CONDITION OF SUBPOPULATION COMPOSITION OF LYMPHOCYTES BLOOD AND ITS RELATIONSHIP WITH APOPTOSIS AND NECROSIS BEFORE AND AFTER DIFFERENT METHODS OF TREATMENT OF CHRONIC TONSILLITIS
DOI:
https://doi.org/10.11603/2415-8798.2017.2.7959Keywords:
chronic tonsillitis, subpopulations, lymphocytes, apoptosis, necrosis.Abstract
At present, the tonsillary problem in its clinical aspect has shifted towards the sparing attitude to the lymphoepithelial structures of the oro- and nasopharynx. However, tonsillectomy continues to be one of the most common techniques performed by otolaryngologists. This dictates the need for further search and development of criteria that would help to differentiate the process of transformation of the tonsils from an organ that carries the beneficial functions to the tonsils as a cell of infection and thereby contribute to the optimal choice of treatment tactics.
The aim of the study – to conduct an analysis of changes in the subpopulation composition of lymphocytes before and after various methods of treatment of chronic tonsillitis in comparison with their apoptosis and necrosis.
Materials and Methods. The survey was conducted in patients with chronic tonsillitis before and after operative and conservative treatment. Determination of the subpopulation composition, as well as the state of apoptosis and necrosis of blood lymphocytes and their correlation were carried out on a flow cytometric meter Becmen Culter Epix XL (USA).
Results and Discussion. The results of the conducted research indicate that chronic tonsillitis is characterized by varying degrees of decrease in the level of individual subpopulations of lymphocytes. Especially for CD3+, CD4+ and CD8+-lymphocytes, moreover, their more intense reduction was noted in patients who were shown surgical intervention as compared to patients who were subject to conservative treatment. Both surgical and conservative treatment contributed to a partial restoration of the relative number of studied subpopulations of lymphocytes. The obtained data indicate that the restoration of the level of subpopulations of lymphocytes after surgical treatment is more intensive. However, due to lower initial data, the level of such recovery continued to be lower than those recorded after conservative treatment. In parallel with changes in the subpopulation composition, changes in the level of apoptosis and blood lymphocytic necrosis and their correlation were also noted. In patients who were shown surgical intervention, this ratio significantly exceeded that recorded in patients who were shown conservative treatment. After the treatment methods, the ratio of apoptosis and necrosis in both groups decreased and became close to the baseline data, although the absolute level of apoptosis continued to be significantly higher than control. A more intense reduction occurred again after the surgical removal of the tonsils.
Conclusions. Chronic tonsillitis is accompanied by a decrease in the level of subpopulations of blood CD3 +, CD4 + and CD8 + - lymphocytes with the simultaneous increase in apoptosis and its correlation with necrosis, the degree of which reflects the depth of the pathological process, which allows the use of these indicators as additional markers to determine the treatment tactics and control its effectiveness.
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