medbioМедико-биологические проблемы жизнедеятельностиMedical and Biological Problems of Life Activity2074-2088Республиканский научно-практический центр радиационной медицины и экологии человека10.58708/2074-2088.2026-2(38)-20-25medbio-515Research ArticleМЕДИКО-БИОЛОГИЧЕСКИЕ ПРОБЛЕМЫMEDICAL-BIOLOGICAL PROBLEMSКлиническое значение определения маркеров TREC и KREC в сухих пятнах крови у детей с тяжёлыми инфекционными заболеваниями, осложнёнными летальным исходомClinical significance of determining trec and krec markers in dried blood spots in children with severe infectious diseases complicated by fatal outcomehttps://orcid.org/0000-0002-0706-6622ПоляковаЕ. А.PolyakovaE. A.

г. Минск

polyakovakat86@gmail.comЗобиковаО. Л.ZobikovaO. L.

г. Минск

info@medcenter.byhttps://orcid.org/0000-0002-1931-7716КупчинскаяА. Н.KupchinskayaA N.

г. Минск

kupchinskayaa@gmail.comСаковичИ. С.SakovichI. S.

г. Минск

Inga.sakovich@mail.ruhttps://orcid.org/0000-0001-9533-4705БелевцевМ. В.BelevtsevM. V.

г. Минск

belevtsev_m@mail.ruНаумчикИ. В.NaumchikI. V.

г. Минск

info@medcenter.byГУ «РНПЦ детской онкологии, гематологии и иммунологии»; УО «Белорусский государственный медицинский университет»BelarusГУ «Республиканский научно-практический центр «Мать и дитя»»BelarusГУ «Республиканский научно-практический центр детской онкологии, гематологии и иммунологии»Belarus202607082026022025Copyright © Полякова Е.А., Зобикова О.Л., Купчинская А.Н., Сакович И.С., Белевцев М.В., Наумчик И.В., 20262026Полякова Е.А., Зобикова О.Л., Купчинская А.Н., Сакович И.С., Белевцев М.В., Наумчик И.В.Polyakova E.A., Zobikova O.L., Kupchinskaya A.N., Sakovich I.S., Belevtsev M.V., Naumchik I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medbio.ejournal.by/jour/article/view/515

В статье представлены результаты исследования уровней продуктов рекомбинации ДНК рецепторов Т-лимфоцитов (TREC) и В-лимфоцитов (KREC) у детей с тяжёлыми инфекционными заболеваниями, осложнёнными летальным исходом. Проведён анализ данных 18 детей, умерших от инфекций, ассоциированных с нарушениями иммунного механизма. У 11 детей из карт неонатального скрининга успешно определены уровни TREC и KREC методом ПЦР в реальном времени. Установлена значительная вариабельность уровней маркеров: количество копий TREC было в диапазоне от 250,0 до 29 988,0, KREC — от 1759,0 до 33 214,0 копий на 106 лейкоцитов. Выявлены случаи как сниженных, так и уровней маркеров в диапазоне нормальных значений. Наиболее низкие уровни TREC отмечены у детей с гипоплазией тимуса, сепсисом (250,0–746,0 копий на 106 лейкоцитов). Полученные данные свидетельствуют о необходимости дифференцированного подхода к интерпретации уровней TREC и KREC у новорождённых детей в критических состояниях с учётом множества факторов, влияющих на иммунный стату

The article presents the results of a study of the levels of T-lymphocyte receptor DNA recombination products (TREC) and B-lymphocyte receptor DNA recombination products (KREC) in children with severe infectious diseases complicated by a fatal outcome. Data from 18 children who died from infections associated with immune mechanism disorders were analyzed. TREC and KREC levels were successfully determined in 11 children from neonatal screening records using real-time PCR. Significant variability in marker levels was established: the TREC copy number ranged from 250,0 to 29 988,0, and KREC – from 1 759,0 to 33 214,0 copies per 106 leukocytes. Cases of both reduced marker levels and marker levels within the normal range were identified. The lowest TREC levels were observed in children with thymic hypoplasia and sepsis (250,0 and 746,0 copies per 106 leukocytes, respectively). These data suggest the need for a differentiated approach to interpreting TREC and KREC levels in critically ill newborns, taking into account the multiple factors affecting immune status

