Prognosis of severe cytomegalovirus infection in newborns

Cover Page

Cite item

Abstract

Objective is to study the features of impaired activation of T and B lymphocytes in order to predicting severe cytomegalovirus infection in newborns. Materials and methods. 133 newborns with cytomegalovirus infection were examined. Immediately after diagnosing cytomegalovirus infection, all patients observed were immunologically ex amined, including assessing count of peripheral blood T and B lymphocytes, as well as their intercellular interaction by using flow cytometry immunostaining for CD3, CD3+CD28, CD3+CD28+, CD3CD28+, CD4, CD8, CD20, CD20+CD40+, CD28, CD40. The test was performed by using a Beckman Coulter Epics XL laser flow cytofluorometer. Depending on the condition severity, all children were divided into two groups: 1 — cytomegalovirus infection, severe form — 60 subjects (45.1%); 2 — cytomegalovirus infection, moderate form — 73 subjects (54.9%). Results of the entire set of studied indicators for cellular and humoral arms of immune system revealed statistically significant differences for the prognosis of severe cytomegalovirus infection: CD3+CD28, CD20, CD20+CD40+, CD4. T lymphocytes with CD3+CD28+ activation markers, through which costimulating signals necessary for the activation of T helper cells are exerted cell-intrinsic features, serving as an important factor ensuring immune response. Using the “classification trees” method, we developed a differentiated approach to forecast severe cytomegalovirus infection in newborns. Systems of inequalities were obtained, four of which classify a subgroup of newborns with severe cytomegalovirus infection. The consistent application of the obtained inequalities makes it possible to isolate from the input stream of sick patients with a prognosis of the development of severe cytomegalovirus infection. The proposed diagnostic rules can be considered as screening markers for predicting a severe cytomegalovirus infection in newborns, which makes possible the timely onset of specific therapy.

About the authors

L. V. Kravchenko

Rostov State Medical University

Author for correspondence.
Email: larakra@list.ru

Larisa V. Kravchenko,  PhD, MD (Medicine), Leading Researcher, Obstetrics and Pediatrics Research Institute 

344012, Rostov-on-Don, Mechnikov str., 43

Phone: +7 (863) 201-14-88 (office), +7 918 853-88-94 (mobile) 

