Association of parameters of the stress system and the immunity in patients with chronic pyelonephritis in dependence on the duration of the disease and the frequency of relapses

The immune response in chronic pyelonephritis (CP) is a compensatory-adaptive response of the growing organism, which determines the character of the course and prognosis of the disease. The aim of the study was the investigation of relationships of the immune and endocrine systems in dependence on the duration of the course and frequency of recurrence of CP in children. There were observed a total of 168 CP children patients at the age of 6-16 years, in a state of clinical and laboratory remission. The reference group was consisted of 20 apparently healthy children of the same age. During the remission of CP duration of the disease and the frequency of CP relapses were established to influence on parameters of the stress-realizing and stress-limiting systems. There was revealed a direct correlation between the levels both of ACTH and cortisol with the number of CP relapses, which were dependent, in turn, on their frequency and duration of disease. There was revealed the inversion of the rhythm of melatonin secretion, the more pronounced the longer course of CP and their relapses occur more frequently. There was revealed adaptive directedness of the impact of melatonin on the immune system, as evidenced by the revealed negative correlations of the peak value of night 6- sulfatoxymelatonin (6-COMT) with TGF-β1 and IL-17. The increasing of the duration of CP was accompanied by an elevation in the concentrations of TGF-β1 and its positive correlation with ACTH levels, as well as a significant decrease in IL-10, IGF-1 and EGF levels. The authors suggest that in CP patients there is formed the imbalance between stress-realizing and stress-limiting systems, the more pronounced the longer course of CP and its relapses occur more often.

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