Immune related prognosis biomarkers for outcomes of joint preservation surgery in children with ischemic deformity of the proximal femur (preliminary results)

Objective Assess the immune status of children with ischemic deformity of the proximal femur taking into account the treatment outcome. Material and methods Preoperative assessment of the immune status was performed for 16 adolescents with ischemic deformity of the proximal femur. Patients' age was 14.4 ± 0.45 years. Immunological parameters of 12 adolescents with satisfactory (group I) and 4 patients with poor (group II) anatomical and functional outcome of surgical treatment were compared. Peripheral blood lymphocyte typing was produced with laser cytometry assay, and IgA, IgM, IgG, IgE, IL-18, IFNγ and circulating immune complexes were quantified with enzyme-linked immunoassay. Results Сomparative analysis of preoperative immunological parameters showed statistically significant decline of Т-helper cells (СD3+СD4+), high levels of activated СD3+CD25 and СD3+HLADR T lymphocytes, low levels of activated NК cells (СD8dimCD38+) and IFNγ in group II. Humoral immune parameters indicated to low levels of IgA, IgM, IgG and higher levels of circulating immune complexes in group II relative to group I. Conclusion Preliminary data obtained suggest that cellular and humoral immune deficiency can be associated with unfavorable outcome of joint preservation procedure. Such immunological parameters as T lymphocytes subpopulation, immunoglobulins, circulating immune complexes and IFNγ can be used as significant prognostic factors for preoperative planning and postoperative rehabilitation of adolescents with ischemic deformity of the proximal femur.