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Napovedna vrednost celicnih in humoralnih imunskih parametrov pri otrocih
Avtor: Simona Puhan, Nina Ostaševski
Mentor: prof. dr. Alojz Ihan, dr. med.
V študijo smo zajeli 809 otrok, ki so bili obravnavani na alergološkem oddelku Pediatricne klinike in preiskani glede vrednosti parametrov limfocitnih populacij iz venske krvi. Znotraj preiskane skupine smo dolocili posamezne skupine: kontrolno skupino, skupino otrok z alergijo ter skupino otrok s hipogamaglobulinemijo.
V nalogi smo ugotavljali povezanost med koncetracijami limfocitnih populacij v venski krvi otrok in klinicnim stanjem preiskovanih otrok. V prvem delu naloge smo v vsaki skupini dolocili povprecne vrednosti za posamezen limfocitni parameter, vrednosti posameznih parametrov limfocitnih populacij pa primerjali med posameznimi skupinami s Studentovim testom t. V skupini otrok z dokazano alergijo oz. atopijo so v primerjavi s kontrolno skupino znacilno ( p< 0,05 ) povecane koncentracije limfocitov T, celic CD4 ter razmerje CD4/CD8. V skupini otrok z dokazano hipogamaglobulinemijo so v primerjavi s kontrolno skupino znacilno povecane ( p<0,05 ) koncetracije limfocitov T, celic T CD4 ter deleži limfocitov, limfocitov T, celic T CD4, celic T CD8, aktiviranih ( HLA-DR) limfocitov T in celic NK. Znacilno je povecano tudi razmerje CD4/CD8. V drugem delu naloge smo postavili za posamezne limfocitne parametre po dve zgornji meji. Ugotavljali smo delež otrok, katerih imunski parametri so presegali izbrano presecno (cut-off) vrednost za posamezne parametre limfocitnih populacij. S pomocjo testa HI2 smo prikazali parametre limfocitnih populacij, glede katerih je pricakovana frekvenca otrok nad presecno vrednostjo pri alergiji ali hipogamaglobulinemiji znacilno razlicna od pricakovane frekvence otrok nad presecno vrednostjo pri populaciji otrok brez alergije ali hipogamaglobulinemije. Pri otrocih z alergijo je znacilno vecje pricakovane frekvence mogoce ugotavljati z merjenjem krvne koncentracije celic T -CD8 in krvne koncentracije celic T, ce se presecna vrednost za oba parametra postavi na vrednost 75-tega percentila normalne populacije. Pri otrocih s hipogamaglobulinemijo je znacilno vecje pricakovane frekvence mogoce ugotavljati z merjenjem krvne koncentracije aktiviranih celic T (HLA DR), deleža celic T CD4, deleža aktiviranih celic T (HLA DR) in razmerja celic T CD4 / T CD8. Rezultati te raziskave potrjujejo našo hipotezo, da med posameznimi opredeljenimi klinicnimi skupinami obstajajo dolocene razlike v koncentracijah ali deležih posameznih limfocitnih subpopulacij. Zato bi rezultate imunskega statusa lahko uporabili v diagnosticne namene, kakor tudi pri spremljanju dolocenih vrst patologije, s katero se srecuje zdravnik pri vsakdanjem delu z otroci.
[Abstract / English version]
Estimated value of cell and hummoral immune parameters with children
Author: Simona Puhan, Nina Ostaševski
Mentor: prof. dr. Alojz Ihan, dr. med.
The study covers 809 children treated in the Allergic Department of the Paediatric Clinic and examined regarding the parameter values of lymphocyte populations from venous blood. Inside the examination group separate groups were defined: a control group, a group of children with allergy, and a group of children with hypogammaglobulinemia.
The study was finding out a connection between concentrations of lymphocyte populations in the children's venous blood and the clinical state of the examined children. In the first part of the study, average values were defined in each group for a specific lymphocyte parameter, but the values of specific parameters of lymphocyte populations were compared among separate groups to the Student's test t. In the group of children with proven allergy or atopy, there are comparing to the control group characteristically (p < 0.05) increased concentrations of the lymphocytes T, the cells CD4, and the ratio of CD4/CD8. In the group of children with proven hypogammaglobulinemia, there are comparing to the control group characteristically increased (p < 0.05) concentrations of the lymphocytes T, the cells T CD4 and the shares of lymphocytes, lymphocytes T, cells T CD4, cells T CD8, activated (HLA-DR) lymphocytes T and cells NK. Furthermore the ratio CD4/CD8 is also characteristically increased. In the second part of the study, two upper limits were set for separate lymphocyte parameters. A share of children was established the immune parameters of whom surpassed the chosen cut-off value for separate parameters of lymphocyte populations. By means of the test HI2, the parameters of lymphocyte populations were shown with regard to which the expected frequency of children was above the cut-off value with allergy or hypogammaglobulinemia characteristically different from the expected frequency of the children above the cut-off value with the population of the children without allergy or hypogammaglobulinemia. With the children with allergy, the characteristically increased expected frequencies could be determined with measurement of the blood concentration of the cells T -CD8 and the blood concentration of the cells T, if the cut-off value of both parameters is set to the value of the 75th percentile of the normal population. With the children with hypogammaglobulinemia, the characteristically increased expected frequencies might be defined by measuring blood concentration of the activated cells T (HLA DR), share of the cells T CD4, share of the activated cells T (HLA DR), and the ratio of the cells T CD4 / T CD8. The results of this research confirm our hypothesis that among the separate defined clinic groups there are certain differences in concentrations or shares of separate lymphocyte sub-populations. Therefore the results of the immune status could be used for diagnostic purposes, as well as with accompanying specific pathology types doctors come across at every day work with children.