ROLE OF GENERAL AND SPECIFIC IMMUNOLOGICAL CHANGES IN THE PROGRESSION OF COXARTHROSIS

The objective of this work was to identify immunological criteria for the progression of coxarthrosis on the basis of studying the dynamics of general and specific immunological indices.

110 patients with coxarthrosis of I–IV stages were examined. The average age was 64.2±2.0 years. The control group consisted of 20 persons comparable in age and sex to the main group. Immunological examination included the determination of CD3+, CD4+, CD8+, T active lymphocytes, IgM, IgA and IgG immunoglobulins, circulating immune complexes, autoimmune lymphocytotoxic and granulocytotoxic antibodies. Cell-specific sensitization to tissue and bacterial antigens was evaluated in the reaction of leukocyte migration inhibition assay (LMIA). Antigens of bone and cartilage tissue, synovial membrane and bacterial antigens – Staphylococcus aureus, Streptococcus pyogenes were used.

In patients with coxarthrosis, an increase in the levels of IgM, IgA, IgG, autoimmune lymphocytotoxic antibodies and a decrease in CD3+, CD8+ and T active lymphocytes are observed. Progression of coxarthrosis is accompanied by a significant increase in the levels of IgM, IgA and IgG, which allows them to be used to control the severity of the disease course. Autoimmune response at coxarthrosis is characterized by humoral-type sensitization to bone and cartilage tissue and synovial membrane antigens, but progression of coxarthrosis leads to an increase in cell-type sensitization – towards the inhibition of leukocyte migration to cartilage tissue and synovial membrane antigens. Bacterial sensitization in coxarthrosis patients is revealed by both acceleration and inhibition of leukocyte migration to Staphylococcus aureus and Streptococcus pyogenes antigens, but while the disease progression predominance of hypersensitivity to bacterial antigens by a delayed type is also observed.

The main features of autoimmune response at coxarthrosis are the hyperproduction of antibodies and the signs of cell tissue and bacterial sensitization along with a decrease in T-suppressor lymphocytes. Progression of coxarthrosis is accompanied by an increase in IgM, IgA, IgG and autoimmune lymphocytotoxic antibodies along with a decrease in CD3+, CD8+ and T active lymphocytes. Leukocyte migration inhibition assay allows one to control the disease course by the type and severity of tissue and bacterial sensitization. Thus, a shift of acceleration of leukocyte migration to the inhibition to cartilage tissue, synovial membrane antigens as well as bacterial antigens of Str. Pyogenes and St. Aureus indicates an intensification of destructive processes in the joint, which requires an immediate medical correction. 

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