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Khirurgii

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Year 2020 Vol. 28 No 3

TRAUMATOLOGY

M.V. CHEPELEVA, N.M. KLIUSHIN, A.M. ERMAKOV, E.I. KUZNECOVA

LYMPHOCYTE POPULATIONS IN PATIENTS WITH PERIPROSTHETIC INFECTION OF THE HIP JOINT

National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of Russia, Kurgan,
The Russian Federation

Objective. To study the peculiarities of cell-mediated immunity in patients with periprosthetic hip joint infection depending on disease severity and according to the method of surgical intervention, subsequently used.
Methods. The values of cell-mediated immunity were studied at the preoperative stage in patients (n=66) with periprosthetic hip joint infection who were divided into three groups: group I (n=13) – debridement of the infected joint with the replacement of the implant modular components; group II (n=36) – articulating spacer installation; group III (n=17) – resection arthroplasty. Lymphocyte subpopulations were studied by laser flow cytofluorimetry method.
Results. In comparison of the cell immunity values in groups I, II, III with those of the control group there was observed the absence of subpopulation alterations in group I, as well as the elevation of relative content of ÑD3+ÑD8+ for normal content of ÑD3+ÑD4+ in group II; the elevation of both relative and absolute values of ÑD3+ÑD8+ while reduction of the values of ÑD3+ÑD4+ in group III. The content of activated T-lymphocytes was elevated in all three groups. A Kruskal-Wallis test to analyze 3 groups revealed significant difference between the groups (I, II, III) regarding the immunoregulatory index (CD4/CD3); (H-6,67; ð=0,035). There was statistically significant difference between groups I-III (p=0,012) and between groups II-III (p=0,011). Intergroup difference was also identified regarding ÑD3+ÑD4+ (%); (H-22,57; ð=0,0003). Statistically significant difference was determined between groups I-III (p=0,0002) and between groups II-III (p=0,0003).
Conclusions. The alterations in lymphocyte population composition can be considered as an informative marker of severe infection. The study of T-lymphocyte subpopulations Ò-helpers (ÑD3+ÑD4+) and cytotoxic T-lymphocytes (ÑD3+ÑD8+)) can be used to reveal immuno-compromised patients. These values can be regarded as additional diagnostic tests to select the optimal surgical treatment of periprosthetic infection.

Keywords: periprosthetic infection, hip joint, cell-mediated immunity, Ò-helpers (ÑD3+ÑD4+), cytotoxic T-lymphocytes (ÑD3+ÑD8+)
p. 276-283 of the original issue
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Address for correspondence:
640014, Russian Federation,
Kurgan, M. Ulyanova str., 6,
National Medical Research Center
of Traumatology and Orthopedics Named
after Academician G.A. Ilizarov of the Ministry
of Health of the Russian Federation,
tel. mobile: +7 912 838-42-49,
å-mail: citoz@mail.ru,
Kuznecova Elena I.
Information about the authors:
Chepeleva Marina V., PhD, Senior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-9731-115X
Kliushin Nicolay M., MD, professor, Head of the Clinic of “Purulent osteology”, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-1601- 9713
Ermakov Artem M., PhD, Traumatologist-Orthopedist, the Clinic of “Purulent osteology”, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0002-5420-4637
Kuznecova Elena I., Junior Researcher, Scientific Clinical Laboratory of Microbiology and Immunology, National Medical Research Center of Traumatology and Orthopedics Named after Academician G.A. Ilizarov of the Ministry of Health of the Russian Federation, Kurgan, Russian Federation.
https://orcid.org/0000-0001-8022-5696
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