EFFECT OF IMMUNOMODULATING THERAPY ON THE CONDITION OF SPECIFIC HUMORAL IMMUNITY IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH IHD

Pavlova Ye. A. EFFECT OF IMMUNOMODULATING THERAPY ON THE CONDITION OF SPECIFIC HUMORAL IMMUNITY IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH IHD. Актуальні проблеми транспортної медицини / Actual problems of transport medicine / 2019;2(56):78-84. ISSN 1818-9385 DOI http://dx.doi.org/10.5281/zenodo.3251614 http://aptm.org.ua EFFECT OF IMMUNOMODULATING THERAPY ON THE CONDITION OF SPECIFIC HUMORAL IMMUNITY IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH IHD Ye. A. Pavlova Kharkov National Medical University, Kharkov, Ukraine Summary Reduction of renal function is an important cause of the development of pathological changes in the cardiovascular system, that due to a number of metabolic and hemodynamic disorders, that develop in patients with reduced glomerular filtration rate, when to the fore stand out “Renal” factors of cardiovascular risk: albuminuria / proteinuria, systemic inflammation, oxidative stress, etc. The latter is accompanied by a violation of the effector functions of cells, inter-cell interactions in the dynamics of the immune response, which usually determines the rate of disease progression. The aim of this work was to study of the effect of immunomodulatory therapy on the state of a specific humoral immunity with the progression of chronic kidney disease in patients with coronary artery disease before and after treatment. Observed 20 people (35 — 65 years). 10 people (control) — patients with coronary artery disease (CAD) associated with hypertension, stage II, (stable angina — 2 FC (according to the criteria of the New York Heart Association (NYHA)). (group B) — 10 patients (CAD, associated with hypertension and CKD in lightly reduced glomerular filtration rate (60-89ml / hv / 1,73m2)). The calculation of glomerular filtration rate was performed using the formula D. W. Coccroft і M. N. Gault. (The level of serum creatinine, age, gender, and body weight were taken into account). The level of circulating immune complexes (CIC) in serum was determined on a spectrophotometer at a wavelength of 450 nm after precipitation of 3.5 % and 7 % solution of polyethylene glycol 6000 (method of Grinevich Yu.A.) The content of serum IgA, IgM, IgG was determined by the method of radial immunodiffusion in a gel (G. Manchini) using sets of monospecific anti-serum kits to immunoglobulins. As an immunomodulator, 2 ml twice a day for 10 days intramuscularly used the drug (Erbisol). Mathematical calculations were performed using the STATISTICA v.6.0 package (StatSoft, Inc ®). Established, that humoral specific immunity with the progression of chronic kidney disease in patients with IHD, reacts by stimulating Ig-producing cells, which is accompanied by an increase in serum IgA, IgG, IgM and CIC before treatment, the latter is probably associated with permanent tissue damage. After immunotherapy, there is a decrease in the stimulation of Ig-produced B-lymphocyte function, so that serum IgA and IgM levels (antibodies of the acute phase) decrease relative to the initial level, and IgG (antibodies of the secondary immune response) increases, indicating that the activation sequence is restored cells — IgM producers for IgG-producers, and may indicate on the regression of inflammatory tissue damage. Key words: ischemic heart disease, chronic kidney disease, humoral specific immunity