IMMUNODIAGNOSIS OF PERITONEAL SEPSIS
DOI:
https://doi.org/10.11603/1811-2471.2022.v.i4.13493Keywords:
immunodiagnostics, sepsis, peritoneal sepsisAbstract
SUMMARY. The work provides an overview of scientific sources related to immunodiagnostics of peritoneal sepsis. As a result of the progression of the inflammatory process caused by microorganisms, there is a massive production of inflammatory mediators, activation of specific and non-specific links of immune protection.
Material and Methods. The work uses bibliographic and analytical methods of searching and analyzing scientific information obtained from scientific publications with an impact factor. The search was carried out in the databases Pubmed, medLine, ClinicalKey, and included publications over the last 10 years.
Results. Sepsis can be viewed as a competition between pathogens and the host's immune response; pathogens seek advantage by disrupting various aspects of the body's defenses. For example, sepsis induces apoptotic deletion of immune effector cells, suppresses the expression of major histocompatibility complex class II molecules, increases the expression of negative costimulatory molecules, increases the number of anti-inflammatory cytokines, and increases the number of regulatory T cells and myeloid cells. In patients with sepsis, monocytes have a reduced ability to release proinflammatory cytokines in response to endotoxin. In sepsis, T cells become insensitive to proliferation and revert to a type 2 profile with increased production of IL-4 and IL-10 and suppression of IL-12 and IFN-γ.
Conclusions. T-cell depletion has been shown in patients with sepsis. The prolonged duration of sepsis is characterized by a high antigenic load and a high level of pro-inflammatory and anti-inflammatory cytokines, which causes exhaustion of T cells. A link between T cell depletion and mortality in sepsis has been established by studies showing that increased expression of PD-1 in circulating T cells in patients with sepsis correlated with decreased T cell proliferative capacity and mortality. The main lever is that the first line of defense against infection – innate immunity – can be a double-edged sword, since the same cells, molecules and mechanisms that participate in the protective process can also participate in pathological inflammatory processes. Therefore, in the diagnosis, it is necessary to find subtle differences between SZR and sepsis, and in its treatment – to maintain a balance between an adequate immune response and an inflammatory reaction, which will allow to effectively fight pathogens, limiting inflammation that can harm the body.
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