THE SPECTRUM OF IMMUNORESISTANCE DISORDERS AND INFLUENCE OF CYTOTOXICITY AND PATHOGENICITY OF DAMP FRACTIONS ON THE POST-COVID-19 SYNDROME FORMATION AND THE MAIN DОISEASE COMPLICATION IN PATIENTS WITH URGENT SURGICAL PATHOLOGY

Abstract

Summary. The infectious nature of COVID-19 leads to complications in the immune system. It is relevant to determine the long-term consequences of COVID-19, which can be triggers for the urgent surgical pathology’s development of the thoracic and abdominal organs in patients with certain risk factors associated with characteristic disorders of immunometabolic reactions. The aim. To determine the spectrum of immune resistance disorders and to find out the effect of cytotoxicity and pathogenicity of DAMP fractions on the post-COVID-19 syndrome formation and complications of the main disease in patients with urgent surgical pathology. Materials and methods. Patients (n = 143) with urgent cardiovascular and abdominal surgical pathology that arose against the background of post-COVID-19 syndrome were examined. We used: spectrophotometry (content of DAMP fractions), immunoturbimetry (concentration of C3 and C4 complement components); luminescent microscopy (phagocytic activity of neutrophils); light microscopy (spontaneous activity of NADPH-oxidase systems of neutrophils); flow cytometry (expression of T lymphocyte activation markers); immunofluorescence (determination of antinuclear antibodies). Results. It was found that the predominance of certain DAMP fractions is the cause of the immunopathological patterns formation in the development of post-COVID-19 syndrome. In patients with urgent surgical pathology and the predominance of the DAMP260 oligonucleotide fraction, significant changes in the hemogram, failure of endocytosis and incomplete phagocytosis of neutrophils, increased expression of the T lymphocytes late activation marker (CD3+HLA-DR+) were found. In all examined patients, a high frequency of autoantibodies to nuclear structures (ANA) was found, which depended on the content of DAMP fractions. The maximum repertoire of antibodies was found in patients with the oligonucleotide fraction (DAMP260) predominance. Conclusions. In patients with urgent surgical pathology, during the formation of post-COVID-19 syndrome, the chronic immunoinflammatory reaction formation occurs against the background of the activation cascades development of innate and adaptive immunity factors.