Author/Editor		Kotnik, V
Title		Ugotavljanje vzroka nekaterih kroničnih ponavljajočih se okužb
Translated title		Determination of the cause of certain chronic recurrent infections
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. Suppl 3
Publication year		1995
Volume		str. III-73-9
Language		slo
Abstract		Background. Determination of defects in immune defence system is important, but complicated. Today many of clinical entities are known with well defined mechanism of origin. In the paper two new methods illustrated with two examples important for detection of decreased activity of the phagomonocytic system are presented. Methods. Phagotest is used for determination of phagocytosis of with FITC labelled E. coli cells. Test is basically very similar to FMT test where Candida albicans is used as testing micro-organism. Data are acquired with flow cytometer. This is the reason that the method is more objective and precise then FMT. The same is valid also for the second test. Bursttest is suitable for detection of oxidising capacity of phagocytic cells. After E. coli phagocytosis the phagocytic cells are activated and the microbicidal oxygen radicals arise. In the test those molecules change nonfluorscent dihydrorhodamin 123 molecule in to the fluorescent rhodamin 123. Bad side of the first and of the second test is, that with none of them the direct microbicidicity on the isolated microorganisms from patients with chronic recurrent infection is possible. Results. Author present a case with the normal phagomonocytic system activity and a case with decreased activity. Cases are illustrated with original flow cytometric recordings and with corresponding comments. Conclusions. Primary defects of fagomonocytic system are rare. The most everyday cases are patients with secondary affected phagocytosis and intracellular killing activity. With both presented methods it is possible to define, and with additional examinations classify those defects. From such the results then the conclusions over the cause and therapy can be drawn.
Summary		Izhodišča. Odkrivanje pomankljivosti v obrambi je pomembno in zapleteno. Znanih je že mnogo kliničnih entitet, pri katerih lahko z gotovostjo trdimo, za kateri način nastanka gre. V delu sta predstavljeni dve novi preiskavni metodi s predstavitvijo primerov, s katerima moremo potrditi način nastanka bolezni pri katerih je zmanjšana učinkovitost fagocitno monocitnega sistema. Metode. S fagotestom ugotavljamo zmožnost fagocitoze s FITC označenih celic E. coli. Test je podoben preskusu FMT, kjer kot testni mikroorganizem uporabljamo Candida albicans. Zaradi odčitanja rezultatov s pretočnim citometrom je fagotest mnogo zaneslivejši in natančnejši od FMT. Isto velja tudi za drugi prikazani test. Z bursttesom odkrivamo oksidativno zmožnost fagocitov. Po fagocitozi E. coli se fagocitne celice aktivirajo in nastanejo kisikovi radikali, ki so smrtni za določene mikroorganizme. V testu te molekule spremenijo nefluorescirajočo snov dihidrorodamin 123 v fluorescirajoč rodamin 123. Slabost enega in drugega testa je v tem, da z njima ne moremo dokazati neposrednega toksičnega učinka na mikroorganizma, ki jih osamimo pri bolniku s kronično ponavljajočo se okužbo. Rezultati. Prikazujemo primer preiskovanca z normalno dejavnostjo fagocitno monocitnega sistema in primer, ko je ta zmožnost zmanjšana. Primera sta ilustrirana z originalnimi posnetki s pretočnega citometra, ki so opremljeni z ustreznim komentarjem. Zaključki. Primarne okvare fagocitno monocitnega sistema so redke. V vsakdanjem življenju večinoma srečujemo bolnike s sekundarno prizadetostjo fagocitoze in znotrajceličnega ubijanja . S predstavljenima metodoma in načinom preiskovanja lahko takšne okvare opredelimo in z dodatnimi preiskavami ustrezno razvstimo. Iz dobljenih podatkov lahko nato sklepamo na vzrok kronične ponavljajoče se okužbe in načrtujemo ustrezno zdravljenje.
Descriptors		PHAGOCYTE BACTERICIDAL DYSFUNCTION PHAGOCYTOSIS GRANULOMATOUS DISEASE, CHRONIC CHEDIAK-HIGASHI SYNDROME LEUKOCYTE ADHESION DEFICIENCY SYNDROME PEROXIDASE JOB'S SYNDROME