zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2023-20-4-07zdor-2646Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEИммунологические особенности течения острой цитомегаловирусной инфекции у иммунокомпетентных пациентовImmunological features of acute cytomegalovirus infection in immunocompetent patientshttps://orcid.org/0000-0002-3061-1836ДоценкоМ. Л.DotsenkoM. L.

Доценко Марина Леонидовна, д.м.н., профессор кафедры инфекционных болезней

Минск

Marina L. Dotsenko, Doctor of Biological Sciences, Professor of the Infectious Diseases Department

Minsk

https://orcid.org/0000-0002-3895-274XФоминаЕ. Г.FominaE. G.

Фомина Елена Георгиевна, д.б.н., заведующий лабораторией иммунологии и клеточной биотехнологии

Минск

Elena G. Fomina, Doctor of Biological Sciences, Head of theHead of the Laboratory of Immunology and Cell Biotechnology

Minsk

https://orcid.org/0009-0005-1166-8561ГуцалюкИ. Я.HutsaliukI. Ya.

Гуцалюк Игорь Ярославович, врач-инфекционист, заведующий диагностическим отделением; аспирант кафедры инфекционных болезней

Минск

Ihar Ya. Hutsaliuk, Infectious Disease Doctor, Head of the Diagnostics Department; PhD student of the Department of Infectious Diseases

Minsk

https://orcid.org/0000-0003-3919-0625ГригорьеваЕ. Е.GrigorievaE. E.

Григорьева Елена Евгеньевна, к.б.н., доцент, ведущий научный сотрудник

Минск

Elena E. Grigorieva, Candidate of Biological Sciences, Associate Professor, Leading Researcher

Minsk

Белорусский государственный медицинский университетBelarus State Medical UniversityРеспубликанский научно-практический центр эпидемиологии и микробиологииRepublican Scientific and Practical Center for Epidemiology and MicrobiologyГородская клиническая инфекционная больница; Белорусский государственный медицинский университетMinsk City Clinical Infectious Diseases Hospital; Belarus State Medical University20230401202420456–62Copyright © Доценко М.Л., Фомина Е.Г., Гуцалюк И.Я., Григорьева Е.Е., 20242024Доценко М.Л., Фомина Е.Г., Гуцалюк И.Я., Григорьева Е.Е.Dotsenko M.L., Fomina E.G., Hutsaliuk I.Y., Grigorieva E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2646

Цель исследования. Выявить и оценить иммунологические особенности у иммунокомпетентных пациентов с острой цитомегаловирусной инфекцией (ЦМВИ).Материалы и методы. В исследование было включено 23 иммунокомпетентных взрослых пациента с острой цитомегаловирусной инфекцией; у 4 из них имели место тромботические осложнения. Контрольная группа состояла из 10 здоровых доноров. Во всех образцах крови проведены исследования методами проточной цитометрии иммунофенотипирования клеток периферической крови. У всех пациентов проверяли содержание антиген-специфических клеток.Результаты. Все пациенты имели положительные тесты ПЦР ДНК цитомегаловируса. Содержание активированных Т-клеток у пациентов с острой ЦМВ-инфекцией и тромботическими осложнениями в 7,7 раза выше (р < 0,001), чем у условно здоровых пациентов (медианы показателей: 36,02 % (31,01; 47,92) и 4,68 % (3,39; 5,25) соответственно). Содержание гранулоцитарных миелоидных супрессорных клеток (Г-МЛСК) у пациентов с острой ЦМВ-инфекцией и тромбозами превышает аналогичный показатель в группе здоровых добровольцев в 8,3 раза (р < 0,001) (медианы показателей составили 0,38 % (0,24; 0,54) и 0,05 % (0,03; 0,07) соответственно). Количество регуляторных Т-клеток у пациентов с острой ЦМВ-инфекцией и тромбозами было снижено в 3,1 раза (р < 0,001) по сравнению с аналогичным показателем в группе здоровых добровольцев (медианы показателей: 0,79 % (0,57; 1,09) и 2,45 % (2,01; 3,86) соответственно). Иммунофенотипирование СD3+ клеток показало тенденцию к увеличению доли более зрелых клеток, а именно клеток эффекторной памяти (TEM) и терминально-дифференцированных клеток памяти (TEM RA) при уменьшении процента «наивных» клеток.Заключение. Высокий уровень антиген-специфического Т-клеточного ответа и низкое содержание Т-регуляторных клеток могут говорить о недостаточном контроле пролиферации Т-цитотоксических лимфоцитов, что может способствовать длительной персистенции вируса и развитию хронического воспаления стенки сосуда, что требует дальнейшего изучения. Таким образом, у пациентов с острой ЦМВ-инфекцией появляется дополнительный фактор риска тромбоза, что необходимо учитывать при проведении лечебно-диагностических мероприятий. 

Objective. To identify and evaluate immunological features in immunocompetent patients with acute cytomegalovirus infection (CMVI).Materials and methods. Thirty-three immunocompetent adult patients with acute cytomegalovirus infection were included in the study; 4 of them had thrombotic complications. The control group consisted of 10 healthy donors. All 33 blood samples were tested by flow cytometry. The content of antigen-specific cells was checked in all patients. Results. All patients had positive cytomegalovirus DNA PCR tests. The content of activated T cells in patients with acute CMV infection and thrombotic complications is 7.7 times higher (p < 0.001) than in conditionally healthy patients (median values: 36.02% (31.01; 47.92) and 4.68% (3.39; 5.25), respectively). The content of granulocytic myeloid suppressor cells (G-MLSC) in patients with acute CMV infection and thrombosis exceeds the same indicator in the group of healthy volunteers by 8.3 times (p < 0.001) (median values were 0.38% (0.24; 0.54) and 0.05% (0.03; 0.07) respectively). The number of regulatory T cells in patients with acute CMV infection and thrombosis was reduced by 3.1 times (p < 0.001) compared to the same indicator in the group of healthy volunteers (median indicators: 0.79% (0.57; 1.09) and 2.45% (2.01; 3.86), respectively). Immunophenotyping of CD3+ cells showed a tendency to increase the proportion of more mature cells, namely effector memory cells (TEM) and terminally differentiated memory cells (TEM RA) with a decrease in the percentage of “naive” cells.Conclusion. A high level of antigen-specific T-cell response and a low content of T-regulatory cells may indicate insufficient control of the proliferation of T-cytotoxic lymphocytes, which may contribute to the long-term persistence of the virus and the development of chronic inflammation of the vessel wall, which requires further study. Thus, in patients with acute CMV infection, an additional risk factor for thrombosis appears, which must be taken into account when carrying out therapeutic and diagnostic measures.

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The authors declare that there are no conflicts of interest present.