровень IL-18 – в 8,7 раза.Выводы. Выявлена взаимосвязь между показателями иммунного статуса и показателями гемосидероза, имеется достоверная разница во всех изученных показателях, применение хелаторной терапии способствует положительной динамике.

Introduction. Data on the increased susceptibility of patients with thalassemia to infections are of great interest to the study of various aspects of the immune status of patients.Aim. The aim of the study was to study the parameters of the humoral immunity and their relationship with chelation therapy in patients with thalassemia.Materials and methods. This study was carried out at the Republican Specialized Scientific and Practical Medical Center for Hematology from 2015 to 2020. The material of the study was the peripheral venous blood of patients with thalassemia. When determining the immunological status of patients with β-thalassemia, we examined 74 schoolchildren, aged 8–12 years. Statistical processing of clinical material was carried out using the statistical package of application programs STATISTICA 10.0.Results and discussion. The results of the study of the content of serum immunoglobulins in the blood of sick children showed a reduced synthesis of IgA (p < 0.001). At the same time, the level of IgM was significantly increased in patients with β-thalassemia, compared with the control (p < 0.001), which indicates the presence of acute inflammation in the body. Also, the results of our studies showed that there is a certain tendency to increase the level of IgG (11.2 ± 0.41 pg/ml in control versus 16.13 ± 0.58 pg/ml), there was a significant increase in the synthesis of this immunoglobulin (p < 0.001), this allows us to state about the autoimmune process. In the group of children with β-thalassemia, the level of C-reactive protein (CRP) was 4 times higher than the values of the control group (3.8 ± 0.1 ng/mg in the control versus 15.33 ± 0.17 ng/mg, p < 0.001). The level of lactoferrin in sick children was reduced by 4.2 times compared with the data of the control group. There is a dysregulation of acute phase protein factors – C-reactive protein and lactoferrin. β-thalassemia is characterized by a sharp increase in the level of pro-inflammatory cytokines – the level of IL-6 is increased by 2.9 times, and the level of IL-18 – by 8.7 times.Conclusion. The relationship between the indicators of the immune status and indicators of hemosiderosis was revealed, there is a significant difference in all the studied indicators, the use of chelation therapy contributes to positive dynamics.

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The authors declare that there are no conflicts of interest present.