[Frequency of opportunistic infections in children with immune neutropenia and their mothers].

AIM: Determine the frequency of opportunistic infections among children with immune neutropenia and their mothers. MATERIALS AND METHODS: 66 mothers and 66 children with immune neutropenia diagnosis were examined for the presence of herpes (HV) and pneumocystic infection. Opportunistic infections markers (IgM, IgG, early and late antigens, virus reproduction) were determined by enzyme immunoassay, immunofluorescence reaction and rapid culture method (vero, u937, human fibroblasts). RESULTS: Pneumocystosis was the most active infection in the group. Among mothers 26 (39.3%) cases of pneumocystic infection in acute form were detected, among children - 18 (27.3%) cases. Infection occurred only in acute form during primary infection; there were no cases of its reactivation, which is an indication of recent pneumocystosis infection. Analysis of data on detection of acute and recent herpes infections showed that HV infection markers were determined in a relatively large number of mothers and their children: herpes simplex virus - 21.2%, Epstein-Barr virus - 12.0%, cytomegalovirus - 15.0%, Human herpesvirus 6 - 10.6%, Pneumocystis carinii - 21.2%. The data provided give evidence on a possible family pattern of the infection. CONCLUSION: A necessity of examination of mothers and their children suffering from immune neutropenia was shown because the specified opportunistic infections can form intra-family foci. The presence of acute form of infection in mother may be one of the conditions of development of this infection in the child.

[Toll-like receptor-mediated functional activity of mononuclear cells in children with neutropenia].

AIM: To study the Toll-like receptor (TLR)-mediated functional activity of peripheral blood mononuclear cells (PBMC) from children with different forms of neutropenia. MATERIALS AND METHODS: TLR-mediated functional activity of PBMC was evaluated by production of proinflammatory cytokines--TNF alpha and IFN alpha. Ligands for TLR1/2, TLR 2/6, TLR4, TLR5, and TLR9 were used to stimulate TNF alpha production by PBMC from healthy children and children with neutropenia. Ligands for TLR3, TLR4, TLR7, TLR7/8, TLR8, and TLR9 were used to induce production of IFN alpha. Levels of TNF alpha and IFN alpha were measured in PBMC supernatants by ELISA. The group of patients with neutropenia included 9 children with immune neutropenia and 3 children with congenital neutropenia. Control group consisted of 12 healthy children of the same age range. RESULTS: It was revealed that TLR2, TLR4, and TLR5 ligands have enhanced stimulating effect on TNF alpha production by PBMC of children with congenital neutropenia and had no effect on PBMC of children with immune neutropenia. Children with immune neutropenia are characterized by significantly increased IFN alpha production induced by ligands of TLR3, TLR8, and TLR9. CONCLUSION: Revealed changes of TLR-mediated functional activity of PBMC from children with various forms of neutropenia may play significant role in development and course of infections in these patients.

[Cyclic neutropenia: a disease or a syndrome?]. / Tsiklicheskaia neitropeniia, zabolevanie ili sindrom!

Peripheral blood and bone marrow morphology, blood and bone marrow lymphocyte subpopulation composition were studied in two children with cyclic neutropenia, using flow cytofluorometry, monoclonal antibodies, colony-forming capacity of granulocytic macrophagal precursors in semi-fluid agar. The studies were conducted in varying periods of the neutropenic cycle. Differences were revealed in immunohematologic parameters and clinical course of neutropenia in the two patients. The analysis of the literature data and the authors' own observations of the patients with cyclic neutropenia permitted a suggestion on high heterogeneity of pathogenetic mechanisms of this disease.

[Phenotyping of blood and bone marrow lymphocytes in children with primary immunologic deficiency]. / Fenotipirovanie limfotsitov krovi i kostnogo mozga u detei s pervichnoi immunnoi nedostatochnost'iu.

Subpopulational composition of peripheral blood and bone marrow lymphocytes was studied in 17 children with different forms of immunodeficiency, combined with hematological shifts (agammaglobulinemia--6, mucocutaneous candidiasis--2, selective IgG-deficiency--2, hyper-IgM syndrome--3, cephalo-oculocutaneous telangiectasia (COCT)--2, general, variable immunodeficiency--2 patients; neutropenia was observed in all the patients, lymphopenia--in 13, anemia-in 6 patients. Surface markers were assayed by flow cytofluorometry with monoclonal antibodies OKT3, OKT4, OKT8, OKB7, produced by "Ortho diagnostics". Changes characteristic of certain forms of primary immunodeficiency have been revealed in the subpopulational composition of peripheral blood and bone marrow lymphocytes: decreased helper potential in patients with general variable immunodeficiency, T-lymphocyte deficiency in patients with COCT increased number of phenotype T3 cells and decreased amount of B-cell in agammaglobulinemia patients. Significant heterogeneity has been noted in the parameters of hemogram, myelogram and in the subpopulational composition of peripheral blood and bone marrow lymphocytes in each nosologic form, the group of patients with hyper-IgM syndrome has proved to be most heterogeneic. It has been suggested that the changes in the subpopulational composition of bone marrow lymphocytes may be responsible for primary immunodeficiency and disorders in hemopoiesis.

[Immunohematologic characteristics and course of chronic neutropenia in children with severe decrease of granulocyte maturation]. / Immunogematologicheskaia kharakteristika i techenie khronicheskikh neitropenii u detei s vysokim obryvom sozrevaniia granulotsitov.

The clinical course and some immunohematologic parameters of the blood and bone marrow were investigated in chronic neutropenia children with a high break of granulocyte maturation. Heterogeneity of etiopathogenetic mechanisms of the disease has been recorded in this group of children.