SPECIAL FEATURES OF CHANGES IN INDICATORS OF THE IMMUNE SYSTEM IN PATIENTS WITH ATHEROSCLEROSIS

A. Prudnikov, A. Shchupakova
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Abstract

In patients with various forms of coronary heart disease (effort angina pectoris of tension II functional class (EAP II FC), myocardial infarction (MI)) an imbalance of immunological reactivity was revealed compared to practically healthy individuals, which was manifested by the increasing of the IL-6 concentration, IL-8, IgA, BAPNA-amidase activity, B-lymphocytes count, circulating immune complexes (CIC) and the decreasing of T-lymphocytes count, IgM and IgG concentration. It was also found that in patients with MI and EAP II FC, atherosclerosis was not limited to only one vascular region, lesions of the extracranial sections of the cerebral arteries, abdominal part of the aorta, arteries of the lower extremities were also recorded. The lesion of extracranial cerebral arteries in patients with EAP II FC was accompanied by the increase of neutrophil elastase activity, the number of СIC and the decrease of IgM concentration, IL-4, B-lymphocytes count, and in patients with MI it was accompanied by the increase of T-lymphocytes count and the decrease of B-lymphocytes count. When the abdominal aorta was affected, patients with EAP II FC had increased T-lymphocytes count, neutrophils and decreased IgM concentration, and patients with MI had increased T-lymphocytes count. The lesion of the lower extremities arteries in patients with EAP II FC was accompanied by the increase of T-lymphocytes count, sVCAM-1 adhesion molecules, the decrease of IgM concentration, BAPNA-amidase activity, and in patients with MI it was accompanied by the increasing of monocytes count, concentration of sVCAM-1 molecules and the decreasing of IL-6 concentration. At the same time, the development of multifocal atherosclerotic lesion (MFA) of peripheral arteries was accompanied only by the decrease of IgM concentration in patients with EAP II FC. The lesion of the anterior interventricular artery in patients with EAP II FC was combined with the increase of sVCAM-1 molecules concentration, and in patients with MI it was combined with the increase of IgG concentration and the decrease of IL-10 concentration. The lesion of the circumflex artery in patients with EAP II FC was combined with the increase of CIC concentration, TNF-α, and in patients with MI it was combined with increased IL-6 concentration. The lesion of the right coronary artery was not accompanied by any significant change in the immune system indicators in the studied groups of patients.
动脉粥样硬化患者免疫系统指标变化的特殊特征
各种形式冠心病(紧张性ⅱ功能级心绞痛(EAPⅱFC)、心肌梗死(MI))患者的免疫反应性与实际健康人相比存在失衡,表现为白细胞介素6 (IL-6)、白细胞介素8 (IL-8)、IgA、bapna -酰胺酶活性、b淋巴细胞计数、循环免疫复合物(CIC)升高,t淋巴细胞计数、IgM和IgG浓度降低。我们还发现,在心肌梗死和EAPⅱ型FC患者中,动脉粥样硬化不仅局限于一个血管区域,还记录了脑动脉颅外段、主动脉腹段、下肢动脉的病变。EAPⅱ型FC患者颅内外脑动脉病变伴中性粒细胞弹性酶活性升高、СIC数量增加,IgM浓度、IL-4、b淋巴细胞计数降低,MI患者伴t淋巴细胞计数升高、b淋巴细胞计数降低。当腹主动脉受影响时,EAPⅱ型FC患者t淋巴细胞计数增加,中性粒细胞增加,IgM浓度降低,MI患者t淋巴细胞计数增加。EAPⅱ型FC患者下肢动脉病变伴t淋巴细胞计数、sVCAM-1粘附分子升高、IgM浓度、bapna -酰胺酶活性降低,MI患者伴单核细胞计数、sVCAM-1分子浓度升高、IL-6浓度降低。同时,外周动脉多灶性动脉粥样硬化病变(MFA)的发展仅伴随EAP II型FC患者IgM浓度的降低。EAPⅱ型FC患者室间前动脉病变合并sVCAM-1分子浓度升高,MI患者合并IgG浓度升高、IL-10浓度降低。EAPⅱ型FC患者旋动脉病变合并CIC浓度、TNF-α升高,MI患者合并IL-6浓度升高。右冠状动脉病变未伴研究组患者免疫系统指标发生明显变化。
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