Перегляд за Автор "Lytvynenko, M.V."

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    Determination of aspergillosis of the female genital organs in women with immunodeficiency
    (Kharkiv National Medical University, 2023) Lytvynenko, M.V.; Bondarenko, A.V.; Bondarenko, O.V.; Gargin, V.V.; Katsap, O.V.
    Background. Morphological diagnosis of aspergillosis sometimes poses great difficulties due to the fact that molds of the genus Aspergillus are very sensitive to the use of antimicrobial therapy and change under its influence. In this regard, we provide information about aspergillosis of the female genital organs, discovered accidentally during an autopsy. The purpose of the study is to conduct a complex pathomorphological analysis of biopsy, operative and sectional gynecological material of women with secondary immunodeficiency conditions, for early diagnosis of aspergillosis (which is the key to a favorable outcome of the disease), differential diagnosis and detection of invasive forms of aspergillosis. Materials & Methods. We analyzed the autopsies of 4,796 women who died in Odesa region from 2009 to 2022. Autopsies revealed 7 cases of aspergillosis with damage to the female reproductive system. All of them were found in women who had confirmed HIV infection. In 5 cases, women additionally suffered from chronic alcoholism. Results. Based on the results of these cases, it can be stated that the detection of characteristic mycelium in the preparations is a reliable sign of aspergillosis, but their absence does not deny this disease. Aspergillus hyphae change as the process develops: they can be weakly stained, and with dystrophic phenomena and the presence of necrotic fragments of mycelium, it can be almost colorless when using hematoxylin and eosin. While necrosis, tissue detritus is observed in the center of the granuloma, fibrous structures, fungal hyphae are formed perifocally. To confirm the diagnosis, it is important to detect granulomatous productive inflammation, conidial heads, inflammatory infiltration, microabscesses, foci of calcifications. However, against the background of immunodeficiency, it is not always possible to see the "classic morphological picture" of aspergillosis. In addition, detection of characteristic mycelium is possible only in a proportion of patients. Conclusions. When examining the autopsy material of deceased women with immunodeficiency states, attention should be paid to the specific etiology of inflammatory processes of the reproductive system and the nature of the inflammatory process, the presence of Aspergillus hyphae and mycelia. The presence of morphological changes characteristic of aspergillosis allows to conduct a diagnostic search in the right direction. Detection of an invasive form of aspergillosis may indicate the presence of an immunodeficient state.
  • Ескіз
    Документ
    Peculiarities of immune status in the presence of secondary immunodeficiency of infectious and non-infectious origin in women of reproductive age
    (Georgian Med News, 2023) Lytvynenko, M.V.; Antonenko, P.B.; Lobashova, K.G.; Kashchenko O.A.; Bondarenko A.V.; Bondarenko O.V.; Gargin V.V.
    The design of studies on the immune system does not have gender peculiarities, but the information about the higher frequency of pathology of the female reproductive system in the presence of immunodeficiency condition determines the purpose of this study, namely, to identify the features of immune status in the presence of secondary immunodeficiency of infectious (i.e., HIV infection, AIDS stage) and non-infectious origin (alcohol dependence syndrome) and their combination in women of reproductive age. The material for the study of cellular and humoral immunity was a lymphocyte suspension obtained by centrifugation of peripheral blood (taken within 12 hours after death) in women of reproductive age with HIV infection (AIDS stage), alcohol dependence syndrome and their combination. Immunological examination included the determination of quantitative indicators of cellular immunity using monoclonal antibodies: T-lymphocytes (CD3) and their main subpopulations of T-helper cells (CD4), cytotoxic lymphocytes (CD8), CD4/CD8 immunoregulatory index; as well as indicators of humoral immunity: B-lymphocytes (CD19) and immunoglobulins of the main classes (IgA, IgG, IgM). Additionally, interleukins IL-6 and IL-10 were studied to determine the parameters of the cytokine profile. The study indicates that the number of leukocytes and lymphocytes in the group of deceased women with alcohol dependence syndrome was 3.6±0.38x109/l and 0.82±0.35x109/l; in deceased women with HIV/AIDS, these indicators were reduced - 2.9±0.03x109/l and 0.39±0.04x109/l, respectively; and in deceased women with combined pathology (AIDS and alcohol dependence syndrome), they were reduced even more intensively - 2.7±0.04x109/l and 0.35±0.06x109/l (p<0.01). Compared to the control group - 5.22±0.4x109/l and 1.73±0.21x109/l - the number of leukocytes and lymphocytes was reduced in all study groups. In the group of deceased women with alcohol dependence syndrome, significant impairments in the proliferative activity of T-lymphocytes (CD3) and their subpopulation (CD4), as well as B lymphocytes (CD19) and natural killer cells (CD16) were found compared to the group of healthy individuals. Thus, in the control group, the percentage, and absolute values of CD3 were 60.37±4.2% and 1.04±0.05×106/l, and in women suffering from chronic alcoholism, they were statistically significantly lower - 49.1±3.1% and 0.42±0.08×106/l, respectively, p<0.01. The same tendency was found when comparing the values of T-helper cells (CD4) in the control group (44.2±2.9% and 0.76±0.13×106/l) and in deceased patients suffering from chronic alcoholism (33.7±4.6% and 0.28±0.23×106/l), p<0.01. Secondary immunodeficiencies of infectious and non-infectious origin in women (in particular, those formed in HIV/AIDS, alcohol dependence syndrome and their combination) are characterized by negative changes in the cellular and humoral components of the immune system, as evidenced by the presence of transient immunodeficiency, activation of cytolytic and auto aggressive reactions. As a result of these processes, systemic and organ pathology develops, in particular, weakening of the body's resistance to various infections and pathological changes in organs and tissues, which may be one of the links in the development of pathological processes in internal organs and tissues.