[Studying of cytokine dynamics in injured persons with severe burns for estimation of severity and prognosis].

Dynamics of a blood serum concentration of tumor necrosis factor-alpha (TNF- alpha), interleukines (IL-1beta, IL-10) in 35 patients, suffering severe burn, and possibility of application of these indices as biomarkers of the severity state and the complications prognosis, were studied. During the investigation there was established, that TNF-alpha concentration on the 8 - 10th and 19 - 21th day after trauma does the best for characterization of a burn total area, while the IL-1beta concentration on the 8 - 10th day after trauma - the deep affections severity and the IL-10 concentration on the 19 - 21th day after trauma - the deep affections severity. Hyperreactivity, caused by enhanced production of TNF-alpha, IL-1beta and IL-10, witnesses the raised risk of development of the organs complications. And adversely, hypo- and areactivity in extended and deep burns witnesses about enhanced risk of lethality. The blood serum concentration of TNF-alpha, IL-1beta and IL-10 is expedient to use as a biomarkers of the patients state severity and for the course prognosis of pathological process.

[FREQUENCY OF IMMUNOGLOBULIN E DEFICIENCY AMONG PATIENTS WITH IMMUNODEPENDENT DISORDERS].

Isolated IgE deficiency is one of the most common primary immunodeficiency, which is still underestimated cause of health disorders of modern man. Recent genetic studies report that the cause of the IgE deficiency is immune dysregulation caused by polymorphisms of the gene, which is responsible for the synthesis of activation-induced cytidinedeaminase (AICDA). The Institute of Immunology and Allergology at Bogomolets NMU during the years 2012-2014 were examined 5298 patients with a range of different diseases, which could be suspected violations of immunity. All patients were conducted comprehensive immunological study, and 4476 of them were examined for content of total serum IgE. The criterion for the selection of patients for follow-up began serum IgE < 10 kIU/l. Serum immunoglobulin E was determined by ELISA. Serum IgE < 10 IU/ml was detected in 342 patients (7%). Average reduction in the study group made up (5.30 ± 1.31) IU/ml. Partial deficiency (5-10 kIU/l) was detected in 212 patients (4%), while the total--130 (3%). For follow-up, we are clinically selected group of patients with deficiency of IgE (n = 60) and control group (n = 30). All patients were distributed as per clinical syndromes, and the frequency of their manifestations: sinopulmonary syndrome (63%), gastrointestinal syndrome (13%), autoimmune manifestations (10%), allergic reactions (7%) and chronic fatigue syndrome (7%). The levels of serum IgG, IgA, IgM in the study group were within the age norm (IgG = 1160.00 mg/dl ± 2.88 mg/dl, IgA = 138 g/l ± 37 mg/dl, IgM = 114 mg/dl ± 30 mg/dl). However, only a small proportion of patients was observed decrease in other classes of immunoglobulins in 8 patients with IgG < 700 mg/dL in 16 patients with IgA < 90 mg/dl and 6 patients with decreased serum IgM < 90 mg/dl. These patients were examined the levels of serum IgG subclasses and sIgA levels in saliva. Significant violations by cellular immunity in determining lymphocyte subpopulations by flow cytometry using monoclonal antibodies also were found. Phagocytic indices were also no significant abnormalities. An important aspect of clinical deficiency of immunoglobulin E is its association with diseases of bacterial origin (H. influenza, M. catarrhalis, Str. pneumoniae), indicating a protective role of these antibodies in the mucosa of the respiratory tract. Thus, isolated IgE deficiency is associated with sustained decrease in serum concentrations of immunoglobulin E (< 10 kIU/l) in patients with normal immune status of other indicators that require dispensary and treatment. The results of their study indicate a high incidence of the IgE-deficiency among the population and its high incidence among the humoral defects.