Immunological and apoptotic disturbances in children with congenital heart defects: pathogenetic aspects and diagnostic significance

The aim of this study was to investigate immunological and apoptotic markers in children with congenital heart defects (CHDs) in order to assess their pathogenetic role and diagnostic significance. Material and methods. A total of 114 children were enrolled and divided into three groups: patients with acyanotic CHDs (n=63), patients with cyanotic CHDs (n=28), and a control group of healthy children (n=23). All participants were evaluated for levels of CD3+, CD4+, CD8+, CD19+, CD16/56+, HLA-DR+, and CD95+ lymphocytes, as well as serum concentrations of IL-6 and TNF-α. The results revealed significant differences between the clinical groups. Children with cyanotic CHDs demonstrated a marked decrease in CD3, CD4, and CD8 levels, along with a substantial increase in CD95 expression and pro-inflammatory cytokines, particularly TNF-α and IL-6 (p<0.01). These changes indicate immune system activation and enhanced apoptosis in the setting of chronic hypoxia. Conclusion. Our findings confirm the pathogenetic relevance of immune and apoptotic disturbances in CHDs and highlight their potential diagnostic value. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee for all participants. The informed consent was obtained from patients. The authors declare no conflict of interest.