Changes of the Immune Status in Patients with Purulent Peritonitis

The analysis of cellular and humoral immunity indicators in the blood of patients with purulent peritonitis (PP) with the determination of their diagnostic value while determining the stage of peritonitis was performed. The levels of CD3, CD4, CD8, CD4 / CD8, CD19, CD16, CD95, CD25, IgA, IgM, IgG during hospitalization of 126 patients with PP was investigated. Monitoring of immune responsiveness stated regular changes in cellular and humoral immunity caused by the influence of cytokine profile, describing immunosuppression, the extent of which depends on the length and stage of PP. The progressive deepening of PP stages (in reactive and toxic stage) led to an increase in white blood cell count, CD95, due to the influence of dose-dependent increase in IL-6, CD19, IgM, G, and NK-cells (CD16) and CD25, the dynamics of which is closely related and dependent of IL-2.This was accompanied by a progressive lymphocytopenia, a decrease in CD3, CD4, which at constant or slightly increasing concentration led to decrease in CD8 IRI (CD4 / CD8) caused by the impact of immunosuppressive IL-6, stepwise reduction of IgA. Severe secondary immunodeficiency was observed in patients with end-stage PP and lymphocytopenia progressed along with the growth of white blood cell and marker CD95 with disruption of T-lymphocytes subsets (CD4 decrease at a constant or insignificant growth of CD8) with critical IRI indicators. The decrease in CD25, CD16 and CD19 dysfunction with sharp inhibition of the antibodies synthesis ? decrease in IgM and G, A concentrations was also determined.