2017 год, №5

Содержание выпуска
IMMUNOLOGICAL MEMORY AS A BASIS FOR A WISE VACCINATION STRATEGY. A RATIONALE FOR INTRODUCING A COMPREHENSIVE SEROEPIDEMIOLOGICAL SURVEILLANCE SYSTEM IN RUSSIA
Gushchin V. A., Manuilov V. A., Mazunina E. P., Kleymenov D. A., Semenenko T. A., Gintsburg A. L., Tkachuk A. P.
Стр. 5 — 25
Immunological memory is one of the key features of the adaptive immunity. It confers the ability to resist infection and prevents development of cancer or autoimmune diseases. Most importantly, immunological memory mediated by preexisting antigen-specific clones of T- and B-cells ensures a rapid and effective response to an invasion by a previously encountered pathogen. Since vaccination induces a specific long-lived response to infectious agents, it becomes a basis for preventive medicine. In a human population, immunological memory of individuals shapes the so-called herd or community immunity crucial for national health. The present review touches upon significant population-wide research studies of immunological memory with regard to immunization. We discuss the principles of serological testing and the outcomes of serological monitoring conducted in different countries, and talk about standard and innovative analytical approaches to studying immunological memory. We also pinpoint the drawbacks of methods used for herd immunity assessment in Russia and propose a comprehensive system for seroepidemiological surveillance.
IMMUNOLOGICAL MEMORY FORMED IN RESPONSE TO ADMINISTRATION OF GamTBvac RECOMBINANT TUBERCULOSIS VACCINE CANDIDATE: CLINICAL TRIALS IN HEALTHY VOLUNTEERS
Kleymenov D. A., Mazunina E. P., Lunin V. G., Koptev E. Yu., Manuilov V. A., Gushchin V. A., Tkachuk A. P.
Стр. 26 — 33
So far BCG, a live attenuated strain remains the only available vaccine for tuberculosis prevention and control. Although BCG is effective against miliary tuberculosis and tuberculous meningitis in children, it barely protects adults and adolescents from the pulmonary form of the disease or reactivation of the latent infection. Still, its effectiveness can be increased by using recombinant booster vaccines containing both and antigens. This article reports preliminary data on the safety and immunogenicity of a recombinant vaccine candidate, GamTBvac, developed for tuberculosis prevention. Its immunogenicity was studied in 12 volunteers. Over the course of 20 weeks following GamTBvac administration, we measured cell-mediated and humoral immune responses using interferon-gamma release assays and multiplex xMAP-based immunoassays. On day 140 after the first administration of the vaccine, 10 participants of the study (83 %) still showed a positive cellular response to all antigens contained in the vaccine. Both sense antigens CFP10 and ESAT6 induced production of IgG antibodies between days 98 and 140 of the observation. The Ag85 antigen induced a relatively weak humoral response. On the whole, the recombinant GamTBvac is safe and activates cell-mediated and humoral components of the adaptive immunity, forming immunological memory.
ADAPTIVE IMMUNITY AND GENETIC ASPECTS OF TUBERCULOSIS IN CHILDREN
Plekhanova M. A.
Стр. 34 — 40
Cell-mediated immunity and the cytokine interferon gamma (IFNγ) have an important role in promoting host resistance against tuberculosis-causing mycobacteria (TBM), but the exact mechanism of developing immunity against tuberculosis (TB) is unknown. In this work we evaluate the immune response in TB and the association between gene polymorphism (T-1488C) and the intensity of specific immune reactions in children. The study was conducted in 310 children below 18 years distributed into 3 groups: the TB group included 110 children with TB confirmed by medical evaluation; the LTB group consisted of 156 children with latent infection; and the NTB group was represented by 44 non-infected children. A few immunoassays and molecular-genetic tests were performed; specifically, we evaluated the immune status of patients and the distribution of genotypic frequencies of the studied polymorphism, in the context of previous vaccination against TB. The cell-mediated immune response was mild in children with LTB, while in children with TB inflammation showed signs of chronicity due to the lack of functional activity of immune cells (p < 0.05). We also measured IFNγ synthesis induced by specific mitogens (PPD-L, CFP32B, Rv2660c, ESAT6, 85a and ESAT6-CFP10), only to detect attenuation of the immune response in patients with TB, which was associated with the heterozygous variant (p < 0.05). Children with homozygous TT and CC genotypes demonstrated a more pronounced immune response. Low effectiveness of the TB vaccine was shown to be associated with the heterozygous genotype (50 %), while its high effectiveness was associated with the homozygous T genotype (40 %), possibly indicating the protective role of the latter. Our findings suggest that the studied polymorphism (specifically, its heterozygous variant) can be a predictive marker of TB in children.
A PROTOCOL OF DEVELOPMENT OF A SCREENING ASSAY FOR EVALUATING IMMUNOLOGICAL MEMORY TO VACCINE-PREVENTABLE INFECTIONS: SIMULTANEOUS DETECTION OF ANTIBODIES TO MEASLES, MUMPS, RUBELLA AND HEPATITIS B
Mazunina E. P., Kleymenov D. A., Manuilov V. A., Gushchin V. A., Tkachuk A. P.
