Objective – to study the cytokine status of blood serum in hypochromic anemias of various origins. M ethods. The studies were carried out in 396 women aged 16 to 60 years. 79 of them were practically healthy and constituted a control group. 317 had anemic syndrome, 103 of them suffered from iron deficiency anemia, 214 – from chronic diseases. Results. The study of the level of proinflammatory cytokines in persons with ACD revealed an increase in the level of IL-6, TNF-α and interferon-γ, and a pronounced correlation was established between the level of pro-inflammatory cytokines and the content of hepcidin. Conclusions. In hypochromic anemias, a significant increase in proinflammatory cytokines was revealed in persons with anemia of chronic diseases, which leads to a decrease in the availability of iron for erythropoiesis and the formation of functional iron deficiency, in contrast to true iron deficiency in iron deficiency anemias. The approaches to the treatment of these anemias (ACD and IDA) are fundamentally different and this explains the importance of the differential diagnosis of these anemias.

Objective – to study the presence and significance of human papillomavirus and Epstein-Barr virus in the development of chronic hyperplastic laryngitis and evaluate the effectiveness of immunomodulating therapy in the treatment of the disease. M ethods. Thirty men with chronic hyperplastic laryngitis aged 30 to 70 years were examined. The comparison group consisted of 30 healthy men over the age of 29 years. The determination of human papillomavirus was carried out by polymerase chain reaction. Antibodies to Epstein-Barr virus antigens were investigated by enzyme immunoassay. Results. Among patients with chronic hyperplastic laryngitis, HPV infection was 50 %: HPV was detected in 15 of the 30 samples studied. At the same time, HPV of type 11 was detected in 3 patients; in 12 cases, human papillomaviruses of high oncogenic risk were detected – genotypes 16, 18, 31, 31. Indirect laryngoscopy revealed diffuse hyperplasia of all sections of the laryngeal mucosa in 9 (30 %) patients with chronic hepatitis C and there was uneven mucosal hyperplasia and its hyperemia in 21 (70 %). Antibodies to capsid and early Epstein-Barr virus antigens were tested in 21 patients with chronic hepatitis C (70 %). Conclusions. The detection of HPV of high oncogenic risk in chronic hepatitis C, the presence of high titers of specific antibodies characterizing the immune response to the Epstein-Barr virus, indicates the activation of the virus in the body of patients with chronic hyperplastic laryngitis. Conducted comprehensive treatment with the inclusion of an inducer of interferon - cycloferon gives a visible clinical effect in the treatment of this category of patients.

Objective – to research the cellular immunity in anemia of chronic diseases of various origin. Materials and methods. The studies included 276 women at the age from 16 to 60. 79 persons were almost healthy and were included into the control group. 197 patients demonstrated anemia of chronic diseases. Anemia at the background of autoimmune connective tissue diseases (rheumatoid arthritis) was diagnosed in 125 women, anemia of chronic diseases in bacterial infections (chronic tonsillitis, bacterial endocarditis, chronic pyelonephritis) – in 72. Results. The patients with anemia in rheumatoid arthritis and in infectious-inflammatory processes demonstrated the decrease in the total number of CD3+ CD19-cells in the peripheral blood by means of the population CD3+CD4+-cells. The level of cytotoxic CD3+CD8+-cells did not differ from the level in the healthy persons. Conclusion. The patients with anemia of chronic diseases demonstrate the evident changes in the cellular immunity, indicating the presence of imbalance in the system of T-cells in combination with the depressed levels of the natural (mediated by NK-cells) cytotoxicity in patients with rheumatoid arthritis. At the background of rheumatoid arthritis with anemia of chronic diseases, the level of regulatory T-cells (they play their significant role in suppression of excessive inflammatory response and autotolerance) decreases significantly that may be the predictor of development of anemic syndrome.

Objective: to investigate the erythron and hematological reactions in miners in relation to the length of underground work. Subjects and methods. A prospective study of peripheral blood red cell parameters was conducted in 482 miners with an underground work length of as long as 40 years, who were divided into 3 length groups. Age subgroups were identified from the length groups to define the significance of age-related changes. A control group comprised 30 apparently healthy volunteers who did not work under harmful working conditions. Results and discussion. The miners were found to have the following statistically significant changes in red blood cell parameters in relation to the underground work length: elevated levels of red blood cells and hemoglobin as their adaptation to chronic hypoxia and intoxication in the first 10 years of underground work, which were more pronounced in young people (aged less than 29 years), this results from the accelerated release of red blood cells from the bone marrow into the bloodstream. Thereafter, there is a satisfactory adaptation or resistance phase that makes itself evident in the stabilization of erythron parameters. This process is accompanied by the change in the morphophysiological parameters of red blood cells themselves, which may present as increases in average hemoglobin concentration in the red blood cells and in their average hemoglobin volume. The alteration of cell volume is associated with the longer maturation of red blood cells and their increased hemoglobin volume. Conclusion. Our investigation has established that that the miners with an underground work length of less than 10 years, exposed to intermittent hypoxia and intoxicated with coal-ore dust, show a compensatory rise in red blood cells and hemoglobin levels; those with a length of 10 years or more had exhausted adaptive resources, as shown by the downward trend for red blood cells and hemoglobin, which is compensated for by increases in the volume of red blood cells and their hemoglobin concentration. Keywords: hypoxia, red blood cells ta^gbWn general adaptation syndrome.

