Irritable bowel syndrome (IBS) is observed mostly in Ukrainian children and may be related to adverse health effects as a result of the Chernobyl disaster. The aim of this study was to determine the status of immune system in patient with IBS and dysbiosis of the gastrointestinal tract flora exposed to natural radiation with clinical symptom of IBS for effective diagnosis and treatment. This study included 75 rural children population aged 4-18 years, who lived in a contaminated area exposed to natural environmental radiation with clinical irritable bowel syndrome which categorized in three groups, and 30 rural children participants aged 5-15 years who were living in Kiev with similar age and categorized in three groups without clinical IBS as control group. Internal radiation activity was measured by gamma-ray spectrometry. Peripheral blood leukocytes were analyzed for B and T-lymphocytes subset such as T-lymphocytes CD3, CD4, CD8, CD22, CD16 subset assayed by flow cytometric method, serum concentration of circulation immune complex was measured by the polyethylene glycol method. Phagocytic activity function was assessed by using latex article and phagocytic index were calculated. Serum immunoglobulins (A, M, G, E) and seum level of cytokine profile ( IL -1alfa , IL -4, TNF -alfa, IFN -gamma) were evaluated by enzyme-linked immunosorbent assay (ELISA) method. The intestinal bacterial microbiota was assessed by medical microbiologic method witch proposed by Sutter. The mean value of the radioactivity of 137Cs in control group had significantly higher amount of radioactive material and proportions compared with the control group at P<0.01. Dysbiosis was found in 81.3% of study group, the population levels of Escherichia, Enterococcus, Lactobacillus and Bifid bacterium counts concentration in cecal contents in 61 subjects was significantly less than in control group , respectively, P<0.01). The population levels of Enterobacter, StaphylococcusKlebsiella Clostridium, Proteus, Citobactr and Candidawas significantly more than in control group , respectively, P<0.01). Percentage of CD3 and CD4 in all study groups decreased significantly in comparison to control group (p < 0.001). Percentage of CD8 increased significantly in all study groups in comparison to control group (p < 0.05). The CD4/CD8 ratio decreased significantly all study groups in comparison to control group (p < 0.001).The percentage of CD22 in study groups is increased significantly in comparison to control group at p < 0.05. Reduced serum immunoglobulins levels specially concentration of IgE in all groups have developed in the majority of the participants. Percent of CD16 cell in groups II and III increased significantly in comparison to control group (p < 0.05). Concentration of circulating immune complexes increased significantly in all study groups compared to control group (p < 0.001). Phagocytes activity and phagocyte index decreased significantly in all study groups in comparison to control group (p < 0.001). A trend towards increased levels of IL-4, IL-1a and TNF-alfa was observed in children with clinical irritable bowel syndrome. In these children, IFN-gamma levels were lower than that of the control group. In conclusion, the IBS symptoms in Ukrainian children residing in a contaminated area may have stemmed from Th1 to Th2 immune deviation and differential expression of IL-4 and IFN-gamma. Hyperproduction of ІgE in result of Th2 activity leads to activation of mast cells synthesizing a number of inflammatory mediators including IFN-gamma and IL-1 alfa. This process plays an important role in development of the pathogenesis of atopic inflammation by immune response in the small and large intestine in patients with IBS. The effect of polyoxidonium on the correction of immune status was studied in vivo. A total number of 16 children with IBS and dysbiosis aged 14- 18 years as a study group received polyoxidonium with basic therapy and 10 children with IBS and dysbiosis in same age received only basic therapy as a control group. The basic therapy is a number of different medications are used to help treat IBS, including antispasmodic medicines and antimotility medicines with pre- and probiotics supplements as like as Lacium. In study group, contrast to control group for comparison basic therapy and therapy with immunomodulatory drug such as polyoxidonium has been shown an established increase of the percentage of CD3 CD4, CD16 and decrease in percentage of CD22 in study group significantly at p < 0.001. Concentration of IL-4, IL-1a and TNF-a was decreased and level IFN-gamma was increased significantly in comparison to control group and in cause the level of IgE was decreased and stayed near the health subjects. In result has been noted a positive trend in treatment with immune modulators in patient with IBS with dysbiosis.