Стр. 41 — 52
Multiplex screening assays for measuring antibodies to vaccine-preventable infections are routinely used in large-scale seroepidemiological studies, but not commercially available, because such studies are too specific and normally employ a particular type of the assay only once. This prompts researchers to develop their own solutions for exploring herd immunity. In this work we discuss theoretical principles and practical approaches to developing multiplex screening assays and give examples of protocols and recommendations based on our own experience in the field.
ESTIMATING THE ACTUAL SUSCEPTIBILITY OF DECREED POPULATION TO MEASLES, RUBELLA AND MUMPS
Nozdracheva A. V., Gritsik A. A., Kuzin S. N., Semenenko T. A.
Стр. 53 — 57
As the modern society becomes more vaccine-dependent, the need arises for population immunity studies aimed to estimate the prevalence of antibodies against a particular infection in the donors from different populations, including sentinel groups. This work reveals the actual susceptibility of the Russian population to a number of vaccine preventable infections, including measles, rubella, and mumps. The study was conducted using blood serum samples provided by the Blood serum bank of Gamaleya Federal Research Center for Epidemiology and Microbiology (Moscow). Of 866 samples used in the study, 293 and 117 samples had been collected from healthcare workers in 2011 and 2017, respectively; 220 samples had been obtained from military servants in 2016-2017, and 236 samples had been collected from healthy donors in 2016. All samples were studied by solid phase enzyme immunoassay using diagnostic kits by Vector-Best (Russia). We discovered that 19.4 % and 28.8 % of individuals were susceptible to measles and mumps, respectively, which is insufficient for ensuring epidemiological safety (the herd immunity thresholds for these diseases are 7 % and 15 %, respectively) and puts the population at risk of infection spread, should the pathogens enter the country. The proportion of individuals susceptible to rubella was 6.5 %, which is below the herd immunity threshold (7 %).
THE ROLE OF IMMUNOLOGICAL MEMORY IN ESTABLISHING ANTITUMOR IMMUNITY IN PATIENTS WITH OVARIAN CANCER UNDERGOING NEOADJUVANT THERAPY
Zlatnik E. Yu., Nerodo G. A., Ardzha A. Yu., Seliutina O. N., Bondarenko E. S.
Стр. 58 — 67
Understanding the role of immunological memory mediated by T-lymphocytes in patients with malignant tumors is a pressing issue. This study aimed to assess the contribution of memory T-cells to antitumor immunity in patients with ovarian cancer undergoing neoadjuvant chemoimmunotherapy with recombinant interferon-gamma (rIFNγ). Quantification of central (Tсm) and effector (Tеm) memory T-cells (Тm), as well as naive T-lymphocytes (Th0), was done using flow cytometry. Compared to healthy females, untreated cancer patients were found to have more Tm and less Th0 cells in their blood CD4 and CD8 T-cell subpopulations. In cancer patients, Tm cells accumulated in the ascitic fluid, exceeding 7.7 times the number of CD4 Th0 cells and 6.5 times the number of CD8 Th0 cells, with Tem prevailing over Tcm. After chemotherapy with rIFNγ, blood Th0 decreased in cancer patients, while Tcm dominated the CD8 Tm subpopulation both in the blood and ascitic fluid. Tem cells were a prevalent cell type in patients who received chemotherapy without interferon-gamma. Decreased Th0 and Tcm prevalence were a positive sign accompanied by a good response to treatment, including lower relapse rates (46.7 % vs. 80 % in controls) and a longer relapse-free period (17.5 ± 1.6 vs. 11.3 ± 1.5 months in controls). Therefore, we conclude that chemoimmunotherapy alters proportions of T-cell subpopulations in the blood and ascitic fluid of patients with ovarian cancer, with Tcm cells prevailing over Tem, which may be one of the mechanisms of rIFNγ (Ingaron) action.
LONG-TERM EFFECT OF HIGH CYCLOPHOSPHAMIDE DOSES ON THE REPERTOIRE OF T-CELL RECEPTORS OF PERIPHERAL BLOOD T-LYMPHOCYTES IN PATIENTS WITH AUTOIMMUNE VASCULITIS
Merzlyak E. M., Kasatskaya S. A., Sosnovskaya A. V., Israelson M. A., Staroverov D. B., Nakonechnaya T. O., Novikov P. I., Chudakov D. M., Britanova O. V.
Стр. 68 — 74
Although mechanisms underlying development of autoimmune vasculitis and polyangiitis remain understudied, these pathologies are already known to be largely mediated by T-lymphocytes. Cyclophosphamide (CF) is widely used to treat autoimmune diseases. Lymphoid cells in general (T, B, and NK cells) and naive T-lymphocytes in particular are highly sensitive to CF. In this work we analyzed the repertoires of T-cell receptors (TCRs) in the peripheral blood of young (aged 24 to 35 years, n = 4) and elderly (aged 52 to 68 years, n = 5) patients with ANCA-associated vasculitis (Wegener granulomatosis and Churg-Strauss syndrome) treated with high doses of CF > 3 years before the study. The control group included 7 young and 14 elderly healthy individuals. We revealed no TCR variants previously reported as typically found in patients with ANCA-associated vasculitis. Relative frequency of “public" (often found in a population, largely formed during an embryonic period) TCR variants in the repertories of young patients was significantly lower than in the repertories of healthy donors of the same age, and was similar to the elderly healthy donors. We hypothesize that CF-treatment eliminates substantial proportion of naïve T-cells in the young donors, that contains "public" TCR variants of fetal origin. Long-term consequences of such changes in the structure of T-cell immunity require further investigations.
