INDICATORS OF THE PERIPHERAL BLOOD CELLULAR IMMUNITY ELDERLY IN THE PATIENTS WITH MALNUTRITION

Abstract

The complex dynamic process of immunosenescence is characterized by significant changes in the components and functions of the innate and acquired defense of the organism with continuous depletion of immune cells. The unbalanced state resulting from insufficient nutrient intake, malnutrition, affects the pathogenesis of chronic diseases. The aim of the study: to determine the subpopulations of CD4+ and CD8+ T-lymphocytes, B-cells, naive and memory cells in malnutrition. Materials and methods. The total number of lymphocytes, cytotoxic, T-helpers, the percentage of CD45RA+ naive and CD45RO+ memory cells, neutrophils and monocytes were determined in the peripheral blood of healthy individuals under (20 people) and over 60 years old (22 people) and in patients with moderate (22 people) and severe malnutrition (20 people). Results. Positive correlations were established for patients with malnutrition between the parameters of standard scales and bioimpedance analysis, namely, fat-free (r=0.654, p<0.001), active cellular (r=0.875, p<0.001) and muscle mass (r=0.679, p<0.001). In elderly individuals, a reliable increase in the percentage of total CD3+ cells of cytotoxic T lymphocytes, neutrophils was observed, and, conversely, a decrease in the number of B lymphocytes and NK cells (p<0.05). Also, the number of naive cells (CD45RA) decreased and the number of memory cells (CD45R0) increased. A negative correlation was established between the presence of malnutrition in patients and the number of CD45RA+ from CD3+ cells and their CD4+ subpopulation (rCD3+= -0.692, rCD4+= -0.595) and, on the contrary, a positive one with the indicators of CD45R0+ T-lymphocytes (rCD3+=0.714, rCD4+=0.718, respectively). With an increase in the severity of malnutrition, the neutrophil-to-lymphocyte ratio significantly decreased (p<0.05). Conclusions. In elderly people, compared to young people, an increase in the number of neutrophils, cytotoxic T-lymphocytes, and, conversely, a decrease in the number of B-lymphocytes and NK cells (p<0.05) was found. In elderly patients with malnutrition, compared to young people, the number of naive lymphocytes and CD8+ T-memory cells decreases, and the number of CD4+ T-memory cells increases significantly. The indicator of systemic inflammation in elderly patients correlates with the severity of malnutrition.