IMMUNOPATHOGENETIC PARAMETERS IN PATIENTS WITH CEREBRAL PALSY

Cerebral palsy (CP) represents a multi-etiological disorder where immunological mechanisms, specifically T- and B-cell immunity, contribute significantly to pathogenesis. TREC and KREC, molecular markers of thymic and bone marrow lymphocyte production, facilitate immune status assessment in this patient category. Objective. To analyze immunohematological and immunogenetic parameters within a general cohort of patients with CP and across gender subgroups, while examining the correlations between these variables. Materials and Methods. This prospective study enrolled 210 patients with CP (U.K. Kurbanov Republican Children's Psychoneurological Hospital, 2022–2025). TREC and KREC levels were quantified via real-time PCR (ROSSAmed PID kit, ROSSA LLC, Uzbekistan; BioRad system), immunoglobulin levels were measured through immunoturbidimetry, and hematological indices were determined using an automated analyzer. The study protocol was approved by the Local Bioethics Committee of the Bukhara State Medical Institute, and the research was conducted in accordance with the Declaration of Helsinki (2013 revision), with written informed consent obtained from the parents or legal representatives of all participants. Statistical analysis utilized Student’s t-test, the Mann–Whitney U test, and correlation analysis, with the significance threshold set at p < 0.05. Data processing was conducted using SPSS Statistics version 26.0. This research was conducted as part of the Bukhara State Medical Institute research plan entitled "Clinico-immunological and genetic aspects of the pathogenesis of cerebral palsy" (2022–2026). Results. No significant sex-related differences were observed in TREC, KREC, or lymphocyte levels (p > 0.05). TREC and KREC concentrations in males nevertheless exceeded those in females by 44% and 58%, respectively. Immunoglobulin levels and hematological parameters similarly demonstrated no statistically significant intergroup differences, although a trend toward elevated IgM concentrations was noted in females. Correlation analysis identified seven significant associations, including positive correlations for IgA/IgM (r = +0,74), IgA/TREC (r = +0,65), IgA/KREC (r = +0,68), alongside inverse relationships for Hb/Plt (r = −0,72), WBC/IgG4 (r = −0,61), Hb/IgG2 (r = −0,72), and ESR/IgG2 (r = −0,68). Conclusions. Reduced TREC and KREC values in a subset of patients with CP suggest potential immune system pathology underlying the disease pathogenesis. Primary immunohematological indices lack significant sex-related differences; however, the observed trends necessitate verification in larger cohorts

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