TRECKRECноворождённыетяжёлые инфекционные заболеваниясепсиспневмониялетальный исходTRECKRECneonatessevere infectious diseasessepsispneumoniafatal outcomeReferencesTrends in Pediatric Primary Immunodeficiency: Incidence, Utilization, Transplantation, and Mortality / T. Eddens [et al.] // J Allergy Clin Immunol Pract. – 2022. – Vol. 10, No. 1. – P. 286–296.e3. – DOI: 10.1016/j.jaip.2021.10.033.Trends in Pediatric Primary Immunodeficiency: Incidence, Utilization, Transplantation, and Mortality / T. Eddens [et al.] // J Allergy Clin Immunol Pract. – 2022. – Vol. 10, No. 1. – P. 286–296.e3. – DOI: 10.1016/j.jaip.2021.10.033.Primary Immunodeficiencies: A Decade of Progress and a Promising Future / I. Meyts [et al.] // Frontiers in Immunology. – 2021. – Vol. 11. – P. 625753. – DOI: 10.3389/fimmu.2020.625753.Primary Immunodeficiencies: A Decade of Progress and a Promising Future / I. Meyts [et al.] // Frontiers in Immunology. – 2021. – Vol. 11. – P. 625753. – DOI: 10.3389/fimmu.2020.625753.Inborn errors of immunity: manifestation, treatment, and outcome - an ESID registry 1994-2024 report on 30,628 patients / G. Kindle [et al.]. – medRxiv. – 2025. – 16 Apr. – Article ID 2025.02.20.25322586. – DOI: 10.1101/2025.02.20.25322586. – Update in: Journal of Human Immunology. – 2025. – Vol. 1, No. 3. – P. e20250007. – DOI: 10.70962/jhi.20250007.Inborn errors of immunity: manifestation, treatment, and outcome - an ESID registry 1994-2024 report on 30,628 patients / G. Kindle [et al.]. – medRxiv. – 2025. – 16 Apr. – Article ID 2025.02.20.25322586. – DOI: 10.1101/2025.02.20.25322586. – Update in: Journal of Human Immunology. – 2025. – Vol. 1, No. 3. – P. e20250007. – DOI: 10.70962/jhi.20250007.New tools for diagnosis of primary immunodeficiencies: from awareness to artificial intelligence / P. Soler-Palacín [et al.] // Frontiers in Immunology. – 2025. – Vol. 16. – Article 1593897. – DOI: 10.3389/fimmu.2025.1593897.New tools for diagnosis of primary immunodeficiencies: from awareness to artificial intelligence / P. Soler-Palacín [et al.] // Frontiers in Immunology. – 2025. – Vol. 16. – Article 1593897. – DOI: 10.3389/fimmu.2025.1593897.The German national registry for primary immunodeficiencies (PID) / B. Gathmann [et al.] // Clinical & Experimental Immunology. – 2013. – Vol. 173, No. 2. – P. 372–380. – DOI: 10.1111/cei.12105.The German national registry for primary immunodeficiencies (PID) / B. Gathmann [et al.] // Clinical & Experimental Immunology. – 2013. – Vol. 173, No. 2. – P. 372–380. – DOI: 10.1111/cei.12105.Clinical and epidemiological characteristics of patients with suspected primary immunodeficiency disorders attending Alexandria University Children´s Hospital / D. A. Heiba [et al.] // International Journal of Contemporary Pediatrics. – 2019. – Vol. 6, No. 5. – P. 1–6. – DOI: 10.18203/2349-3291.ijcp20192810.Clinical and epidemiological characteristics of patients with suspected primary immunodeficiency disorders attending Alexandria University Children´s Hospital / D. A. Heiba [et al.] // International Journal of Contemporary Pediatrics. – 2019. – Vol. 6, No. 5. – P. 1–6. – DOI: 10.18203/2349-3291.ijcp20192810.Thymic hypoplasia induced by copy number variations contributed to explaining sudden infant death based on forensic autopsies / C. Chen [et al.] // Forensic Science International. – 2023. – Vol. 345. – P. 111741. – DOI: 10.1016/j.forsciint.2023.111741.Thymic hypoplasia induced by copy number variations contributed to explaining sudden infant death based on forensic autopsies / C. Chen [et al.] // Forensic Science International. – 2023. – Vol. 345. – P. 111741. – DOI: 10.1016/j.forsciint.2023.111741.Walong, E. Primary immunodeficiency diagnosed at autopsy: a case report / E. Walong, E. Rogena, D. Sabai // BMC Research Notes. – 2014. – Vol. 7. – Article 425. – DOI: 10.1186/1756-0500-7-425.Walong, E. Primary immunodeficiency diagnosed at autopsy: a case report / E. Walong, E. Rogena, D. Sabai // BMC Research Notes. – 2014. – Vol. 7. – Article 425. – DOI: 10.1186/1756-0500-7-425.Vorsteveld, E. E. Next-generation sequencing in the field of primary immunodeficiencies: current yield, challenges, and future perspectives / E. E. Vorsteveld, A. Hoischen, C. I. van der Made // Clinical Reviews in Allergy & Immunology. – 2021. – Vol. 61. – P. 212–225. – DOI: 10.1007/s12016-021-08881-0.Vorsteveld, E. E. Next-generation sequencing in the field of primary immunodeficiencies: current yield, challenges, and future perspectives / E. E. Vorsteveld, A. Hoischen, C. I. van der Made // Clinical Reviews in Allergy & Immunology. – 2021. – Vol. 61. – P. 212–225. – DOI: 10.1007/s12016-021-08881-0.Beyond TREC: pivotal role of tandem TREC/KREC assay in Czech SCID NBS pilot programme / M. Bloomfield [et al.] // Pediatric Allergy and Immunology. – 2025. – Vol. 36, No. 5. – Article e70100. – DOI: 10.1111/pai.70100.Beyond TREC: pivotal role of tandem TREC/KREC assay in Czech SCID NBS pilot programme / M. Bloomfield [et al.] // Pediatric Allergy and Immunology. – 2025. – Vol. 36, No. 5. – Article e70100. – DOI: 10.1111/pai.70100.Determination of excision rings of T- and Bcell receptor DNA by real-time multiplex PCR : instructions for use / E. A. Polyakova [et al.]. – Minsk, 2020. – 24 p.Determination of excision rings of T- and Bcell receptor DNA by real-time multiplex PCR : instructions for use / E. A. Polyakova [et al.]. – Minsk, 2020. – 24 p.Lessons learned from five years of newborn screening for severe combined immunodeficiency in Israel / A. Lev [et al.] // The Journal of Allergy and Clinical Immunology: In Practice. – 2022. – Vol. 10, No. 10. – P. 2722–2731.e9. – DOI: 10.1016/j.jaip.2022.04.013.Lessons learned from five years of newborn screening for severe combined immunodeficiency in Israel / A. Lev [et al.] // The Journal of Allergy and Clinical Immunology: In Practice. – 2022. – Vol. 10, No. 10. – P. 2722–2731.e9. – DOI: 10.1016/j.jaip.2022.04.013.

The authors declare that there are no conflicts of interest present.