- Characteristic of the immunological changes at different stages of juvenile rheumatoid and reactive children’s arthritis
Characteristic of the immunological changes at different stages of juvenile rheumatoid and reactive children’s arthritis
PERINATOLOGIYA I PEDIATRIYA.2014.2(58):64-67; doi 10.15574/PP.2014.58.64
Characteristic of the immunological changes at different stages of juvenile rheumatoid and reactive children's arthritis
Lebec I. S., Panko N. O., Nelina I. M.
SE «Institute for Children and Adolescents Health Care of NAMS of Ukraine», Kharkiv, Ukraine
Purpose: the difficulty of the differential diagnosis of juvenile rheumatoid arthritis (JRA) and reactive arthritis (ReA) in the early stages of their development is not only due to the similarity in clinical symptoms, but also with changes in the immune system.
Patients and methods: there were involved 128 children within 2–18 years with symptoms of arthritis, who were hospitalized in the clinic of SE «Institute for Children and Adolescents Health Care of NAMS of Ukraine». In a cellular link of immunity subpopulation of lymphocytes (CD3, CD4, CD8, CD22) was determined by membrane immunofluorescence method with monoclonal antibodies. Level of serum immunoglobulins (Ig) class A, M, G was determined by spectrophotometric method, the concentration of circulating immune complexes (CIC) was defined by screening test, the content of complement was determined by Chudomels method. Content interleukins (IL-1β, IL-6, TNF-a) was studied by ELISA. The deviations frequency of an immunological parameters were determined based on the age and sex of the child.
Results and Conclusions. Thus, JRA, starting from the first weeks of disease, characterized by decreased activity of T-lymphocytes, imbalance in the processes of phagocytosis and its deficiency, there were heightened readiness and responsiveness by the reduction in its activity.
The distinctive feature of JRA was a significant sustained increase of IL 6 after its debut and the stages of its subsequent evolution. At ReA changes of cellular immunity manifested mainly in the form of relative decline of CD8 regardless of disease duration. The function of phagocytic cells in patients with ReA was changed like JRA and humoral shifts were characterized by an increase in Ig M and Ig G, generally on the early stages of the ReA. From the pro-inflammatory cytokines as in JRA, there was an increased level of IL 6, but only in the debut of the pathological process against the background of its greatest activity.
Key words: juvenile rheumatoid arthritis, reactive arthritis, immunological violations, children.
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