Antiendotoxin Immunity and C-Reactive Protein Level in Patients with Diffuse Toxic Goiter and Heart Pathology

Abstract

The changes in cardiovascular system take one of the leading places in the clinic of diffuse toxic goiter (DTG) and can define prognosis for a disease. Endotoxin (ET) can be the inductor of a systemic inflammation in patients with DTG and aggravate its clinical course. From there, the purpose of this work was to study humoral and cellular antiendotoxin immunity and C-reactive protein (CRP) level in patients with heart pathology. The level of antiendotoxin antibodies and CRP were studied by enzyme-linked immunosorbent assay. As an antigen, we used ET of the Gram-negative Escheriсhia coli K30 (09:K30:P12), isolated from bacterial biomass by method of water phenol extraction and additionally purified from RNA admixtures using cetavlon processing (Serva, Германия). Receptors to ET were determined by flow lase cytometry using a two-color immunofluorescence analysis using a monoclonal anti-CD14-PE IOTest® (CD14) and conjugate of lipopolysaccharide Escherichia coli K235 with fluorescein isothiocyanate (ET-P). For the study we allocated 3 groups of patients. The first group included 11 patients with DTG who do not have heart disease, the second group consisted of 47 patients with DTG and endocrine cardiomyopathy complicated by arrhythmia, and the third group — 13 patients with DTG and concomitant ischemic heart disease (IHD). Control group consisted of 33 apparently healthy subjects. It is found that in all patients with DTG and heart pathology, a possible reduction of anti-ET-sIgA, anti-ET-IgM and anti-ET-IG is observed in comparison with the control group. This is accompanied by an increase in CRP levels in these groups, especially in patients with DTG and IHD, in whom its level was significantly higher than in patients with DTG and without heart disease. Analysis of literature data and our results confirm the hypothesis that extravasation of the excess amount of ET into the bloodstream depletes reserves of synthesis of specific antibodies, assists enhance of the systemic inflammatory response and the emergence of typical cardiac pathology in examined patients, which makes the course of the underlying disease difficult.

Keywords

• diffuse toxic goiter
• cardiovascular system
• endotoxin
• immunity