Features of adaptive immunity in patients with peritonitis.

Abstract

The review is devoted to the features of cascade interactions of the immune system links during the development of acute peritoneal inflammation. The features of cytokine activity, alternative regulation of the immune response intensity by means of immune checkpoints, features of neutrophil interactions and the role of extracellular neutrophil traps in the development of the adaptive immune response are reflected. Information on the dynamics of the development of the microcirculatory bed at the onset of the disease is provided. Features of the protracted and complicated course of widespread purulent peritonitis are due to the features of the reaction of innate and adaptive immunity, hyperactivation and inertia of inflammatory processes in the parietal and visceral peritoneum. The pathogen has only a triggering value. At the same time, the performed surgical intervention cannot completely neutralize the pathomorphological processes in the visceral and parietal peritoneum, which have an inertial nature. It should be noted that excessive activation and features of the mechanisms of regulation of the immune response, such as coinhibitory and coactivating immune points, excessive release of proinflammatory cytokines, dysfunction of anti-inflammatory cytokines, carry an element of autoaggression, thereby enhancing tissue destruction. Without a doubt, the study of the role of the above markers and features of immunity will allow us to obtain new links in pathogenesis, on the basis of which it will be possible to predict the options for the course of peritonitis and its long-term consequences.