Science and Innovations in MedicineScience and Innovations in Medicine2500-13882618-754XFSBEI of Higher Education SamSMU of Ministry of Health of the Russian Federation5087710.35693/2500-1388-2021-6-4-45-49Research ArticleMethod for predicting the course of peritonsillar abscess in patients with exacerbation of chronic tonsillitisKonnovaTatyana V.<p>PhD, Associate professor of the Department of Infectious diseases with epidemiology</p>konnova63@yandex.ruhttps://orcid.org/0000-0003-2425-6732SuzdaltsevAleksei A.<p>PhD, Professor of the Department of Infectious diseases with epidemiology</p>a.a.suzdaltsev@samsmu.ruhttps://orcid.org/0000-0002-8968-7560KonstantinovDmitrii Yu.<p>PhD, Associate professor, Head of the Department of Infectious diseases with epidemiology</p>d.u.konstantinov@samsmu.ruhttps://orcid.org/0000-0002-6177-8487KonnovaMariya P.<p>4th year student</p>marykonnova63@mail.ruSamara State Medical University151220216445492211202008112021Copyright © 2021, Konnova T.V., Suzdaltsev A.A., Konstantinov D.Y., Konnova M.P.2021<p><strong>Objectives </strong> clinical and laboratory examination of patients with acute tonsillitis for early diagnosis and prognosis of peritonsillar abscess.</p>
<p><strong>Material and methods.</strong> The study included 101 patient with lacunar tonsillitis complicated by peritonsillar abscess and 64 donors (control group). Immunological studies were performed according to WHO recommendations, on the basis of the immunological department of the EMB Research Institute and the immunological laboratory of the SamSMU.</p>
<p><strong>Results.</strong> Immunological examination of patients with abscess showed an increase in: neutrophil phagocytic activity, CD4<sup>+</sup>/CD8<sup>+</sup>, the number of cells expressing HLA-DR<sup>+</sup> markers, complement activity, IgA, IgM, IgG plasma concentration, fibronectin level, pro-inflammatory cytokines IL-8, IL-1, IL-1 and a decrease in: the level of TNF-, myeloperoxidase activity, number of cells containing CD4<sup>+</sup>, CD8<sup>+</sup>, CD16<sup>+</sup>, CD20<sup>+</sup>, CD25<sup>+</sup> markers. High correlation was registered between total lymphocytes and CD3<sup>+</sup> and CD4<sup>+</sup> cells (p 0.01); between CD3<sup>+</sup> and CD4<sup>+</sup> markers (p 0.01); as well as high correlation of IL-1 levels with IL-8 and IL-1 (p 0.01). Cluster analysis revealed different types of immune homeostasis. The first type (cluster) had high values of leukocytes (total), lymphocytes (total), cells with CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>+</sup>, CD16<sup>+</sup>, CD20<sup>+</sup>, CD95<sup>+</sup> and HLA-DR<sup>+</sup> markers; the second type (cluster) was characterized by significantly lower levels of these immune status indicators. 41 patient had the first type of immune response, with an explicit clinical picture and rapid formation of an abscess. The second type of immune response was registered in 60 patients having a torpid course of the disease with delayed development of abscess. Further, to assess the type of immune reactions, it is necessary to substitute the values of indicators into the model and calculate the integral coefficient of the body's reaction (ICTRO<sub>I</sub> and ICTRO<sub>II</sub>).</p>tonsillitisperitonsillar abscesstypes of immune responsescellular and humoral immunityангинапаратонзиллярный абсцесстипы иммунных реакцийклеточный и гуморальный иммунитет[Bychkova MV, Trusov DV, Kulyutsina ER, Pochinina NK. Informative value of laboratory parameters defined according to the standards of medical help at patients with chronic sinusitis and chronic tonsillitis. Bulletin of TSU. 2017;22(6):1612–1620. (In Russ.). [Бычкова М.В., Трусов Д.В., Кулюцина Е.Р., Починина Н.К. Информативность лабораторных показателей, определяемых по стандартам медицинской помощи у больных с хроническими синуситами и хроническими тонзиллитами. Вестник ТГУ. 2017;22(6):1612–1620]. doi: 10.20310/1810-0198-2017-22-6-1612-1620][Arefyeva NA, Aznabaeva LF, Hafizova FA. Immunocorrectors in the complex treatment of paratonsillitis. Vestn. Otorhinolaryngol. 1999;2:42–45. (In Russ.). [Арефьева Н.А., Азнабаева Л.Ф., Хафизова Ф.А. Иммунокорректоры в комплексном лечении паратонзиллита. Вестник оториноларингологии. 1999;2:42–45].][Baryshevskaya LA, Vladimirova TYu, Zeleva OV, Koldova EV. Chronic inflammation of the tonsils associated with Epstein – Barr virus. Science and innovation in medicine. 2018;1(9):6–10. (In Russ.). [Барышевская Л.А., Владимирова Т.Ю., Зелева О.В., Колдова Е.В. Хроническое воспаление небных миндалин, ассоциированное с вирусом Эпштейна – Барр. Наука и инновации в медицине. 2018;1(9):6–10]. https://doi.org/10.35693/2500-1388-2018-0-1-6-10][Bochorishvili VG. Pathology of internal organs in patients with angina and chronic tonsillitis. L.: Medicine, 1991. (In Russ.). [Бочоришвили В.Г. Патология внутренних органов у больных ангиной и хроническим тонзиллитом. Л.: Медицина, 1991].][Grechukhina YuA, Oslopov VN, Fazylov VH. Features of immune status and central hemodynamics in patients with angina depending on the level of cardiac troponin T in blood serum. Kazan medical journal. 2003;2:89–97. (In Russ.). [Гречухина Ю.А., Ослопов В.Н., Фазылов В.Х. Особенности иммунного статуса и центральной гемодинамики у больных ангиной в зависимости от уровня сердечного тропонина Т в сыворотке крови. Казанский медицинский журнал. 2003;2:89–97].][Egorova EA, Galimzyanov HM, Alieva AA. Optimization of treatment of uncomplicated angina and lacunar state after opening peritonsillar abscess. Herald of the DSMA. 2016;1(18):65–70. (In Russ.). [Егорова Е.А., Галимзянов Х.М., Алиева А.А. Оптимизация лечения неосложненной лакунарной ангины и состояния после вскрытия паратонзиллярного абсцесса. Вестник ДГМА. 2016;1(18):65–70].]