ASSOCIATION OF HLA AND PROINFLAMMATORY CYTOKINES OF BLOOD IN PATIENTS WITH GLOMERULONEPHRITIS

Introduction. Cytokines and HLA are of important part of immunogenesis of many diseases, therefore the analysis of these indices and this associations in dependence of glomerulonephritis (GN) can define their value as the additional prognostic markers. Aim of the work is to determine the peculiarities of associations the high serum levels ofproinflammatory cytokines (TNF a, MCP-1, IL-18) and some HLA in phenotype to substantiate of chronic glomerulonephritis with nephrotic syndrome (CGN, NS) immunogenesis and to ascertain the additional prognostic markers. Materials and methods. There was studied the HLA-antigens distribution in the 264 CGN, NS adult patients and 350 healthy donors by typing the lymphocytes with the aid of standard microlymphocytotoxic test (Terasaki's test). Using IFA, the level of the proinflammatory cytokines was studied in the blood serum - MCP-1 in 39, IL-18 – 40 and TNF-a - 96patients. Results. HLA-A23, -24, -B8, -38, -41, -44, DR1, -4, -w52 in adults patients have associations (RR>2) CGN, NS; the attributive risk (a>0,1) to develop GN detected in patients have A24, B8, DR 1, 4, w52. The relative risk (RR) to develop chronic renal failure (CRF) is in detection of HLA-10, -29, -30, -41, -51, DR4; attributive risk (AR) - A10. The CGN, NS patients showed statistically higher level of the serum proinflammatory cytokines – TNF-6, IL-17, MCP-1 with more high indices of the TNF-a in patients with HLA-A23, -A28, -B44 (RR of CGN, NS), -A10 (AR of CRF), IL-18 - A24 (AR of CGN, NS) ma A10 (AR of CRF). The highest levels of MCP-1 detected in adults case have risk antigens - relative B41, attributive - A28, B8, and predictor of CRF B41, wich may be negative marker for prognosis. Conclusion. It was to determine associations the serum levels of some cytokines and HLA in patients with CGN, NS. We think it appropriate to study HLA and proinflammatory cytokines TNF-a, IL-18 and MCP-1 in blood as additional negative prognostic predictors for the differentiating approach to treatment.