Regularities of changes in a1-antitrypsin level in patients with chronic lymphocytic leukemia

Introduction. The mainfunction of alpha-1 antitrypsin (A1AT) is inhibition of neutrophil elastinase and control over TNFα secretion. Anti-inflammatory properties of A1ATare manifested in leucocyte migration decrease and proliferation of T-lymphocytes through an increase in the amount of cAMP in the cells. Study objective. To examine the level of A1AT in chronic lymphocytic leukemia (CLL) patients at different stages of the progression of the main disease, as well as depending on the type of infectious complications and location of the pathological process. Methods. Data of 177 CLL patients in dynamics were analyzed. Methods for examining etiologic agents of CLL infectious complications were applied according to Order No.535 «On Unification of Microbiological (Bacteriological) Examination Methods, Applied in Treatment and Diagnostic Laboratories of Medical and Preventive Institutions» dated April 22, 1985. ELISA method was applied to identify antibodies to the viruses Varicella zoster, Cytomegalovirus. A1AT concentration also was measured with ELISA method with the use of test systems IDKa1-Antitrypsin Clearance ELISA (Immundiagnostik AG company, Bensheim). Results. The examination of the A1AT concentration mostly showed its moderate increase under bacterial infections. A significant increase in the A1AT content with respect to the normal values was identified under viral and mycotic complications. Significant difference between the serum A1AT level under the treatment of infectious complications and their base values was identified (р<0,001): after the beginning of the treatment of infectious complications, the A1AT level increased by 24,7% under bacterial complications, by 9,8% under viral complications and by 7,0% under mycoses. The A1AT level became 1,5-2 times lower during the stabilization of the process and leveling of clinical implications of the infection. Conclusion. The mechanism of the А1АТ level increase under the effect of the medications may be associated both with the death of infectious agents, the destruction of which causes release of pyrogenic agents and endotoxins, triggering the mechanisms of inflammatory reaction development and causing significant release of А1АТ in patients with CLL, and with a hepatotoxic effect of chemotherapy. Therefore, measurements of the A1AT level can be used to control effectiveness of treatment of infectious complications in patients with CLL.

chronic lymphocytic leukemia, alpha-1 antitrypsin