Objective: to study the time course of immunological changes in patients with acute severe brain injury (SBI) and their use along with the integrated indices of evaluation of its severity to define criteria for predicting the development of pyoseptic complications. Subjects and methods. Immunological parameters were studied in 53 SBI patients aged 17—65 years on days 1, 7, and 14 days after injury. There were 2 groups: 1) 16 patients without complications; 2) 37 patients with pyoseptic complications in the acute period of the disease. The integral scales SIRS, CPIS, Glasgow coma scale (GCS), APACHE II, laboratory parameters (immunograms, platelets, soluble fibrin-monomer complexes, and medium molecular weight peptides) in the prediction of pyoseptic complications were analyzed in patients with SBI. A control group consisted of 23 apparently healthy individuals. Results. The found immunological parameters lead to the conclusion that patients with SBI had significant immunodeficiency of mixed genesis by the cellular and humoral types in the acute period of the disease, immune system activation at week 2 of the disease in the development of pyoseptic complications. The decrease in the immunoregulatory index or less than 1.17 or its increase or more than 2.55 on day 1 after SBI was associated with the higher risk of pyoseptic complications. Some indices of an immunogram and the integral scales APACHE II, SIRS, CPIS, and GCS were found to be of low importance in the prediction of pyoseptic complications in SBI. Multivariate regression analysis showed that indices, such as the relative blood count of CD3+, CD95+ lymphocytes, platelets, the serum levels of immunoglobulin M and medium molecular weight peptides (at 262 nm), as well as GCS scores and the maximum temperature on the day of the investigation, were of the greatest value in the construction of prognostic models. Conclusion. The proposed models for the prediction of pyoseptic complications in the acute period of SBI may be useful in optimizing the use of antibiotics and immunomodulating therapy. Key words: severe brain injury, prediction of pyoseptic complications, cellular and humoral immunological parameters.

Fifty-three patients aged 17-65 years who had severe brain injury (SBI) were examined and randomized to 2 groups: 1) 16 patients without complications; 2) 37 patients developed pneumonia (35.2%), bronchitis (32.4%), meningitis (10.8%), meningitis concurrent with pneumonia (8.1%), bedsores concurrent with bronchitis (13.5%) on days 4-7. The authors studied the immune status: the subpopulation composition of lymphocytes (CD+, a marker of adult lymphocytes; CD+, a marker of T helper/inductor cells, CD8+, a marker of cytotoxic lymphocytes, CD16+, a marker of natural killer cells, CD20+, a marker of B lymphocytes) by the indirect immunofluorescence technique using monoclonal antibodies; the functional activity of lymphocytes from the expression of activation antigens, such as CD71+, CD25+, HLA-DR; serum immunoglobulins (IgG, IgA, and IgM) by the immunoturbidimetric technique using the test systems (Spinreakt, Spain). A control group included 23 apparently healthy individuals. Immunosuppression developing as significant T lymphopenia due to lower CD4+ and CD8+ lymphocytes, as well as impaired humoral immunity with inadequate IgG generation was detected in the acute phase of SBI. The indicators reflecting the development of secondary pyoseptic complications were elevated CD3+, CD4+, and CD8+ lymphocytes on day 7 and the higher lymphocytic expression of the activation antigens CD25+ and CD71+. The findings show that the diagnostic markers, such as CD3+, CD4+, CD8+, CD25+, and CD71+ lymphocytes, should be included into a comprehensive examination of patients with SBI.

Objective: to study the time course of changes and relationship of the serum indicators of apoptotic processes in neurore-suscitation patients. Subjects and methods. Thirty-eight neuroresuscitation patients, including 14 patients with severe brain injury (SBI) (mean age 41.4±4.3 years) and 24 patients with strokes (mean age 53.8±2.5 years), were examined. The group of patients with strokes was divided into 2 subroups: 1) 11 patients with ischemic strokes (IS) and 2) 13 with hemorrhagic strokes (HS). The Glasgow coma scores for admission consciousness loss were 7.6±0.8 in the SBI group and 9.5±0.7 in the stroke group; mortality was 28.6 and 37.5%, respectively. A control group included 16 subjects (mean age 47.9±3.8 years). The investigators measured the serum levels of FAS antigen and its ligand (sAPO-I/FAS and sFAS-L), cas-pase-1/ICE, sCD40 (Bender MedSystem, Austria) and hTRAIL (Biosource, Belgium) by solid-phase immunoassay in neuroresuscitation patients on days 1, 7, and 14 of the acute period of diseases. They used statistical methods, such as Wilcoxon-Mann-Whitney U-test, Spearman’s rank correlation test. Results. A reduction in hTRAIL was observed in all the groups. There was a decrease in serum sCD40 in strokes on days 1 to 14 and in SBI on days 7 to 14. An increase in caspase 1/ICE was seen in HS in the first 24 hours, in IS on days 1 to 7, and in SBI on days 1 to 14. The most pronounced rise in caspase-1/ICE was induced by ischemic brain lesion within the first week of disease. A prolonged increase up to 2 weeks was noted in SBI. No rise in serum FAS-L was found in the examinees. The time course of changes in sAPO-I/FAS was different in all the groups. The most marked, moderate, and none reductions were revealed in HS, IS, and SBI, respectively. There was a pronounced serum sAPO-I/FAS increase in SBI within the first 24 hours. Assessment of correlations between the serum indicators of apoptosis revealed that there were differences in the association between the indices under study in all the patient groups and in the control group. Conclusion. There are general features and differences in the time course of changes in serum apoptotic markers and their association in the acute period of SBI, IS, and HS. Key words: severe brain injury, stroke, apoptosis, APO-I/FAS, FAS-L, caspase-1/ICE, CD40, hTRAIL.