ПРОДУКЦИЯ ФАКТОРОВ РОСТА И ДЕСКВАМАЦИЯ ЭНДОТЕЛИОЦИТОВ В СЕРДЦЕ ПРИ ИШЕМИЧЕСКОЙ КАРДИОМИОПАТИИ

oai:oai.kpccz.elpub.ru:article/1324Highlights Dysregulation of angiogenesis may be the pathogenetic factor of ischemic cardiomyopathy (ICMP). Aim. To determine the content of growth factors and desquamated endothelial cells (DEC) in the blood from the coronary sinus and ulnar vein in association with the number of progenitor endothelial cells (PEC) in the blood from the ulnar vein in patients with coronary heart disease (CHD), suffering and not suffering from ICMP.Methods. The study included 30 patients with ICMР and 22 patients with CHD, and 18 healthy donors. The content of DEC (CD45–CD146+) was determined in blood from the cubital vein (peripheral) and coronary sinus, and the content of DEC (CD14+CD34+VEGFR2+) was determined in peripheral blood by flow cytometry (antibodies “BD Biosciences”, USA). The concentrations of VEGF-A, VEGF-B, PDGF, SDF-1, SCF, FGF-1, TGF-β1 in blood plasma from both locations were evaluated by multiplex analysis (set “Cloud-Clone Corp.”, USA).Results. The content of DEC in peripheral blood was elevated in patients with CHD of both groups, and in patients with ICMP in sinus blood was higher than in peripheral. At the same time, in patients with CHD without cardiomyopathy, an excess of PEC and SDF-1 in the blood from the ulnar vein was established in combination with an increase in the concentration of PDGF and a decrease in the content of VEGF-B in the blood from the coronary sinus relative to the parameters of systemic blood flow. In patients with ICMP, these changes were not detected, but there was an increase in the concentration of TGF-β1 in sinus blood compared with peripheral blood. Regardless of the presence of ICMP, the concentration of SCF, FGF-1, VEGF-A in the blood from the ulnar vein corresponded to the norm and that in sinus blood; the content of VEGF-A in the coronary bloodstream exceeded its systemic level.Conclusion. In patients with ICMP, desquamation of the coronary vascular endothelium is enhanced against the background of violations of its repair processes due to insufficient (relative to CHD without cardiomyopathy) mobilization of PEC from the bone marrow due to the absence of an excess of SDF-1 in the blood and their insufficient homing into the myocardium due to weak PDGF production in the heart.Основные положенияПатогенетическим фактором ишемической кардиомиопатии может быть нарушение регуляции ангиогенеза. Цель. Определить содержание факторов роста и десквамированных эндотелиальных клеток (ДЭК) в крови из коронарного синуса и локтевой вены в ассоциации с численностью прогениторных эндотелиальных клеток (ПЭК) в крови из локтевой вены у больных ишемической болезнью сердца (ИБС), страдающих и не страдающих ишемической кардиомиопатией (ИКМП).Материалы и методы. В исследование включили 30 пациентов с ИБС и ИКМП, 22 больных ИБС без ИКМП, 18 здоровых доноров. Содержание ДЭК (CD45–CD146+) определяли в крови из локтевой вены (периферическая) и коронарного синуса (синусовая), а содержание ПЭК (CD14+CD34+VEGFR2+) – в периферической крови методом проточной цитофлуориметрии (антитела BD Biosciences, США). В плазме обоих образцов крови оценивали концентрацию VEGF-A, VEGF-B, PDGF, SDF-1, SCF, FGF-1, TGF-β1 методом мультиплексного анализа (набор Cloud-Clone Corp., США).Результаты. Содержание ДЭК в периферической крови было повышенным у больных ИБС обеих групп, а в синусовой крови у пациентов с ИКМП было выше, чем в периферической. У больных ИБС без ИКМП установлен избыток ПЭК и SDF-1 в крови из локтевой вены в сочетании с увеличением концентрации PDGF и снижением содержания VEGF-В в крови из коронарного синуса относительно параметров системного кровотока. У пациентов с ИКМП данные изменения не выявлены, но отмечен рост концентрации TGF-β1 в синусовой крови по сравнению с периферической. Вне зависимости от ИКМП концентрация SCF, FGF-1, VEGF-А в крови из локтевой вены соответствовала норме и таковой в синусовой крови; содержание VEGF-А в коронарном кровотоке превышало системный уровень.Заключение. При ИКМП усилена десквамация эндотелия коронарных сосудов на фоне нарушений его репарации за счет недостаточной (относительно ИБС без ИКМП) мобилизации ПЭК из костного мозга ввиду отсутствия избытка SDF-1 в крови и недостаточного их хоминга в миокард вследствие слабой продукции PDGF в сердце

