[The clinical significance of immunological indices in chronic pyelonephritis]

Humoral and cellular immunity and data on biopsy tissue inoculation were evaluated for 72 patients with morphologically confirmed pyelonephritis. Cellular immunity was judged by lymphocyte rosette-test. T-lymphocyte subpopulation was counted in absolute numbers. No case of the biopsy bacterial contamination was shown bacteriologically. A complement C3 component was obtained in amounts similar to those in the controls. In remission IgA tended to a significant increase which (in IgM fall) continues in the disease aggravation. T-lymphocytes (total, active and suppressors) reduced in number, the changes arising in the remission with further intensification in a pyelonephritis exacerbation. Basing on the evidence obtained it is inferred that a significant suppression of cellular immunity, particularly T-suppressors, agrees with the idea of pyelonephritis as genetically determined, infection-mediated immune inflammation initially involving the medullary layer and urinary mucosa. The disease is characterized by defects in local immunity and changes in the density of receptors to the agent antigens. The predisposition came to action in disorders of urodynamics consequent to obstruction or ureteral hypotonicity of nonobstructive nature.