THE CONDITION OF CELLULAR IMMUNITY IN PATIENTS WITH OSTEOARTHROSIS BEFORE AND AFTER ENDOPROSTHESIS IMPLANTATION

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Abstract

Impairments of immune system are an important mechanism of the degenerative dystrophic processes in the arthral tissues onset and development.The objective of this research was to study the cellular immunity condition in patients with osteoarthrosis before and after endoprosthesis implantation. The research methods included immunophenotyping of lymphocytes in the peripheral blood. The immunologic impairments before the surgery referred to change in T-cell immunity reflecting in the imbalance of immunoregulatory subpopulations (decrease of T-suppressor level and increase of T-helper content). At that the number of NK-cells rose which didn’t exclude a possible connection with the cartilage tissue degradation impurities on the background of B-cell number decrease. During the post-surgery period the decrease in T-helper and T-suppressor numbers was detected which may be related to their migration to implantation area due to the decrease of their number in the systemic circulation, at that no significant changes in T-lymphocytes were observed. By contrast, there was a decrease of NK-cell number at higher level of B-cell number showing an adequate response of the bodies for surgery aggression. The results of immunological research are worth being taken into account when preparing patients for endoprosthesis implantation surgery for the purpose of prescribing the immune-correcting drugs for pre-existing impairments of cellular immunity as well as in the post-surgery period to relieve the effects of surgical interference aggravating the impairments in this population of patients.

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Introduction. Impairments of immune system are an important mechanism of the degenerative dystrophic processes in the arthral tissues onset and development [1, 2]. The objective is researching of the cellular immunity condition in patients with osteoarthrosis before and after endoprosthesis implantation. Material and methods. Knee endoprosthesis implantation was performed on 23 female patients with III-IV stages of post-traumatic osteoarthrosis. The control group consisted of 11 women of the similar age. Lymphocytes immunophenotyping was performed using the laser flow cytofluorometry method on BD FACSCantoII cytometer (BD, США). The results are presented in the form of a median with the lowest and the topmost quartiles being indicated. Results and discussion. Compared to indices in the control group, the decrease in T-lymphocyte number was observed in patients before the surgery mainly owing to T-suppressors on the background of the increase in T-helper number and NK-cell number with the moderate decrease in B-cell number (Table 1). During the post-surgery period, the decrease in T-helper and T-suppressor numbers in patients was established which may be related to their migration to implantation area due to the decrease of their number in the systemic circulation, at that no significant changes in T-lymphocytes were observed. At the same time there was a decrease of NK-cell number at higher level of B-cell number (Table 1). Conclusion. The results of this research are worth being taken into account when preparing patients for endoprosthesis implantation surgery for the purpose of prescribing the immune-correcting drugs for pre-existing impairments of cellular immunity as well as in the post- surgery period to relieve the effects of surgical interference aggravating the impairments in this population of patients.
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About the authors

S V Belova

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Saratov

E V Gladkova

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Saratov

V Yu Ulyanov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Saratov

R A Zubavlenko

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Saratov

V V Blinnikova

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V.I. Razumovsky, Saratov

References

  1. Dmitrieva LA, Korshunova EY, Lebedev VF. Immunological Manifestations in Patients with Severe Coxarthrosis. Medical Immunology. 2009;2(3):161-168.
  2. Popkov VM, et al. Cytokines: Their Biologic Role in The Development of Adjustment and Damage Response Under Normal and Pathological Conditions of Various Genesis. Saratov: Saratov State Medical University n.a. V.I. Razumovsky; 2016. 448 p.

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Copyright (c) 2019 Belova S.V., Gladkova E.V., Ulyanov V.Y., Zubavlenko R.A., Blinnikova V.V.

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