Number№82 (4) 2020


Lomakovsky A.N.

Summary. Relevance. The mechanisms behind the onset and progression of atherosclerosis remain an area of intense research. Immune dysregulation and inflammation are considered key factors for the development of atherosclerosis. Almost all components of the pathogenesis of atherosclerosis and its thrombotic complications are reflected in the quantitative measurement of certain blood factors — biomarkers. Unfortunately, there are indeed very few valuable biomarkers that would be etiologically specific for atherosclerosis. The aim of the study is to identify the relationship between the cellular and humoral links of the immune system, to explain the structure of the relationship between quantitative indicators and to reduce the number of indicators of the immune system included in the consideration to optimize the analysis. Object and research methods. Examined 290 patients with stable coronary artery disease (CAD). The material for the immunological study was peripheral venous blood. To determine the parameters of cellular and humoral innate and adaptive immunity in blood serum and supernatants of mononuclear cells, enzyme immunoassay was used. Research results. In case of stable coronary artery disease, the most complete changes in the immune status can be characterized by the following independent indicators: cellular immunity — CD95 lymphocytes, CD4, CD16; humoral immunity — antibodies to oxidized LDL, sCD40L, antibodies to arterial wall tissues; phagocyte systems — the activity of neutrophils according to the NST-test, the phagocytic number of monocytes and neutrophils, the activity of monocytes according to the NS-test; proinflammatory cytokines and acute phase proteins — TNF-α, IL-6, CRP. Conclusions. According to the analysis of the main components, four independent unequal factors of the activity of the immune system in stable coronary artery disease were identified: inflammatory-T-suppressor (IL-6, CD8) (21% of the total dispersion), inflammatory-phagocytic (activity of neutrophils and monocytes according to the NST-test, TNF-α) (20%), inflammatory-humoral (antibodies to oxidized LDL, antibodies to arterial wall tissues) (15%), inflammatory T-helper (CRP, CD4, lymphocyte sensitization) (12%).

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