Phagocytal activity of neutrophiles and peripheral blood monocytes in patients with HBV infection

Abstract

Introduction. Treatment of HBV infection is one of the global problems of modern medicine, which is confirmed by the extraordinary prevalence and high mortality from this disease. Elimination of acute hepatitis B (GHB) from the human body cannot be achieved without an effective antiviral immune response. Infiltration into the body, infectious agents collide with the innate structures of the immune system, among which phagocytes are on the first line of defense. The purpose of the work – study of the functional state of polymorphonuclear neutrophils and indicators of phagocytic activity of monocytes in the blood of patients with HBV of varying degrees of severity in the dynamics of conventional treatment and after the appointment of a symbiotic. Material & methods. Under supervision were 108 patients with HBV, from 18 to 69 years, of which 56 men and 52 women, the overall average age of patients was 34 ± 1.88 years. The control group consisted of 17 healthy individuals. To evaluate phagocytic the activity of neutrophils (PAN) was determined by the neutrophils phagocytic index (NPI) and the phagocytic count of neutrophils (PCN). The monocytes phagocytic index of (MPI) and phagocytic count of monocytes (PCM) were determined for evaluation of phagocytic activity of monocytes (PAM). Three incubation periods of 30, 60 and 180 minutes were used. Results & discussion. Discussing the results obtained, it is possible to state that polymorphonuclear neutrophils do not remain inert foreign cells in the antiviral process, they are involved in HBV infection. However, what role does neutrophils play - have a direct antiviral effect or indirectly participate in the elimination of viruses, or vice versa, HBV uses the functionality of phagocytes to replicate and spread, yet to be clarified. It is known that in the process of absorption, a phagosoma is formed, which is then connected to the lysosomes of the cell, thus ensuring the implementation of monocytes as effective killing of microorganisms and the cleavage of antigens. Therefore, determining the duration and stability of contact of the object of phagocytosis with lysosomal enzymes monocytes, exhibiting an exposure of 180 minutes, is an important criterion for determining the reliable absorbing function of phagocytic monocytes. Analyzing the absorbing function of monocytes in patients with moderate severity in the period of reconvalescence, it can be stated that the indicated ability of monocytes in patients of 3 groups is significantly increased in the period from 30 to 60 minutes, which presumably indicates significant compensatory reserves of monocytes. But in the future at an exposure of 180 minutes obviously there is a depletion of the functional capabilities of phagocytic cells, which manifests itself as a sharp decrease in absorbent capacity against the background of a decrease in the total number of phagocytic monocytes. Patients in the 4 groups taking symbiotic demonstrate stable levels of monocyte absorption capacity in all exposure periods that do not differ from healthy subjects. The use of a symbiotic increases both the intensity of phagocytosis and regulates the absorption capacity of microphages in patients with mild severity and especially in patients with moderate severity, thereby maintaining the PAN at HBV at an optimal level. Conclusions. In patients with mild to moderate hepatitis, a significant activation of polymorphonuclear neutrophils during the active phase of HBV infection has been detected, which is characterized by an increase in the levels of NPI and AFN in 1.1-1.8 times and 1.5-1.9 times, respectively, in comparison with the control group . While indicators of MPI in HBV were reduced by 1.1-3.2 times compared with the control group, possibly due to a decrease in the number of phagocytic monocytes in the blood of patients with HBV infection. The intensity of reduction of phagocytic reactions of monocytes correlates with the degree of severity of HBV. It is possible to assume that a significant reduction in the number of phagocytes in the peripheral blood of infected persons is due to the redistribution of monocyte phenotypes and the recruitment of these immune cells in the inflammatory site. In patients with moderate severity in different periods of the disease, there is a significant inhibition of phagocytosis, which manifested by a decrease in the number of neutrophils that are involved in phagocytic reactions (1.2-1.5 times compared with the control group). However, despite the significant inhibition of the intensity of phagocytosis, the absorption capacity of neutrophils in these patients is elevated or is at the level of healthy individuals. Increasing the PCM to 1.8 times in patients with HBV may indicate significant compensatory opportunities for monocytes by increasing their absorption capacity. Thus, it is possible to assume that the patients with HBV infection of moderate severity increase the functionality of activated neutrophils by mobilizing the reserve properties of each eukaryotic immune cell that has undergone active phagocytosis. The use of symbiotic in the complex therapy of patients with GHB increases the intensity of phagocytosis, as due to an increase in the number of monocytes (however, their level does not reach the values of the control group) and neutrophils (in 1,2 - 1,4 times).