Lomakovsky A.N.

Summary. Relevance. The ability of lipids to influence the properties of cells involved in the innate and adaptive immune response, modulation of the inflammatory response, antigen presentation for macrophages, as well as B- and T-cell activation has been revealed. The purpose of the study is to clarify the pathogenesis of coronary atherosclerosis to evaluate the relationship between the blood lipid spectrum and peroxidation of lipoproteins and proteins with the state of the humoral link of specific immunity in patients with IHD. Material and methods. 290 patients with stable CAD were examined. The material of the immunological study was peripheral venous blood. To determine the indicators of humoral innate and adaptive immunity in blood serum, enzyme immunoassay was used. The content of cholesterol (CS), triglycerides (TG) and high-density lipoprotein (HDL) cholesterol was determined using a biochemical analyzer using appropriate test kits; the composition of lipoproteins — by electrophoresis. The cholesterol content of low density lipoproteins (LDL) and very low density lipoproteins (VLDL) was calculated using the corresponding formulas. Spectrophotometric and fluorometric methods were used to determine the levels of intermediate and end products of lipid peroxidation (LPO) and proteins, antioxidant defense enzymes in blood serum and atherogenic lipoproteins. To assess the total effect of several independent factors — dyslipidemia and lipid peroxidation — on the indicators of the humoral link of specific immunity, multivariate regression analysis was used — logistic regression and multiple stepwise linear regression. Research results. A relationship was found between lipid metabolism disorders and humoral immune response in patients with coronary artery disease with stable angina pectoris — the blood level of IgG and IgM directly depends on the level of triglycerides and VLDL cholesterol, and the level of cholesterol-containing immune complexes — on the blood level of total cholesterol and LDL cholesterol. A moderate direct correlation was found between the level of cholesterol-containing immune complexes, the level of antibodies to damaged aorta, the level of IgG, and the severity of free radical oxidation of proteins.. A moderate direct correlation was found between the blood level of the B-lymphocyte activation marker CD40 and the level of diene conjugates. Multivariate regression analysis did not reveal a complex total effect of dyslipidemia (LDL-C) and lipid peroxidation (DC, MDA, catalase, SOD) on the studied parameters of humoral immunity in patients with stable coronary artery disease. Conclusions. The activity of the humoral link of the immune response is directly related to the level of peroxidation of lipoproteins and proteins in patients with coronary artery disease with stable angina pectoris. The activity of humoral immunity is associated with blood lipid fractions, as evidenced by the direct dependence of the level of cholesterol-containing immune complexes on the level of total cholesterol and low-density lipoprotein cholesterol. Dyslipidemia and lipid peroxidation do not have a net potential effect on humoral immunity.

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