CLINICAL AND IMMUNOLOGICAL CRITERIA AND PREVENTION OF RELAPSE OF CROHN'S DISEASE

Background. Recurrence of Crohn's disease (CD) in the postoperative period develops in more than 80% of operatedpatients.Material and methods. The object of the study was the analysis of the results of examination and treatment of 82patients with CD. General clinical, immunological, biochemical, endoscopic, visual, and statistical research methodswere used.Results. It has been established that relapse of the disease develops in the remote postoperative period in 59.5% ofcases; it was revealed that immunological changes in CD are characterized by an imbalance of cellular and humoralimmunity in the form of an increase in the expression of antigen-dependent T-naïve lymphocytes and suppressionof T-regulating lymphocytes, creating conditions for an increase in immunoreactivity under the influence ofactive production of pro-inflammatory cytokines; it has been revealed that the low inducing properties of TGF-β andIL-4 in CD reduce the intensity of the production of anti-inflammatory cytokines, supporting the chronic inflammatoryprocess and the intensity of granuloma formation.Conclusion. The therapeutic and diagnostic algorithm developed by us for predicting and preventing the recurrenceof CD has the frequency of true-positive and true-negative results, which significantly increased the frequency of theprognostic value of the method compared to the traditional one, as well as to reduce the frequency of mild and moderateforms of CD recurrence and completely avoid the development of its severe forms in the remote postoperativeperiod.Keywords: Crohn's disease, relapse of Crohn's disease, clinical and immunological prognosis criteria, prevention ofCrohn's disease relapse.

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