Method for predicting the course of peritonsillar abscess in patients with exacerbation of chronic tonsillitis

Objectives – clinical and laboratory examination of patients with acute tonsillitis for early diagnosis and prognosis of peritonsillar abscess.

Material and methods. The study included 101 patient with lacunar tonsillitis complicated by peritonsillar abscess and 64 donors (control group). Immunological studies were performed according to WHO recommendations, on the basis of the immunological department of the EMB Research Institute and the immunological laboratory of the SamSMU.

Results. Immunological examination of patients with abscess showed an increase in: neutrophil phagocytic activity, CD4⁺/CD8⁺, the number of cells expressing HLA-DR⁺ markers, complement activity, IgA, IgM, IgG plasma concentration, fibronectin level, pro-inflammatory cytokines IL-8, IL-1α, IL-1β and a decrease in: the level of TNF-α, myeloperoxidase activity, number of cells containing CD4⁺, CD8⁺, CD16⁺, CD20⁺, CD25⁺ markers. High correlation was registered between total lymphocytes and CD3⁺ and CD4⁺ cells (p < 0.01); between CD3⁺ and CD4⁺ markers (p < 0.01); as well as high correlation of IL-1β levels with IL-8 and IL-1α (p < 0.01). Cluster analysis revealed different types of immune homeostasis. The first type (cluster) had high values of leukocytes (total), lymphocytes (total), cells with CD3⁺, CD4⁺, CD8⁺, CD16⁺, CD20⁺, CD95⁺ and HLA-DR⁺ markers; the second type (cluster) was characterized by significantly lower levels of these immune status indicators. 41 patient had the first type of immune response, with an explicit clinical picture and rapid formation of an abscess. The second type of immune response was registered in 60 patients having a torpid course of the disease with delayed development of abscess. Further, to assess the type of immune reactions, it is necessary to substitute the values of indicators into the model and calculate the integral coefficient of the body's reaction (ICTRO_I and ICTRO_II).