The role of receptor-mediated T-cells activation disorders in pulmonary tuberculosis

Aim. To analyze the peculiarities and mechanisms of receptor-mediated T-lymphocytes disorders in different clinical forms of pulmonary tuberculosis.Materials and мethods. The study involved 116 patients with first diagnosed infiltrative and disseminated drug-sensitive and drug-resistant pulmonary tuberculosis. The key stages in receptor-mediated activation of T-lymphocytes, isolated from blood, after their CD3/CD28-induction in vitro with addition of intracellular transport blocker were analyzed. Their immunotyping was carried out with the method of two- and threecolor flow cytofluorometry. The obtained results were statistically analyzed.Results. The breach of extracellular and intracellular stages of T-lymphocytes activation, shown by reduction in total number of CD3- and CD28-positive cells, and CD3+CD28+IL2+, CD3+CD28+IL2–, CD3+NF-kB+, CD3+NFAT2+ lymphocytes, and increase in number of CD3+CTLA4+ cells, was identified with most of their manifestations in disseminated drug-resistant pulmonary tuberculosis. It was shown that the content of CD3+AP-1+ lymphocytes is variable in drug-resistant pulmonary tuberculosis: it increases in the infiltrative form and decreases in the disseminated form.Conclusion. The results showed different mechanisms leading to a deficiency of IL-2-positive lymphocytes and T-lymphocytopenia: from “functional reserve” exhaustion of T-cells in drug-sensitive pulmonary tuberculosis to immunosuppression under the influence of suppressive cytokines (in case of the infiltrative form) and inhibitory protein CTLA4 (in case of the disseminated form) in drug-resistant pulmonary tuberculosis

Galectin 3 and non-classical monocytes of blood as myocardial remodeling factors at ischemic cardiomyopathy

Aims: To identify an imbalance of cardiac remodeling mediators and monocytes subpopulation in blood, distribution of myocardium macrophages in patients with ischemic cardiomyopathy (ICMP). Methods: The study engaged 30 patients with ICMP, 26 patients with coronary heart disease (CHD) without ICMP, 15 healthy donors. Concentrations of TGFb, MMP-9, MCP-1, galectin-3 were measured in plasma of blood from the coronary sinus and peripheral blood in CHD patients, as well as in peripheral blood in healthy donors, by enzyme immunoassay method. The ration of classical, intermediate, nonclassical, transitional monocytes in peripheral blood of patients and healthy donors was assessed by flow cytometry (expression CD14, CD16); the content of CD68+ macrophages in myocardium – by immunohistochemistry method. Results: In both samples of blood, the content of galectin-3 in patients with ICMP was higher than in CHD patients without ICMP and the level of TGFb was comparable between the groups. At ICMP, the concentration of MMP-9 in sinus blood was higher than that in CHD patients without ICMP in whom an excess of MCP-1 in the general blood flow was determined. The density of distribution of CD68+ cells in the myocardium in patients with ICMP was higher in the perianeurysmal zone than in the right atrium appendage. ICMP was characterized by a deficiency of non-classical monocytes, and CHD without ICMP – by an excess of intermediate cells in peripheral blood. Conclusion: Myocardium remodeling at ICMP is mediated by not so much TGFb but intracardiac galectin-3, which determines the subpopulation composition of blood monocytes