ASSESSMENT OF CONCENTRATION OF CD3+, CD4+, CD8+, CD16+, CD22+- LYMPHOCYTES EVALUATION IN THE PATIENTS WITH DIFFERENT VARIANTS OF TRAUMATIC BRAIN INJURY REMOTE PERIOD COURSE

Abstract

Pathology of the nervous system is related to different immune processes: destructive changes in tissues of the brain are controlled by the immune system and the loss of regulator mechanisms from the side of central nervous system causes immune disturbances. The aim of the study – to find out the pattern of immune disorders, in accordance with the course of remote period at traumatic brain injury (TBI). Materials and Methods. 280 patients with the consequences of TBI and 30 patients of control group were examined. We studied the content of CD subpopulations in them. The average age of the main group was (42.54±0.59) years, the average injury catamnesis was (8.02±0.49) years. In 130 patients, we diagnosed stationary course of the remote period, in 57 patients – paroxysmal and in 93 patients - progressive course of the remote period at TBI. Neurological deficit was evaluated by means of Neurological Outcome Scale for Traumatic Brain Injury (scale NOS-TBI), cognitive impairments were evaluated by means of Montreal scale for cognitive deficits (MoCA). We studied the content of CD subpopulations (CD3+, CD4+, CD8+, CD22+, CD16+) by flow cytometry (flow cytoflowmetry Epics XL («Beckman Coulter», USA). Results and Discussion. Regardless of the course of TBI, the content of subpopulations of lymphocytes (CD3+, CD4+, CD8+ and CD22+) was significantly lower compared with the control group (p<0,05). The immune regulative index values in patients of all groups were significantly lower compared with the control group, reaching a minimum (1.68) in the group with paroxysmal course of TBI. In case of stationary and paroxysmal course of remote period at mild TBI we found significant difference (p=0,001) of values of CD16+-lymphocytes. Patients with paroxysmal course of moderate TBI had significantly lower CD4+ values compared with a group that was characterized by progressive course of TBI (p=0.037). Paroxysmal course of severe TBI (compared with stationary one) was characterized by significant (p=0.034) increase of CD4+-lymphocytes on the background of significant (p=0.038) reduction of CD22+-lymphocytes. In case of progressive course of mild TBI the content of CD4+-lymphocytes increased with extension of catamnesis of TBI (r=0,43, p=0,046). The level of CD3+- declined at higher rates of anxiety (r=-0.50, p=0.018). In this group, the correlation between MoCA-test and: CD3+ - r=0.46, p=0.032, CD4+ - r=0.48, p=0.025, CD8+ - r=0.53, p=0.012. These results point to the negative impact of immunosuppression on cognitive functioning. Conclusions. The patients with TBI demonstrate significant (p<0.05) reduction of subpopulations: CD3+, CD4+, CD8+, CD22+ lymphocytes on the background of growth of CD16+- lymphocytes. At progressive course of mild TBI consequences the level of CD4+ levels increased with extension of catamnesis of TBI, the level of CD3+- declined at higher rates of anxiety. The correlation with MoCA-test pointed to the negative impact of immunosuppression on cognitive functioning.

Keywords

• черепно-мозкова травма
• віддалений період
• CD-лімфоцити.