Immunological reactivity among young patients with community-acquired pneumonia and cytomegaloviral persistence
DOI:
https://doi.org/10.14739/2310-1210.2018.6.146575Keywords:
pneumonia, young adult, cytomegalovirus infection, immunosuppression, PORTAbstract
The article discusses the main basic immunological changes among patients with community-acquired pneumonia (CAP) and cytomegaloviral infection (CMVI), the group is compared with control one and with CMVI-negative individuals. The research data are used for diagnostic approach optimization on the part of immunology among immunocompetent young patients and CAP-prognosis (by PORT scale) according to CMVI occurrence and persistence.
The aim is to recognize the main cell and humor disturbances in immunological reactivity among CAP-patients with CMVI persistence and their influence on CAP course and prognosis.
Materials and methods. One hundred and five CAP-patients (51 (48.6 %) males, 54 (51.4 %) females) and 61 healthy individuals (26 (42,6%) males, 35 (57.4 %) females) have been examined according to clinical, laboratory and instrumental standards regulated by the MH of Ukraine. All responders were additionally studied for CMVI persistence (CMV IgM, CMV IgG, CMV IgG-avidity) and immunological test of cellular (CD3, CD4, CD8, CD22) and humoral (IgA, IgM, IgG) immunity.
Results. CMVI persistence was prevailed significantly higher (P = 0.003) among the CAP-patients (80 (48.2 %) patients) than in the control group (34 (20.5 %) responders) and was mostly characterized by high avidity level (51 (48.6 %) patients (P = 0.007)). The percentage of CD22 increased with age among the CAP-patients (χ2 = 8.479; P = 0.037) and made up (15.5 ± 7.19) % in the group of 18–20 years old compared to the group of 30–39 years old – (22.07 ± 6.06) %. The healthy individuals were characterized by CD4 decreasing with age (χ2 = 8.585; P = 0.037). The number of respondents with decreased levels of CD4 (P = 0.032), IgA (P = 0.005), IgM (P = 0.018), IgG (P = 0.009) was significantly higher among the CAP-patients than in the control group. Decrease in СD3, CD4, CD8 values was statistically significant with CAP severity increasing by PORT score (P < 0.0001). CD3 ((47.353 ± 1.503) %) and CD4 ((27.137 ± 0.992) %) levels were significantly higher in the CAP-group patients with high CMV IgG-avidity than in those ones with moderate ((46.174 ± 2.044) % and (25.696 ± 0.944) %, respectively) and low avidity ((39.429 ± 1.730) % and (22.429 ± 1.837) %, respectively) (P < 0.0001). The amount of lymphocytes, CD4, CD8 was significantly lower among the CMV-positive CAP-patients. Their deficiency progressed with the mortality risk score by PORT.
Conclusions: The CMV-positive CAP-patients differ statistically significantly by immunological reactivity from CMV-negative respondents and healthy ones (P < 0.05). The progression of cellular (lymphocytes, CD3, CD4, CD8, CD22) and humoral (IgA, IgM, IgG) immunosuppression depends on the duration of CMV persistence (by avidity level) and CAP severity level (by PORT score).
References
Makarchuk, P., Belousova, E., Volchkova, E., & Kudriavtseva, E. (2017). P517 Features of cytomegalovirus infection in inflammatory bowel disease. Journal of Crohn's and Colitis, 11(1), 343–343. https://doi.org/10.1093/ecco-jcc/jjx002.641.
Merhi, B., Bayliss, G., & Gohh, R. Y. (2015). Role for urinary biomarkers in diagnosis of acute rejection in the transplanted kidney. World journal of transplantation, 5(4), 251. doi: [10.5500/wjt.v5.i4.251].
Lytvynets, Y., & Fedoriv, A. (2018). Ethiopathogenetic Peculiarities of Diagnosis, Clinical Course and Treatment of Chronic Abacterial Prostatitis. Galician Medical Journal, 24(4), E201742. doi: 10.21802/gmj.2017.4.2.
Chichirello-Konstantinovich, K., Konstantynovych, T., & Moroz, L. (2017). Peculiarities of Immune Status among Young Patients with Community-Acquired Pneumonia (CAP) during Cytomegaloviral Persistence (CMVP). European Respiratory Journal, 50(61), PA987. doi: 10.1183/1393003.congress-2017.PA987.
Moroz, L. V., Chichirello-Konstantinovich, K. D., & Konstantynovych, T. V. (2015). Poshyrenist ta osoblyvosti persystentsii tsytomehalovirusnoi infektsii pry nehospitalnii pnevmonii [Prevalance and characteristics of persistent cytomegalovirus infection with community-acquired pneumonia]. Visnyk morfolohii, 21(2), 404–407. [in Ukrainian].
Levkovich, A. Y., Afonin, A. A., Levkovich, M. A., & Kravchenko, L. V. (2016). G61 (P) New mechanisms of formation of a generalised cytomegalovirus infection in newborns. British Paediatric Allergy Immunology and Infection and British Society of Paediatric Gastroenterology, Hepatology and Nutrition, 101, 35. http://dx.doi.org/10.1136/archdischild-2016-310863.58.
Rájová, J., Pantůček, R., Petráš, P., Varbanovová, I., Mašlaňová, I., & Beneš, J. (2016). Necrotizing pneumonia due to clonally diverse Staphylococcus aureus strains producing Panton-Valentine leukocidin: the Czech experience. Epidemiology & Infection, 144(3), 507–15. doi: 10.1017/S0950268815001521.
Ma, W. Y., Peng, S., & Zhang, T. (2017). Changes in serum YKL-40 level and humoral immune function and their significance in children with recurrent pneumonia. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics, 19(4), 425–429. doi: 10.7499/j.issn.1008-8830.2017.04.013}.
Terrazzini, N., & Kern, F. (2014). Cell-mediated immunity to human CMV infection: a brief overview. F1000Prime Rep, 6, 28. doi: [10.12703/P6-28].
Feshchenko, Yu. I., Holubovska, O. A., & Goncharov, K. A. (2014). Nehospitalna ta hospitalna (nozokomialna) pnenmoniіa u doroslykh osib: etiolohiia, patohenez, klasyfikatsiia, diahnostyka, antybakterialna terapiia [Community-acquired and nosocomial pneumonia in adults: etiology, pathogenesis, classification, diagnostics, antibiotic therapy]. Kyiv. [in Ukrainian].
National Committee for Clinical Laboratory Standards (1998). Procedures for the collection of diagnostic blood specimens by venipuncture. Wayne, Pa.: NCCLS.
Pokrovskij, V. I., Tvorogova, M. G., & Shipulin, G. A.(Eds.) (2013). Laboratornaya diagnostika infekcionnykh boleznej [Laboratory diagnostics of infectious diseases]. Moscow: Binom. [in Russian].
Mel'nik, A. A. (2011) Klinicheskie laboratornye testy dlya prakticheskoj medicyny, ikh interpretaciya [Clinical laboratory tests for practical medicine, their interpritation]. Kyiv: Kniga-plyus. [in Russian]. 288
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)