Журнал «Здоровье ребенка» 2 (61) 2015
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Peculiarities of the cell immunity component in the children suffering from mono- and mixed-versions of rotavirus infection.
Авторы: Maidannik V.G.(1), laugh-Gorbunov K.O.(2)
(1) — National Medical University Bogomolets
(2) — Sumsky State University
Рубрики: Педиатрия/Неонатология
Разделы: Клинические исследования
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Rotavirus infection (RVI) is the main reason of dehydration diarrhea in young children [1]. This disease causes hospitalization of the third part of children suffering from diarrhea.
Mortality because of this pathology is 25% of all diarrhea cases and is equal to 500 000-800 000 deaths per year. Frequency of the recurrent disease is very high among infants and young children - 30-70% [2]. Rotavirus infection is spread worldwide, but it affects children in developing countries the most. Direct and indirect costs spent on treatment of RVI are about 400 million Euros in Europe and more than $ 1 billion dollars in the United States [3].
Hyman immune response to viral infection is difficult and complex. One of the components of a specific immune response is a cellular immunity component (B-lymphocytes, T- lymphocytes, T-helper cells, T-suppressors, and T-killers).
Materials and methods of investigation
The investigation has been fulfilled on the basis of the department of infectious disease №3 at "Sumy City Clinical Hospital of St. Zenaida" in the period of 2013-2014. There were observed 35 children (19 boys and 16 girls), patients suffering from acute intestinal infection of rotavirus etiology
The children under observation were divided into two groups. The first group (group I) included 16 children having mono -version of rotavirus infection. The second group (group II) consisted of 19 patients suffering from mixed-version of rotavirus infection. The control group included 15 healthy children representative by age and sex.
The investigation has been conducted during the height of the disease (for the first 3 days) and during recovery period (for the 5-6 days).
Study of cellular immunity component was based on determining the content of CD3 + (T lymphocytes), CD4 + (T-helper cells), CD8 + (T suppressors) immunoregulatory index (CD4 + / CD8 +), CD16 + (NK-cells), CD21 + (B lymphocytes) using the method of immune fluorescence of monoclonal antibodies in the serum [4].
Statistical analysis of the results was performed using methods of variation row, calculating the arithmetic mean value, standard deviation of the arithmetic mean. The reliability
of two samples difference was evaluated using Student's test (t). The calculations were performed on a personal computer using a program «Microsoft Excel» adapted for biomedical research.
Results and Discussion
During the study of the immune system cellular component in children having mono- and mixed-versions of rotavirus intestinal infection there were found out the immune status disturbances in the acute phase of the disease. In the first group of children having mono-version of RVI indicator CD3 + in serum reduced significantly to (45,13 ± 0,55)% comparing with that of control group children (55,53 ± 0,69)% (p <0.001). There also took place a typical significant decrease of T-helper cells (CD4 +) and NK-cells (CD16 +), the concentration of which was (31,25 ± 0,65)% and (14,94 ± 0,62)%, comparing with almost healthy children (36,47 ± 0,48) % та (27,53 ± 0,48) % respectively, (p <0.001)%.
While conducting the investigation one also observed a significant increase of T-suppressors (CD8 +) and B lymphocytes (CD21 +) up to (19,43 ± 0,56)% and (19,50 ± 0,57)% corresponding figures of the control group were (17 93 ± 0,41)% and (17,73 ± 0,62)% respectively (p <0.05). Immunoregulatory index in children having mono-infection was reduced (1,62 ± 0,39) comparing with control group -(2,14 ± 0,10), (p> 0.05).
Reconvalescence period of mono-RVI was characterized by changes of immune status indicators, but none of them reached the level of the control group of children. The concentration of CD3 + and CD16 + increased to (52,25 ± 0,70)% and (16,67 ± 0,39)% respectively (p <0.001) and (p <0.05). The level of CD4 +in serum significantly increased to (34,06 ± 0,44)% (p <0.01). Indicators of CD8 +, CD21 +, and the ratio of CD4 + / CD8 + slightly increased to (18,94 ± 0,27)%, (19,43 ± 0,41)% and (1,78 ± 0,02) (p> 0, 05).
In children of the group II, having mixed-version of RVI, indicators of cellular immunity were also characterized by significant changes. In the acute phase of the disease the concentration of CD3 + and CD16 + significantly decreased to (47,68 ± 0,72)% and (11,84 ± 0,65)% respectively (p <0.001). The level of CD4 + in serum decreased to (30,58 ± 0,53)% (p <0.01). At the same time CD8 + (20,16 ± 0,81)% (p <0.05) increased as long as concentration of CD21 + to (19,79 ± 0,31)% (p <0.01). Immunoregulatory index was (1,52 ± 0,03), which was less than the index in healthy children (p <0.001).
Indicators CD3 + (50,32 ± 0,82)% (p <0.05) increased in the children of the group II at the time of discharge from the hospital. Concentration of CD4 + and CD8 + increased to (32,53 ± 0,43)% and (23,79 ± 0,58)% respectively, (p <0.01). At the same time there was a tendency to increase in CD21 + and CD16 + (20,21 ± 0,30) and (13,21 ± 0,52) respectively (p> 0.05). Index of CD4 + / CD8 + decreased to (1,35 ± 0,04) (p <0.01).
When comparing indicators of the children in the acute phase of the disease one observed a significant increase of CD3 + and reduction of CD16 + in children of the group II comparing with the group I (p <0.01). At this time, there was a slight increase of CD8 + and CD21 + and reduction of CD4 + in the second group of patients.
Thus, in the course of the study it was found out the increasing of CD8 + and CD21 + and reduction of CD3 +, CD4 + and CD16 + in children of both groups on admission to hospital. Convalescence period was characterized by indicators change, but they did not reach the level of the control group of children. These changes are probably due to inhibition of the immune cells function. In the course of the study one has noted the significant difference between CD3 + (45,13 ± 0,55) and (47,68 ± 0,72), and CD16 + (14,94 ± 0,62) and (11,84 ± 0, 65) respectively, of cellular immunity in children having mono- and mixed-version of infection (p <0.01).
Conclusions:
1. Children suffering from mono-version of rotavirus disease had immune status characterized by T- lymphopenia, reduction of CD3 +, CD4 +, CD16 +concentration and immunoregulatory index, increased level of CD8 +, CD21 +. 3. During early recovery one observed positive indicators dynamics but not their complete normalization.
2. In patients having mixed-version of rotavirus infection at the height of the disease there was noted the reduction of CD3 +, CD4 +, CD16 + and immunoregulatory index, increased level of CD8 +, CD21 + comparing with that of healthy children. After the basic treatment dynamics of the indicators normalization was less intense than in children having mono- version of rotavirus infection.
3. When comparing study results of the children from the group I and II one can see a significant reduction of CD3 + and CD16 + (p <0.01) in patients having mixed- version of rotavirus infection.
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