mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2022.042mes-202Research ArticleОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕORIGINAL RESEARCHРегуляторные Т-клетки и T-хелперы 17-го типа с экспрессией эктонуклеотидаз CD39 и CD73 при тяжелой механической травме у детейRegulatory T cells and T helper 17 cells expressing CD39 and CD73 ectonucleotidase in children with severe injuryЗакировР. Ш.ZakirovR. Sh.

Рустам Шакирович Закиров

Ломоносовский проспект, д. 2/1, г. Москва, 119296

Rustam Shakirovich Zakirov

Lomonosovsky prospect, 2/1, Moscow, 119296

zakirov.rsh@nczd.ruКупцоваД. Г.KuptsovaD. G.

Москва

Moscow

ФрейдлинЕ. В.FreidlinE. V.

Москва

Moscow

СемикинаЕ. Л.SemikinaE. L.

Москва

Moscow

ПетричукС. В.PetrichukS. V.

Москва

Moscow

КарасеваО. В.KarasevaO. V.

Москва

Moscow

Национальный медицинский исследовательский центр здоровья детей, Минздрава России; Научно-исследовательский институт неотложной детской хирургии и травматологии, Департамента здравоохранения г. МосквыРоссияNational Medical Research Center for Children's Health; Institute of Urgent Children Surgery and TraumatologyRussian FederationНациональный медицинский исследовательский центр здоровья детей, Минздрава РоссииРоссияNational Medical Research Center for Children's HealthRussian Federation2022281020242442330Copyright © Закиров Р.Ш., Купцова Д.Г., Фрейдлин Е.В., Семикина Е.Л., Петричук С.В., Карасева О.В., 20242024Закиров Р.Ш., Купцова Д.Г., Фрейдлин Е.В., Семикина Е.Л., Петричук С.В., Карасева О.В.Zakirov R.S., Kuptsova D.G., Freidlin E.V., Semikina E.L., Petrichuk S.V., Karaseva O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/202

Исследование механизмов развития иммунного ответа при тяжелой механической травме (ТМТ) у детей — актуальная и социально значимая задача по причине высокой инвалидизации и летальности. Целью работы было определение информативных иммунологических критериев тяжести и прогноза исхода травматической болезни у детей (n = 43) на основе оценки экспрессии эктонуклеотидаз CD39 и CD73 в популяциях регуляторных Т-клеток (Treg, CD4+CD127lowCD25high) и T-хелперов 17-го типа (Th17, CD4+CD161+CD3+) при ТМТ в группах с благоприятным (ТМТбл, n = 24), неблагоприятным (ТМТнебл, n = 17) и летальным исходом (n = 2). C помощью метода проточной цитофлуориметрии было выявлено выраженное снижение абсолютного количества Treg и Тh17, а также Treg и Тh17, экспрессирующих CD39 и CD73, в раннем посттравматическом периоде ТМТ. В группах ТМТбл и ТМТнебл относительное число Treg и Th17, экспрессирующих CD39, значимо различалось (p <0,05) и было существенно повышено с первых по третьи сутки после травмы для ТМТнебл. Уровень Treg CD39 (44,4 %) является предпосылкой неблагоприятного исхода у выживших детей при ТМТ. Для больных с летальным исходом были получены крайне низкие показатели экпрессии эктонуклеотидаз: CD39+Treg — 9,52% (9,52–13,75) и CD39+Th17 — 0,92% (0,74–1,1). Для ТМТнебл интенсивность флюоресценции (FL) CD39 на Treg в раннем посттравматическом периоде была повышена в сравнении с ТМТбл. Для средней интенсивности флуоресценции (FL) CD39 на Treg пороговое значение составило 8,25 у.е. Для пациентов с летальным исходом значения FL CD39 на Treg выявлены крайне низкие: 3,95 у.е. (3,7–4,67). Полученные результаты показывают, что экспрессия CD39 и CD73 в популяциях Treg и Th17 в значительной степени связана с тяжестью и исходом травматической болезни у детей.

Frequent resulting disability and case mortality support the urgency of investigation of the immune response mechanisms triggered by severe injury (SI) in children. This study aimed to determine the informative immunological criteria of traumatic injury severity and prognosis in children (n = 43) based on the assessment of expression of CD39 and CD73 ectonucleotidase in populations of regulatory T cells (Treg, CD4+CD127lowCD25high) and T-helper 17 cells (Th17, CD4+CD161+CD3+) in SI cases grouped by the outcome (favorable (SIfav, n = 24), unfavorable (SIunfav, n = 17) and lethal (n = 2)). With the help of flow cytometry, we identified a pronounced decrease in the absolute number of Treg and Th17, as well as Treg and Th17 expressing CD39 and CD73, in the early post-traumatic period. In the SIfav and SIunfav groups the relative number of Treg and Th17 cells expressing CD39 differed significantly (p <0.05); it was substantially higher form the first to the third day post injury in the SIunfav group. The level of Treg CD39 (44.4%) is a premise for an unfavorable outcome in children surviving an SI. In fatality cases, we registered extremely low ectonucleotidase expression rates: CD39+Treg — 9.52% (9.52–13.75) and CD39+Th17 — 0.92% (0.74–1.1). In the SIunfav group, the intensity of fluorescence (FL) of CD39 on Treg cells in the early post-traumatic period was higher than seen in the SIfav group. The threshold value for the average fluorescence intensity (FL) of CD39 on Treg was 8.25 c.u. In fatality cases, the Treg CD39 FL values were extremely low: 3.95 c.u. (3.7–4.67). The results of the study indicate that in children, the expression of CD39 and CD73 in Treg and Th17 populations is significantly associated with the severity of injury and outcome of the traumatic disease.

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The authors declare that there are no conflicts of interest present.