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[The specific features of immune disorders in acute severe brain injury].

Fifty-three patients aged 17-65 years who had severe brain injury (SBI) were examined and randomized to 2 groups: 1) 16 patients without complications; 2) 37 patients developed pneumonia (35.2%), bronchitis (32.4%), meningitis (10.8%), meningitis concurrent with pneumonia (8.1%), bedsores concurrent with bronchitis (13.5%) on days 4-7. The authors studied the immune status: the subpopulation composition of lymphocytes (CD+, a marker of adult lymphocytes; CD+, a marker of T helper/inductor cells, CD8+, a marker of cytotoxic lymphocytes, CD16+, a marker of natural killer cells, CD20+, a marker of B lymphocytes) by the indirect immunofluorescence technique using monoclonal antibodies; the functional activity of lymphocytes from the expression of activation antigens, such as CD71+, CD25+, HLA-DR; serum immunoglobulins (IgG, IgA, and IgM) by the immunoturbidimetric technique using the test systems (Spinreakt, Spain). A control group included 23 apparently healthy individuals. Immunosuppression developing as significant T lymphopenia due to lower CD4+ and CD8+ lymphocytes, as well as impaired humoral immunity with inadequate IgG generation was detected in the acute phase of SBI. The indicators reflecting the development of secondary pyoseptic complications were elevated CD3+, CD4+, and CD8+ lymphocytes on day 7 and the higher lymphocytic expression of the activation antigens CD25+ and CD71+. The findings show that the diagnostic markers, such as CD3+, CD4+, CD8+, CD25+, and CD71+ lymphocytes, should be included into a comprehensive examination of patients with SBI.