Peculiarities of the phenotype of T-lymphocytes in the dynamics of the postoperating period in patients with peritonite depending on the outcome of disease

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Abstract

The aim of the study was to investigate the phenotype of blood T-lymphocytes in the dynamics of the postoperative period in patients with widespread purulent peritonitis (WPP) depending on the outcome of the disease. A total of 36 patients aged 30–65 with acute surgical diseases and abdominal injuries complicated by WPP years were examined. Blood sampling was performed before the operation (preoperative period), and also on the 7th, 14th and 21st day of the postoperative period. 40 relatively healthy people of the same age range were examined as a control. Study of the phenotype of blood T-lymphocytes was carried out by the method of 5-color f low cytometry using direct immunof luorescence of whole peripheral blood. Mean levels of fluorescence were used to evaluate the expression levels of surface receptors. It was established that in the preoperative period in patients with WPP regardless of the outcome of the disease against the background of a decrease in the absolute amount of total lymphocytes in the blood the content of T cells increases. The T-lymphocytes of patients with WPP are significantly more intense expressing the CD28 and CD62L receptors than the cells of healthy people. In the preoperative period and within two weeks of postoperative treatment with a favorable outcome of the WPP an increased amount of CD62L+T-lymphocytes is detected in comparison with the indices of patients with an unfavorable outcome of the disease. Other features of the phenotypic composition of T-lymphocytes in patients with a favorable outcome of WPP is an increase in T-regulatory activity which manifests itself both in the preoperative period and within two weeks of postoperative treatment. With a favorable outcome of WPP an increase in the number of activated cytotoxic T-lymphocytes is observed on the 14th day of treatment which with an unfavorable outcome is observed only on the 21st day of treatment. It is assumed that T-cell suppression and activation of cytotoxic T cells are the factors determining a decrease in the intensity of inflammatory processes in WPP and thereby increasing the level of the favorable outcome of the disease. In case of an unfavorable outcome of the disease, postoperative therapy has a weaker or delayed effect on the dynamics of the studied parameters than with a favorable outcome. With a favorable outcome of WPP an increase in the CD3+CD57+cell count is observed already from the second week of treatment and is more pronounced whereas in the case of an adverse outcome of WPP an increase in the level of these cells is observed only at the third week of treatment. However, the level of expression of CD57 on T-lymphocytes is more pronounced throughout the course of the examination with an unfavorable outcome of WPP.

About the authors

A. A. Savchenko

Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of Medical Problems of the North; Siberian Federal University

Email: aasavchenko@yandex.ru

Savchenko Andrei Anatolyevich - PhD, MD (Medicine), Professor, Head of Laboratory of Molecular Cell Physiology and Pathology, Scientific Research Institute of Medical Problems of the North; Head of the Department of Physiology, Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky.

Russian Federation

A. G. Borisov

Federal Research Center “Krasnoyarsk Science Center” of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of Medical Problems of the North; Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky

Email: 2410454@mail.ru

Borisov AlexandrGennadyevich - PhD (Medicine), Leading Researcher, Laboratory of Molecular Cell Physiology and Pathology, Scientific Research Institute of Medical Problems of the North; Associate Professor, Department of Infectious Diseases, Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky.

Russian Federation

D. V. Cherdancev

Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky

Email: aasavchenko@yandex.ru

Cherdantsev Dmitrij Vladimirovich - PhD, MD (Medicine), Professor, Head of the Department and Clinic Surgical Diseases named after prof. A.M. Dychno with the course of endoscopy and endosurgery, Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky.

Russian Federation

O. V. Pervova

Krasnoyarsk State Medical University named after Prof. V.F. Voyno-Yasenetsky

Email: 2410454@mail.ru

Pervova Ol'ga Vladimirovna - PhD, MD (Medicine), Professor of the Department and Clinic Surgical Diseases named after prof. A.M. Dychno with the course of endoscopy and endosurgery,  Krasnoyarsk State Medical University named after prof. V.F. Voino-Yasenetsky.

Russian Federation

I. V. Kudryavtsev

Research Institute of Experimental Medicine

Email: igorek1981@yandex.ru

Kudryavtsev Igor Vladimirovich - PhD (Biology), Senior Researcher, Laboratory of Immunology, Institute of Experimental Medicine; Associate Professor, Department of Immunology, Pavlov First St. Petersburg State Medical University.

197376, St. Petersburg, Akademika Pavlova str., 12.

Phone: +7 (812) 234-29-29.

Russian Federation

V. D. Belenjuk

Federal Research Center «Krasnoyarsk Science Center» of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of medical problems of the North

Author for correspondence.
Email: dyh.88@mail.ru

Belenyuk Vasilij Dmitrievich - Junior Researcher, Laboratory of Molecular Cell Physiology and Pathology, Scientific Research Institute of Medical Problems of the North.

Russian Federation

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Copyright (c) 2019 Savchenko A.A., Borisov A.G., Cherdancev D.V., Pervova O.V., Kudryavtsev I.V., Belenjuk V.D.

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