Russian Federation

References

  1. Ватазин А.В., Зулькарнаев А.Б., Федулкина В.А., Крстич М. Основные межклеточные взаимодействия при активации T-клеток в отторжении почечного трансплантата // Альманах клинической медицины. 2014. № 31. С. 76–82. [Vatazin А.V., Zul’karnaev А.B., Fedulkina V.А., Krstic М. Major intercellular interactions at the T cell activation in renal transplant rejection. Al’manakh klinicheskoy meditsiny = Almanac of Clinical Medicine, 2014, no. 31, pp. 76–82. (In Russ.)]
  2. Карпова А.Л., Нароган М.В., Карпов Н.Ю. Врожденная цитомегаловирусная инфекция: диагностика, лечение и профилактика // Российский вестник перинатологии и педиатрии. 2017. Т. 62, № 1. С. 10–18. [Karpova A.L., Narogan M.V., Karpov N.Yu. Congenital cytomegalovirus infection: diagnosis, treatment, and prevention. Rossiiskii vestnik perinatologii i pediatrii = Russian Herald of Perinatology and Pediatrics, 2017, vol. 62, no. 31, pp. 10–18. (In Russ.)] doi: 10.21508/1027-4065-2017-62-1-10-18
  3. Клинические рекомендации (протокол лечения) оказания медицинской помощи детям больным цитомегаловирусной инфекцией / Под ред. Ю.В. Лобзина. СПб.: ФГБУ НИИДИ ФМБА России, ЕАОИБ, АВИСПО, 2015. 31 с. [Clinical recommendations (treatment protocol) for the provision of medical care for children with cytomegalovirus infection / Ed. by Yu.V. Lobzin. St. Petersburg: Pediatric Research and Clinical Center for Infectious Diseases under the Federal Medical Biological Agency of Russia, Euro-Asian Society for Infectious Diseases, St. Petersburg and Leningrad Region Infectious Diseases Physicians Association, 2015. 31 p. (In Russ.)]
  4. Клинические рекомендации (протоколы) по неонатологии / Под ред. Д.О. Иванова. СПб.: Информ-Навигатор, 2016. 464 с. [Clinical recommendations (protocols) on neonatology / Ed. by D.O. Ivanov. St. Petersburg: Inform-Navigator, 2016. 446 p. (In Russ.)]
  5. Кравченко Л.В. Роль нарушений активации Т-лимфоцитов у новорожденных с цитомегаловирусной инфекцией в случаях позднего обнаружения ДНК цитомегаловируса // Инфекция и иммунитет. 2019. Т. 9, № 2. С. 288–294. Kravchenko L.V. A role of impaired neonatal T cell activation upon late CMV detection. Infektsiya i immunitet = Russian Journal of Infection and Immunity, 2019, vol. 9, no. 2, pp. 288–294. (In Russ.)] doi: 10.15789/2220-7619-2019-2-288-294
  6. Кравченко Л.В., Левкович М.А. Механизмы иммуносупрессии при частых острых респираторно-вирусных инфекциях у детей, перенесших цитомегаловирусную инфекцию в периоде новорожденности // ВИЧ-инфекция и иммуносупрессии. 2017. Т. 3, № 9. С. 34–38. [Kravchenko L.V., Levkovich M.A Mechanisms of immunno-supression upon frequent acute viral respiratory infections in infants after neonatal cytomegalovirus infection. VIČ-infekcia i immunosupressii = HIV Infection and Immunosuppressive Disorders, 2017, vol. 9, no. 3, pp. 34–38. (In Russ.)] doi: 10.22328/2077-9828-2017-9-3-34-38
  7. Кравченко Л.В., Левкович М.А., Пятикова М.В. Роль полиморфизма гена интерферон γ и интерферонопродукции в патогенезе инфекции, вызванной вирусом герпеса 6-го типа у детей раннего возраста // Клиническая лабораторная диагностика. 2018. Т. 63, № 6. С. 357–361. [Kravchenko L.V., Levkovich M.A., Pyatikova M.V. The role of polymorphism of the interferon gene γ and interferonoproduction in the pathogenesis of infection caused by herpes 6 type virus in children of early age. Klinicheskaya laboratornaya diagnostika = Russian Clinical Laboratory Diagnostics, 2018, vol. 63, no. 61, pp. 357–361. (In Russ.)] doi: 10.18821/0869-2084-2018-63-6-357-361
  8. Сенников С.В., Куликова Е.В., Кнауэр Н.Ю., Хантакова Ю.Н. Молекулярно-клеточные механизмы, опосредуемые дендритными клетками, участвующие в индукции толерантности // Медицинская иммунология. 2017. Т. 19, № 4. С. 359–374. [Sennikov S.V., Kulikova E.V., Knauer N.Y., Khantakova Y.N. Molecular and cellular mechanisms mediated by dendritic cells involved in the induction of tolerance. Meditsinskaya immunologiya = Medical Immunology (Russia), 2017, vol. 19, no. 4, pp. 359–374. (In Russ.)] doi: 10.15789/1563-0625-2017-4-359-374
  9. Сизякина Л.П., Харитонова М.В. Характеристика В2-лимфоцитов у пациентов с серопозитивным ревматоидным артритом суставной формы // Иммунология. 2017. Т. 38, № 4. С. 226–228. [Sizyakina L.P., Kharitonova M.V. Characteristics of B2 lymphocytes in patients with seropositive rheumatoid arthritis articular form. Immunologiya = Immunologiya, 2017, vol. 38, no. 4, pp. 226–228. (In Russ.)] doi: 10.18821/0206-4952-2017-38-4-226-228
  10. Ярилин А.А. Иммунология. Москва: ГЭОТАР-Медиа, 2010. 752 c. [Yarilin A.A. Immunology. Moscow: GEOTAR-Media, 2010. 752 p. (In Russ.)]
  11. Berthelot J.M., Jamin C., Amrouche K. Regulatory B cells play a key role in immune system balance. Joint Bone Spine, 2013, vol. 80, no. 1, pp. 18–22. doi: 10.1016/j.jbspin.2012.04.010
  12. Candando K.M., Lykken J.M., Tedder T.F. B10 cell regulation of health and disease. Immunol. Rev., 2014, vol. 259, no. 1, pp. 259–272. doi: 10.1111/imr.12176

Supplementary files

There are no supplementary files to display.


Copyright (c) 2021 Kravchenko L.V.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies