Klinik fanlar yilnomasi Volume 2 Issue 4 (2025)
IMMUNOLOGICAL DETERMINANTS OF THE RISK OF POSTOPERATIVE ENTEROCOLITIS IN CHILDREN WITH GIRSHPRUNG'S DISEASE
Абдурахмонов Исроилжон Иброхимжон угли, Умаров Бахтиёржон Ятгарович
Abstract
Postoperative enterocolitis in Hirschsprung's disease remains one of the most dangerous and frequent complications of surgical treatment, developing in 25-42% of patients. Despite the improvement of surgical methods, the pathogenesis of POEBG remains insufficiently studied, which limits the possibilities of early prediction and prevention. The purpose of the study is to assess the immunological determinants associated with the development of POEBG and to determine their prognostic significance. The study included 153 children with Hirschsprung's disease: 75 with POEBG and 78 without complications. A comprehensive assessment of congenital, adaptive, and mucosal immunity was conducted before and after surgery. It was established that children with POEBG are characterized by a decrease in the level of CD4+ lymphocytes, the CD4+/CD8+ index <1.2, pronounced activation of NK cells, an increase in IL-6 (2.8 times), TNF-α (2.3 times), a decrease in IL-10 (1.9 times), an increase in the expression of TLR4, the levels of zonulin and sCD14, as well as a significant deficiency of sIgA. An immunological prognostic scale based on five independent biomarkers has been proposed. The obtained data demonstrate the high prognostic significance of immune indicators and confirm the key role of neuroimmune imbalance and barrier dysfunction in the development of POEBG. The results allow for the inclusion of immunological monitoring in the postoperative observation standard.
Hirschsprung disease, postoperative enterocolitis, immunological determinants, TLR4, zonulin, sCD14, CD4/CD8, sIgA, prognosis of complicationsболезнь Гиршпрунга, послеоперационный энтероколит, иммунологические детерминанты, TLR4, zonulin, sCD14, CD4/CD8, sIgA, прогнозирование осложненийГиршпрунг касаллиги, операциядан кейинги энтероколит, иммунологик детерминантлар, ТЛР4, зонулин, sCD14, CД4/CD8, сИгА, асоратларни башоратлаш
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