ОСНОВНЫЕ И МАЛЫЕ СУБПОПУЛЯЦИИ ЛИМФОЦИТОВ КРОВИ И ЦЕРЕБРОСПИНАЛЬНОЙ ЖИДКОСТИ ПРИ МЕНИНГИТАХ У ДЕТЕЙ

Abstract Introduction. The analysis of current literature data indicates insufficient understanding of subpopulation composition of lymphocytes in blood and cerebrospinal fluid (CSF) during neuroinfectious diseases in children. It has been established that cells of the main lymphocyte populations are divided into many small (minor) subpopulations. The purpose of this research was to study the relative content of major and minor subpopulations of blood and CSF lymphocytes in children with aseptic viral meningitis (AM) or bacterial purulent meningitis (BM). Materials and methods. Phenotyping of blood and CSF lymphocytes of children aged from 4 months to 17 years with the diagnosis of AM (n=86) and BM (n=39) was carried out by the method of flow cytometry. To make a comparison, we assessed blood and CSF samples of the children with acute respiratory viral infections (ARVI) with the syndrome of meningism (n=27). There was investigated the relative content of the major subpopulations: (CD3 + T-lymphocytes, T-helpers - CD3 + CD4 + Th, cytotoxic T-lymphocytes - CD3 + CD8 + CTL, natural killer cells - CD3 - CD16 + CD56 + NK, B-cells - CD3 - CD19 + ); and the minor lymphocyte subpopulations: (double positive/DP/(CD3 + CD4 + CD8 + ), double negative/DN/(CD3 + CD4 - CD8 - ) T-cells, NKT (CD3 + CD16 + CD56 + ), CD3 - CD8 + NK, CD3 + CD8 dim and CD3 + CD8 bright ). Results. In the acute period of BM and AM in the blood and CSF there were found significant differences in the content of major and minor lymphocyte subpopulations in contrast with the comparison group (ARVI). The predominance of T-cells, Th, CTL, NK, NKT, DN, CD3 - CD8 + NK, CD3 + CD8 bright and CD3 + CD8 dim with a significantly lower B-cell content compared to BM was characteristic for lymphocyte subpopulation composition of blood in AM. In the CSF of children with AM, T-cells and Th prevailed, while the number of B-cells and CD3 - CD8 + NK was lower compared to those in BM. The dynamics of the disease revealed differences in CSF and blood subpopulation composition depending on the nosological form, while maintaining differences of some major and minor lymphocyte subpopulations from the comparison group. The calculation of the ratio of CSF/blood for the major and minor lymphocyte subpopulations revealed the prevalence of most subpopulations (the coefficients ranged from 1.2 to 16.4) in the CSF of the comparison group (ARVI), except B-cells, NK and CD3 - CD8 + NK (coefficients ranged from 0.07 to 0.31). In AM and BM there occurred various changes in the CSF/blood ratio for most of the studied subpopulations in the acute period and in the recovery phase with characteristic features for each nosological form. Conclusion. The results indicate the presence of specific features in the activation of systemic and intrathecal immune response in viral and bacterial meningitis in children and can be used as an additional differential diagnostic criterion.