Determination of the degree of peripheral blood neutrophil dysfunction in patients with obstructive jaundice

Introduction. Mechanical jaundice (MF) is the most severe complication of the pathology of the hepato-pancreato-duodenal zone. Despite the improvement in results due to the use of minimally invasive surgery, the mortality rate remains high.

Goal. To study the state of neutrophilic granulocytes by atomic force microscopy in patients with benign obstructive jaundice of varying severity.

Materials and methods. The polycentric study included 84 patients aged 41 to 64 years who were treated in hospitals in Krasnoyarsk with a diagnosis of obstructive jaundice of benign origin. The control group consisted of 60 donors. All patients were divided into 3 groups according to the severity of obstructive jaundice. The chemiluminescence of neutrophils and atomic force microscopy of neutrophil granulocytes were studied to determine the shape, state of the membrane, and adhesion forces.

Results. In patients with mechanical jaundice, the intensity of spontaneous chemiluminescence depends on the severity of mechanical jaundice. Atomic force microscopy revealed violations of the structural organization of the neutrophil granulocyte. As the severity of mechanical jaundice increased, the neutrophil acquired a convex shape, the number of nuclear segments increased, and the cell membrane became uneven. The magnitude of neutrophil adhesion forces decreased from 25 % to 31 %.

Discussion. Based on the analysis of the chemiluminescent activity of neutrophilic blood granulocytes, it can be concluded that the functional capabilities of cells in patients with breast cancer are depleted in parallel with an increase in the severity of breast cancer. This is accompanied by changes in the neutrophil itself.

Conclusion. As the degree of benign obstructive jaundice worsens, the number of neutrophilic leukocytes in the peripheral blood decreases and the number of lymphocytes increases. The intensity of spontaneous chemiluminescence also depends on the severity of breast cancer, and, accordingly, decreases as the degree of jaundice increases, which leads to depletion of the functional capabilities of neutrophils. This process is aggravated by changes in the shape of the neutrophil and its membrane. Together, this causes a decrease in the body's immune response and worsens the course of the disease.

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