Cellular and humoral immune parameters in the peripheral and local blood flow in patients with primary pelvic varicose

Abstract

Pelviс varicose veins (PVV) in women is of extremely high relevance due to a close relationship with reproductive disorders and disease relapse. Despite on research in the field, the results of the analysis on immune reactivity in PVV are rather contradictory, and mainly relate to general mechanisms. The study of cell-mediated and humoral arms of adaptive immunity will allow us to assess an intensity and dynamics of PVV progression as well as a potential for using immune status parameters to optimize diagnosis and immunological correction. The aim of this study was to assess characteristics of cellular and humoral immunity in peripheral (ulnar) and local (ovarian) venous pools in women with mild and moderate PVV. The study involved 142 women of reproductive age (mean age 37.27.1 years) with diagnosed PVV mild (Group 1) (n = 79) and moderate (Group 2) (n = 63) forms. Data from 30 apparently healthy women (mean age 33.56.3 years) were in control group. Flow cytometry was used to identify lymphocyte subsets. The functional state of the humoral immunity was assessed by measuring concentration of immunoglobulins IgA, IgG, IgM by using radial immunodiffusion in the gel. According to our data obtained, patients in group 1 had changes found only in the local blood flow such as prominent lymphocytopenia (decreased level of CD3+ and CD4+ lymphocytes). Patients in group 2 were featured with more pronounced changes: increased lymphocyte level, CD3+, CD4+/CD8+, IgA and lower levels of IgM, IgG in peripheral blood; high average leukocyte and lymphocyte count, IgA and reduced levels of CD3+, CD4+, CD4+/CD8+, IgM and IgG in the local area. It can be concluded that altered parameters in the local blood flow are of primary origin in mild PVV being characterized by disturbed cellular immune arm. Along with increasing disease severity, the host compensatory capabilities decline, which is manifested by pronounced combined immunodeficiency at the level of local blood flow less evident at peripheral level. These results may contribute to a more accurate assessment of intensity and dynamics of PVV progression to optimize diagnostics and immunological correction.