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Defects in the functioning of neutrophilic granulocytes (NG) are accompanied by various purulent-inflammatory diseases that have a persistent-relapsing course. The bactericidal activity of NG, the processes of intracellular and extracellular killing of bacteria, is directly dependent on their phenotypic features: the expression level of functionally significant membrane receptors CD64, CD16, CD32, CD11b triggering effector processes. It was shown that there are subsets of NG with different phenotypic characteristics and the course and outcome of infectious and inflammatory diseases directly depends on their usefulness. Despite the large amount of accumulated information, the question of the transformation of NG subpopulations phenotype during NG response formation in children with local purulent processes of soft tissues - a small purulent infection (SPI) remains poorly understood. Purpose: to evaluate the local and systemic effector function of neutrophilic granulocytes (phagocytosis, NET formation) with clarification of the phenotype of functionally significant CD64-CD16+CD32+CD11b+, CD64+CD16+CD32+CD11b+ and CD64-CD16+CD32-CD11b+ NG subpopulations in peripheral blood (PB) in children with SPI. Materials and methods. We evaluated the phagocytic function of NG in 60 PB samples of children 5-9 years old, on the 2-3rd day of acute purulent process, before surgery, in smears - prints taken from the local focus of purulent inflammation and 17 PB samples of conditionally healthy children. Also the ability to form NET was additionally determined in smears-prints in children with SPI. In parallel, in PB we evaluated:% NG simultaneously carrying CD64, CD16, CD32, CD11b receptors and their expression density (MFI) by flow cytometry (CYTOMICS FC500, Beckman Coulter, USA). Statistical data processing was performed in the Microsoft Exel 2016 and Stat Plus 2010 software packages. Nonparametric criteria were used: median (Me) and interquartile range (Q1; Q3), Mann-Whitney U-test and Wilcoxon test. Results . We found a significant increase in the content of the NG subpopulation with a negatively transformed phenotype CD64-CD16+CD32-CD11b+ with defects in the expression of CD64 and CD32 receptors, which is the cause of inadequate inclusion of NG in inflammatory processes, disruption of phagocytic activity at the systemic and local levels and the occurrence of SPI in children. The formation of NET in the first stage is necessary to supplement the effector function of NG in order to compensate for disorders of phagocytosis.

The problem of rehabilitation of children with congenital cleft lip and palate (CCLP) is a difficult task and doesn’t lose its relevance. Children with CCLP often suffer from repeated acute viral and bacterial infections of the respiratory tract and upper respiratory tract, which leads to a forced delay in surgical, orthodontic treatment, adequate speech therapy and complications after staged surgical operations. The development of inflammatory processes in children with CCLP is associated with anatomical and topographic features that facilitate the penetration of pathogenic microflora in oral and nose mucosa and, consequently, negative changes in the immune system (IS). The key cells of IS in maintaining homeostasis and ensuring oral health are neutrophil granulocytes (NG). NG dysfunctions in CCLP interfere with the elimination of pathogens and support their persistence. This can occur against the background of previously existing defects in the functioning of the NG system and is aggravated by the significant pathogenicity and massiveness of the impact of various infectious agents. Full diagnostics of NG dysfunctions is necessary for the further implementation of their timely immune correction and prevention of the development of pathological chronic inflammation in response to the pathogenic microflora long-term on the mucous membrane of the mouth and nose. For this purpose study was conducted of the functional activity and phenotypic characteristics of NG in children with CCLP at different stages of complex rehabilitation. Blood samples of 56 children with CCLP 1-3 years (n = 20, group 1), 4-6 years (n = 20, group 2), and 7-12 years (n = 20, group 3) at different stages of complex rehabilitation and 30 conditionally healthy children (control groups) of the corresponding age was studied. A violation of the microbiocenosis of the mucous membranes of the oral and nasal cavities was revealed, which may be a cause or a consequence of a decrease in antibacterial immunity, first of all NG dysfunctions. Common for all age groups children with CCLP NG dysfunction was found: the appearance of NG expressing CD14 receptors that are absent in children of all three control groups, which indicates the presence of viral and bacterial load; defects of phagocytosis associated with a decrease in the number of actively phagocytic NG, impaired NG capture functions; impaired NADPH oxidase release with partial or complete blockade of the response to additional antigenic load, even in the absence of acute clinical manifestations. Comparative analysis of the studied indicators of the expression level of the receptors CD64, CD16, CD32, CD14 NG in children with CCLP demonstrates different equipment, which determines the inconsistency of the phagocytic and microbicidal function of NG in different age periods. Thus, an increase in the expression of these membrane markers, especially CD64 and CD14, in older age groups is accompanied by more significant defects in phagocytic and killing functions of NG, which is associated not only with recurrent viral respiratory infections, but also with a high frequency of associated bacterial infections of the respiratory system and ENT – organs. Revealed NG dysfunctions in children with CCLP of various age groups indicate their inability to implement adequate anti-infective protection, which can lead to atypically occurring viral – bacterial infections and the occurrence of various, including purulent complications in the postoperative period, which requires the development of targeted immunotherapy, included in the program of comprehensive rehabilitation in children with CCLP and aimed at restoring impaired NG functions.

