Download AUTOIMMUNE RESPONSE TO BACTERIAL ANTIGENS IN

AUTOIMMUNE RESPONSE TO BACTERIAL ANTIGENS IN PATIENTS WITH
CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ARTERIAL
HYPERTENSION
Dielievska V. YU, Khilko M.S.
Scientific advisor: d.med.sciences, prof. Kravchun P.G.
Kharkiv National Medical University, department of internal medicine № 2
and clinical immunology and allergology, Kharkiv, Ukraine
Introduction. Most of the patients with chronic obstructive pulmonary disease (COPD) and
arterial hypertension (AH) have high risk of congestive heart failure (CHF). Today the attention
of the scholars in many countries is drawn to the role of immune mechanisms in the development
and progression of many diseases [1, 2]. Of great importance is to determine the role of specific
immune response not only to the host tissues, but also to bacterial antigens, since they are able to
make a direct damaging effect on the cells, resulting in the loss of their functional activity.
The aim.We investigated whether remodeling of the left ventricle as a sign of CHF progression
is associated with sensibilisation to bacterial antigens of Staphilococcus aureus (St. aureus),
Streptococcus pneumoniae (Str. Pneumoniae) and Esherichia Coli (E. Coli).
Material and methods. A total of 65 patients with CHF at COPD and AH were included in the
study. The diagnosis of COPD was established according to GOLD 2014 guidelines [3]. Patients
were subdivided into two groups according to the II and III class of congestive heart failure by
NYHA. All the patients underwent echocardiography and laboratory investigation of leucocyte
migration index in specific leucocyte migration inhibition test.
Results. Among investigated patients an acceleration of leucocyte migration to E. Coli was
recorded in 82%, to St. aureus – in 24 %, to Str. Pneumoniale – in 20%. The mean index of the
reaction of specific leucocyte migration inhibition to E. Coli was 1.35 ± 0.001, to St. Aureus –
1.1 ± 0.001, Str. Pneumoniae – 1.17 ± 0.02. Correlation analysis by Spearman revealed the
strong relationships between echocardiographic parameters of the left ventricle of the heart and
the degree of patients sensibilisation to E. Coli. Thus index of specific leucocyte migration to E.
Coli positively correlated with end diastolic volume of the left ventricle (r = 0.85), end diastolic
diameters of the left ventricle (r = 0.83), End systolic volume of the left ventricle (r = 0.87) and
end sistolic diameter of the left ventricle (r = 0.87) and negatively correlated with ejection
fraction of the left ventricle (r = 0.74). While progression of CHF from NYHA II to NYHA III
class there was an increase of leucocyte migration index to E. Coli on 31.0 % (p<0.05). There
was not any significant differences in leucocyte migration indeces to St. Aureus and
Str.Pneumoniae.
Conclusions. The study showed a strong relationship between sensibilisation to E. Coli and left
ventricle remodeling of the heart as well as with progression of congestive heart failure in
patients with COPD and AH. Thus, the consumptions discussed in literature about intestinal
bacteria involvement into the heart failure progression and cardiac remodeling are being
supported by obtained facts, and demand further profound investigations.
References. 1. Hogg, J.C., Chu, F., Utokaparch, S., Woods, R., Elliott, W.M., et al. 2004. The
nature of small-airway obstruction in chronic obstructive pulmonary disease. N. Engl. J. Med.
350: 2645–2653.
2. Cavaillès А, Brinchault-Rabin G, Adrien Dixmier et al. Comorbidities of COPD. Eur Respir
Rev 2013;22(130):454-75.
3. Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative
for Chronic Obstructive Lung Disease (GOLD) 2014. http://www.goldcopd.org.