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Polymorphonuclear leukocyte functions in patients with acute rheumatic fever and rheumatic heart disease
S Naik1, S Jambotkar, J R Kamat
1Department of Pathology, Seth G.S. Medical College, Bombay, India.
Insights
Polymorphonuclear (PMN) cell function, including phagocytosis and opsonic activity, was impaired in patients with active rheumatic fever (ARF) and rheumatic heart disease (RHD), even during remission.
Area of Science:
- Immunology
- Rheumatology
Background:
- Rheumatic fever (ARF) and rheumatic heart disease (RHD) are inflammatory conditions affecting the heart valves.
- Polymorphonuclear (PMN) cells play a crucial role in the innate immune response.
- Understanding PMN function in ARF/RHD is vital for assessing disease activity and immune status.
Purpose of the Study:
- To evaluate polymorphonuclear (PMN) cell function in patients with active rheumatic fever (ARF) and rheumatic heart disease (RHD).
- To assess PMN function in patients with ARF and RHD in remission and quiescent stages.
- To compare PMN function across different disease states and with healthy controls.
Main Methods:
- Assessed spontaneous and chemotactic movement of PMN cells.
- Measured phagocytosis of yeast particles by PMN cells.
- Evaluated opsonic activity of patient sera and intracellular metabolic activity of PMN cells.
Main Results:
- Spontaneous and chemotactic PMN movement were normal across all groups.
- Phagocytosis was significantly reduced in active RHD, ARF/RHD remission, and quiescent RHD groups.
- Opsonic activity was consistently low in all patient groups, indicating impaired opsonization.
Conclusions:
- Phagocytic capacity and opsonic activity of PMN cells are persistently impaired in rheumatic fever and rheumatic heart disease, irrespective of disease activity or remission status.
- These functional deficits suggest a compromised innate immune response in patients with ARF/RHD.
- Further research into immune modulation strategies may be beneficial for managing ARF/RHD.
Abstract:
Polymorphonuclear (PMN) cell function was assessed in 30 children with active rheumatic fever (ARF) (Group I), 30 cases with active rheumatic heart disease (RHD) (Group II), 28 cases of ARF and RHD in remission (Group III) and 34 adults with quiescent RHD along with their age matched controls. All the groups showed normal spontaneous and chemotactic movement. Phagocytosis of yeast particles was significantly reduced in groups II (P less than 0.0005), III (P less than 0.025) and IV (P less than 0.005). The opsonic activity of disease sera was low in all 4 groups (P less than 0.0005). The intracellular metabolic activity was moderately elevated in Group III. Phagocytosis and opsonic activity were thus persistently low in all the groups including the remission and quiescent group.