ESTIMATING THE NUMBER OF HIV-SPECIFIC T-CELLS IN HEALTHY DONORS USING HIGH-THROUGHPUT SEQUENCING PROFILES OF T-CELL RECEPTOR REPERTOIRES
Eliseev A. V., Fedorova A. D., Lebedin M. Y., Chudakov D. M., Shugay M
Стр. 75 — 80
In-depth study of mechanisms of immune response to the human immunodeficiency virus (HIV) is critical for better understanding of how immunodeficiency develops in patients with HIV, as well as for designing effective immunotherapy strategies and vaccines against the virus. In this work we analyze sequencing profiles of T-cell receptor repertoires previously obtained from healthy donors (601 Americans and 65 Russians) to estimate the population frequency of HIV-specific naive T-cells. We demonstrate that frequencies of T-cells recognizing different HIV epitopes vary considerably across the population (F-statistic = 2007, p < 10-100, ANOVA). Although the frequency of T-lymphocytes recognizing a particular epitope does not change significantly between the individuals, it still largely depends on the presence of certain HLA alleles (p < 0.01, post-hoc Tukey’s test), cytomegalovirus infection (F = 61, p = 7 × 10-15, ANOVA), and age (Pearson correlation coefficient ranging from -0.53 to -0.14 in different groups).
CLINICAL CHARACTERISTICS OF PREMENSTRUAL PAINS
Dobrokhotova Yu. E., Friptu V. G., Grishin I. I., Saprykina L. V., Mazur I. A.
Стр. 81 — 85
Premenstrual syndrome (PMS) profoundly affects a woman’s quality of life, causing physical and emotional distress. This study aimed to describe premenstrual pains in reproductive-age women (18-45 years). The main group included 136 women with moderate and severe PMS; the control group consisted of 136 healthy females with only sporadic premenstrual symptoms. We encouraged the participants to rate their symptoms using the menstrual distress questionnaire by Rudolf H. Moos and to keep a symptom diary over the course of 3 menstrual cycles. We also used the visual analogue scale, which allows estimating pain intensity. In the main groups the participants scored an average of 47.14 ± 3.67 total points on the distress questionnaire (moderate PMS), whereas the controls scored 10.28 ± 1.94 points (mild PMS) (p < 0.05). Among the most typical premenstrual symptoms observed in the main group and the controls were: headaches (66.17 % vs. 22.79 %, respectively; p < 0.001); breast tenderness/pain (83.08 % vs. 49.26 %, respectively; p < 0.001); pelvic pain (70.58 % vs. 35.29 %, respectively; p < 0.001); bloatedness/stomach ache (64.7 % vs. 25.73 %, respectively; p < 0.001), and muscle/joint pain (51.47 % vs. 21.32 %, respectively; p < 0.001). The average number of premenstrual symptoms observed in the main group was 5.62 ± 0.92, of which 2.47 ± 0.68 represented intense pains determining PMS severity. The results of our study suggest that premenstrual symptoms should be monitored prospectively over at least 2 consecutive menstrual cycles using a diary, because retrospective data are unreliable.
MODERN ASPECTS OF MULTIMODALITY APPROACH TO THE DIAGNOSIS OF IDIOPATHIC EPIRETINAL MEMBRANE
Takhchidi Kh. P., Kachalina G. F., Kasmynina T. A., Tebina E. P.
Стр. 86 — 90
Idiopathic epiretinal membrane (iERM) is the most common abnormality of the vitreoretinal interface. This condition often stays asymptomatic for a long time. At present, the diagnostic “gold standard” for iERM is spectral-domain optical coherence tomography (SDOCT) and biomicroscopy. However, other diagnostic approaches to ocular fundus pathologies have emerged recently, including multispectral imaging in the MultiColor mode used to estimate tissue proliferation, En Face OCT-angiography that can precisely locate retinal lesions, and microperimetry instrumental in assessing retinal sensitivity and the impact of tissue proliferation. In this work we evaluate the effectiveness of the multimodal approach to iERM diagnosis. We examined 46 patients (46 eyes; mean age was 65.3 ± 11.2 years) with different stages of iERM, pseudophakia and incipient cataract. The multimodal approach allowed us to better discriminate between disease stages and to identify 15 patients with stage 0 iERM, 19 patients with stage 1, and 12 - with stage 2. We were also able to generate a map of the vitreoretinal interface for 2 patients with stage 2 iERM that facilitated the choice of treatment and allowed planning a sparing surgical intervention. Based on our clinical experience and study findings, we conclude that the multimodality approach should be promoted in the clinical setting.