The research has shown that the functional state of neutrophilic granulocytes (NG) is determined by the state of NG subpopulation phenotype composition in evaluating the simultaneous expression of CD16, CD32, CD11b membrane markers with considering the density of expressed molecules. The change in NG subpopulations phenotype indicates active or defective inclusion of NG in the immune response in inflammation. Various inducers of endo- and exogenous nature activate NG and promote translocation from cytoplasmic granules and vesicles or expression to the surface cytoplasmic membrane of receptor molecules. In this regard, our interest was in studying the expression peculiarities of CD16, CD32, CD11b NG receptors in patients with atypically occurring bacterial infections (chronic sinusitis) and the possibility of remodeling the NG phenotype under the influence of glucosaminylmuramyl dipeptide (GMDP) and IFNγ in vitro. Subjects of this study were blood samples of patients with chronic sinusitis and conditionally healthy individuals. Flow rate cytometry at CYTOMICS FC500 (Beckman Coulter, USA) was used to evaluate the % NGs expressing CD16, CD32, CD11b, and the fluorescence intensity of these molecules (MFI) before and after incubation with the test substances. Flow cytometry (CYTOMICS FC500, Beckman Coulter, USA) were used to evaluate amount (%) of NGs expressing CD16, CD32, CD11b and mean fluorescence intensity of these molecules (MFI) before and after incubation with the test substances. The studies showed that in patients with chronic sinusitis with persistent recurrent course the presence is characterized by transformed phenotype CD16dimCD32midCD11bbr of CD16+CD32+CD11b+NG subpopulation. We have shown that the revealed changes in the level of expression of trigger membrane receptors do not allow NG to fully engage in inflammatory process and to realize its effector and regulatory functions. Under the influence of GMDP and IFNγ regulatory molecules was demonstrated high mobilization capacity of the studied NGs for functionally significant membrane receptors in realization of various functions.

Aim. A comprehensive assessment of the various links of immunity in women of reproductive age with genital infectious-inflammatory processes. Materials and methods. The study used peripheral blood of 30 patients with inflammatory diseases of the pelvic organs (IDPO), 30 patients with a viral infection of the urogenital tract (IUT), and peripheral blood of 20 apparently healthy women of reproductive age (Control). The cell immunity was evaluated by the contents of CD3 (+), CD4(+)-, CD8(+)-, CD19(+)-, CD56(+)CD16 (+) lymphocytes, the humoral level – by the concentration of serum immunoglobulins of major classes (IgA, IgM, IgG), the functions of neutrophils – in terms of their phagocytic and oxygen-dependent microbicidal functions. Results. The study of population composition of peripheral blood lymphocytes showed that the absolute and relative levels of lymphocytes in peripheral blood, CD3 (+)-, СD8 (+) lymphocytes, as well as the relative level of CD4 (+) and СD19 (+) lymphocytes, is increased in women with IDPO and IUT relatively to the age reference. Along with this, a strong tendency to decrease in the serum concentration of immunoglobulins A and M and predominant depressive changes in the neutrophilic granulocyte system were revealed in patients suffering from infectious and inflammatory diseases of the genital tract. Conclusion. The revealed immunity disorders in women of reproductive age suffering from IDPO and IUT are pathogenetically significant, and a complex pregravid immunocorrection of defects of phagocytic and microbicidal function of phagocytic cells, as well as certain parameters of cellular (quantitative deficiency of NK- and B-lymphocytes) and humoral (inadequate level of serum IgA, IgM, IgG) immunity are important for maintenance of reproductive potential.