UDC 617.55-002.5-07:616.155-097.36-07

Despite the high level of development of modern diagnostics, there is still a problem of diagnosing extrapulmonary and latent forms of tuberculosis. The purpose of the study was to determine the features of the immune status during the Koch immunoprovocation test. Studies were conducted in the venous blood of 50 patients with abdominal tuberculosis before and 72 hours after the Koch skin test. Indicators of cellular immunity were determined by the indirect immunofluorescence method and the content of cytokines by the immunoenzymatic method. The existence of statistically significant differences in the immunogram and in the cytokine profile of the examined patients before and after the Koch test was proved. The Koch immunoprovocation test
exacerbates the pathogenetic manifestations of the chronic inflammatory process, which is manifested by a change in the cytokine spectrum of the blood and makes it possible to clarify the diagnosis of abdominal tuberculosis. Determination of the level of TNFα in the blood serum of patients after the Koch test can be a marker of the latent form of the course of abdominal tuberculosis. Key words: immune system, cytokines, extrapulmonary tuberculosis, Koch test. 

Abstract

Pathogenetic mechanisms of diabetic retinopathy are associated with the toxic effects of hyperglycemia and subsequent activation of stress-sensitive systems. The purpose was to determine the features of immune dysfunction in patients with diabetic retinopathy against the background of metabolic syndrome. Clinical and laboratory examinations of 130 patients with diabetic retinopathy have been carried out (70 insulin-dependent patients – group 1 and 60 insulin-independent patients – group 2). In determining the surveyed individuals’ contents of the lymphocyte populations and subpopulations, the monoclonal antibodies were used to CD3 +, CD4 +, CD8 +, CD19 +, CD23 +, CD25 +, CD56 + in the reaction of indirect immunofluorescence with fluorescein-isothiocyanate labeled antibodies and indices were calculated – the ratio of the lymphocyte populations and subpopulations. The population and subpopulation composition of blood lymphocytes were studied, and the ratio of cellular factors of immunity in patients with diabetic retinopathy was calculated. The immune status of patients with diabetic retinopathy is characterized by more pronounced changes in insulin-dependent patients’ cellular immunity – the activation of nonspecific killer immunity, suppressor potential and humoral immunity than in insulin-independent patients. The results allow the pathogenetic correction of diabetic retinopathy with the immune imbalance.