Levels of E, A, M, G immunoglobulins in children with newly diagnosed tuberculosis at the beginning of antimycobacterial therapy

Abstract

Tuberculosis in children is a chronic inflammatory process in which immunological mechanisms occupy one of the leading positions in pathogenesis. Therefore, the immune status indicators study among children makes it possible to determine the disease activity, predict its course for the purpose of revealed violations early correction and determine the effectiveness of the treatment. One of the immunological indicators of tuberculosis is immunoglobulins level.

The aim of the work – To investigate IgE, A, M, G levels in children’s blood serum with newly diagnosed tuberculosis at the beginning of antimycobacterial therapy for further development of rationally directed immunocorrective therapy.

Materials and Methods. The study of IgE, A, M, G levels in blood serum was performed in 28 children with newly diagnosed tuberculosis aged 1 to 16 years (average age was 9.2 ± 1.1 years old). The levels of IgE, IgA, IgM and IgG in the blood serum were studied using the method of solid phase enzyme-linked immunosorbent assay on the equipment of the Sirio S immuno-enzyme reader with the use of reagent kits “Granum” LLC (Kharkiv, Ukraine). The results of the study were processed by modern methods of analysis on a personal computer using statistical software package Statistica^® for Windows 6.0 (StatSoft Inc., AXXR712 D833214FAN5).

Results. Children with newly diagnosed tuberculosis at the beginning of the intensive phase of antimycobacterial therapy had a significant increase in IgE and A levels in 2.1 and 1.2 times respectively. With an increase in the prevalence of a specific process and the appearance of destruction, there is a significant increase in the IgG level in 1.2 times. Direct correlations between IgE and IgA, IgA and IgM, IgM and IgG in the disseminated process, and IgA, IgM levels in the local process have been found. A reliable correlation between the decrease in the BCG post-vaccination sign size and the increase in IgE content has been revealed, that may be a prognostic factor in the post-vaccination immunity evaluation. Cellular component of immune system activation is determined in the children, as evidenced by a significant increase in albumins level in 1.5 times against the background of the specific inflammatory process low activity (α₁ and α₂-globulins levels were within the age norm). There is a significant worsening of dysproteinemia (a decrease in albumin levels by 9 % and an increase in β- and γ-globulins levels in 1.3 times) and specific inflammatory process activity (an increase in α₁-globulin level in 1.3 times) with the increase in the specific process prevalence and destruction development. It has been established that the decrease in the albumin level is associated with growth in the IgE, A and G levels; growth in the β-globulin level is associated with growth in the IgA and G levels, and with IgE, M, and G – in γ-globulins. It has been found that IgA, M and G, and the protein fractions parameters – albumins, β and γ-globulins are significant and highly informative for the immune changes diagnosis in children with newly diagnosed tuberculosis.

Conclusions. In children with newly diagnosed pulmonary tuberculosis at the beginning of an intensive phase of antimycobacterial therapy with increase in the specific process prevalence and destruction development, significant changes in the levels of immunoglobulins and protein fractions are observed. Data resulting from the study suggest that the humoral component of immune system is also activated on the background of the cellular component of immune system activation with patient's state aggravation, which is an unfavorable prognosis for patients’ recovery.