Akymova V. Immune mechanisms in the pathogenesis of the abdominal cavity organs inflammation

The dissertation is devoted to the study of immune mechanisms in the pathogenesis of various forms of inflammation of the organs of the abdominal cavity. 226 people were examined with acute non-specific inflammatory process of the organs of the abdominal cavity (acute appendicitis, acute calculous cholecystitis, acute mesadenitis) and 60 persons with abdominal tuberculosis, which represents a specific chronic inflammation. The study was conducted to identify specific signs of various forms of inflammation of the organs of the abdominal cavity for further implementation in the diagnostic and therapeutic process. It has been established that the development of acute inflammation in the abdominal cavity is determined by profound changes in the immune system. This is evidenced by the neutrophilic type of hemogram, the activation of the humoral and killer immune system against the background of the T-cell immunodeficiency state. Increased expression of membrane activation antigens of CD25, CD95, CD23 on blood lymphocytes was revealed and differences in their correlation with different inflammation forms were revealed. It has been proved that in acute inflammatory processes that run smoothly, processes of activation of apoptosis over proliferation prevail, which is confirmed by a decrease in the ratio of CD25/CD95. Complicated forms of inflammation (purulent-septic, destructive process) are accompanied by a more pronounced decrease in the CD25/CD95 compared to the uncomplicated ones. Significant activation of the macrophage monocytic system is established, which is manifested by the growth of levels of IL-1β, IL-6, IL-8, TNF-α. A key role in the pathogenesis of gangrenous inflammation is established for TNF-α. An increase in the content of humoral immune factors has been established and informativeness of the index of inflammatory activity as an integral indicator characterizing a non-specific humoral immune response has been proved. Analyzing the correlations found between the levels of interleukins, the parameters of cellular and humoral immunity, we noted that during the chronic inflammatory process of the abdominal organs, the number of strong correlation bonds is increased, compared with the acute inflammation process. The “Factors” that combine the indicators of cellular immunity and cytokines are distinguished, which makes it possible to differentially characterize the mechanisms of the immune response in conditions of acute and chronic inflammation of the abdominal organs. In the dissertation the important task is solved - improvement of differential diagnostics of inflammatory processes of abdominal organs, by revealing pathogenetic mechanisms of development of acute and chronic inflammation.