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CURRENT ISSUE

№1' 2022

SURGERY

International Medical Journal, Vol. 28., Iss. 1, 2022, P. 24−28.

DOI (https://doi.org/10.37436/2308-5274-2022-1-5)

EXAMINING THE ADAPTIVE IMMUNITY DYNAMICS IN SEVERE BURNS TREATMENT

Zaitsev Institute of General and Emergency Surgery, National Academy of Medical Sciences of Ukraine, Kharkiv
Municipal Non−Profit Enterprise "City Clinical Hospital of Ambulance and Emergency Medicine named after Prof. O. I. Meshchaninov", Kharkiv City Council, Kharkiv, Ukraine

Burn injury is one of the most severe types of injuries, accompanied by damage to the skin, severe intoxication, and frequent infectious complications. The favorable outcome of the wound process depends on the state of the non−specific defense system and the organism immune reactivity. To study the dynamics of adaptive immunity in treatment of severely burnt patients, the indices of celland humoral immune response and metabolic products (phagocytic activity of neutrophils, subpopulations of T−lymphocytes, concentration and constant of circulating immune complexes, molecules of average molecular weight) were examined. It was found that the change in these indices in the patients with complete recovery of the skin, detected within the early post−traumatic period, had a positive trend in future. Functional insufficiency of the neutrophilic immune system and decreased ceruloplasmin content were determined in deceased patients. These processes disordered the elimination and accumulation of immune complexes and led to an aggravation of the underlying pathological process. In severely burnt patients, the concentration of oligopeptide, peptide and nucleotide fractions of medium molecular weight molecules was significantly increased, which indicated a high level of catabolic reactions and cell destruction processes, that leads to unfavorable development of the pathological process. Therefore, the detected functional insufficiency of neutrophil and T−cell immune systems, high concentrations of circulating immune complexes and fractions of molecules of medium molecular weight were most pronounced in the patients with lethal outcome. The study of the dynamics of immune reactivity and metabolism allows to optimize the therapy by correcting the identified disorders.

Key words: burns, immune response, metabolic disorders, severe burns.

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