Gnedkova I.A., Lisyanyi N.I., Shmeleva A.A., Vaslovych V.V., Gnedkova M.A.

Hormones of the hypothalamic-pituitary-­adrenal system (HPA) are involved in maintenance of body homeostasis and modulation of inflammation and immune response reactions. The direction of hormones effects on cells of innate and adaptive immunity to some extent is reflected in neutrophils and lymphocytes content ratio (NLR) in the peripheral blood (PB). Earlier we have studied and analyzed the changes in ratio of before mentioned cells in PB of patients with brain tumors depending on histogenetic origin and malignancy grade, but patients with pituitary adenoma (PA) were not included. Aim: to study content and features of blood cells ratio (platelets (PLT), leukocytes (WBC), neutrophils (NEUT), lymphocytes (LYMPH)) in patients with PA comparing to patients with meningioma and glioblastoma in the preoperative, postoperative periods and with continued tumor growth. Object and methods: parameters of PB were studied in 122 patients (age 32–67) of whom 18 patients were diagnosed with PA, 40 patients with glioblastoma, 25 with meningioma, 28 with non-oncological diseases of the central nervous system (the comparison group). PB cells count was performed on a MINDRAY BC-3000 plus automatic hematology analyzer (China). The total content of PLT, NEUT and LYMPH, relative content (%) of NEUT and LYMPH, NLR (%) ratio and PLR and PNR indexes were determined. Results: in patients with different stages of PA, the content of PLT, WBL, total and relative content of NEUT and LYMPH in the PB did not differ statistically significantly from the comparison group. PLT indexes of patients with tumors of different histostructure also did not differ significantly. In patients with PA, WBC content, total and relative count of NEUT was lower, while the LYMPH count was higher as compared to patients with meningioma and glioblastoma in similar stages of the disease. In patients with PA, signs of adaptive immunity activation were noted — a significant decrease in NLR and PLT ratios with continued tumor growth. High NLR ratio, indicating the predominant activation of innate immunity, was noted in patients with glioblastoma. Conclusion: in patients with different stages of PA as well as with continued meningioma growth, reactions of adaptive immune responses are activated. In patients with glioblastoma, reactions of innate immunity are activated at all clinical stages of the disease. The NLR ratio reflects activity of innate and adaptive immunity as well as the balance and direction of HPA hormones with pro- and anti-inflammatory activity influence on the immune system of a particular patient.

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