THE OUTCOME OF CEREBRAL PATHOLOGY BY THE END OF THE FIRST YEAR OF LIFE IN NEWBORN BABIES WITH CYTOMEGALOVIRUS INFECTION

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Objective: to study costimulatory molecules (CD28, CD40) on lymphocytes of the peripheral blood in newborn babies with CMVI and to determine prognostic indices of the cerebral pathology outcome by the end of the first year of life. We examined 114 children at the age of three months, who had CMVI during neonatal period. In 37 children neurological symptoms remained by the end of the first year of life. At 37 children the neurologic symptomatology by the end of the first year of life remained: delay of psychomotor development (44.8%), deafness (5.9%), epilepsy (11.9%), spastic tetraparesis (32.2%) blindness (13.4%). At 77 children was absent neurologic symptomatology by the end of the first year of life. A control group was comprised of 15 healthy newborns. The content of lymphocytes, expressing CD28, CD40, CD3+, CD4+, CD28+, CD20+, was determined using laser flow cytofluorometer “Beckman COULTER” Epics XL II (USA) by means of monoclonal antibodies to the clusters of differentiation CD3+, CD20+, CD4+, CD28+, CD40+ of IMMUNOTECH Company (France). The analysis of multidimentional nonlinear dependencies was performed using PolyAnalist 3.5. Pro package. The formula of the forecast of preservation of neurologic symptomatology is calculated. ((CD3-CD28+ * 0.074) + CD4+ * (-0.182) + (CD3+CD28- * 0.035) + CD40 * (-0.2862) + CD3 * 0.1062) + + (CD28 * 0.1952)) - 0.4588. If the result of the calculation according to the formula is > 0.39, than a child will have brain damages by the end of the first year of life. Sensitivity - 71.43%, specificity - 88.89%. The likelihood ratio of the positive result is 13.5. The determination of CD3+T-lymphocytes, lymphocytes, expressing CD28 in the total population, T-lymphocytes without the costimulatory marker CD28 (CD3+CD28-) and also B-lymphocytes, expressing CD40 on their surface, is significant for the prognosis of neurological symptomatology preservation by the end of the first year of life. Keywords: neonates; cytomegalovirusinfection; lymphocytes.

About the authors

L V Kravchenko

Rostov State Medical University, Rostov-on-Don

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