Immunological Profiles in Elderly Individuals with Occupational Organophosphate-Related Pathology

The literature describes cases of chronic poisoning by organophosphates: pesticides, flame re-tardants, and other industrial and household chemicals. The delayed effects of acute, subacute, subchronic and chronic poisoning manifest themselves years after exposure, with the effects of the toxic factor eventually masked by age-related diseases with an immunological component. The aim of this study was to investigate the immunological profile of blood cells in a cohort of elderly patients diagnosed with occupational pathology caused by subacute or (sub)chronic ex-posure to organophosphates in the 1980s. Analysis of well-being assessments revealed that patients in the control and organophos-phate-exposed groups had approximately equal levels of memory and thinking impairments, anxiety, melancholy and depression, and cognitive function assessments. However, the organo-phosphate-exposed group experienced significantly more balance and memory impairments, and more pronounced neurological symptoms, manifested by abnormal wrist reflexes, cranio-cerebral changes, impaired vibration and distal sensitivity, and depressed abdominal, ankle and plantar reflexes. The organophosphates-exposed group showed decreased red blood cell counts and hematocrit, white blood cell counts were unchanged in both groups. Lymphocyte phenotyping revealed a 1.5-2-fold increase in the relative and absolute levels of circulating plasma cell precursors with the CD19+IgD–CD27++ phenotype, an absolute count of cells with the CD19+CD27++CD38++ phenotype, and an absolute count of TEMRA CD4+ T cells in the organophosphate-exposed group of patients. However, the proportion of CD56+CD57+ cells of the EM4 (CD27–CD28+) CD8+ T cell subset was more than 2-fold reduced. The identified changes indicate a disruption of immune regulation in elderly people with occu-pational pathology, which along with indicators of the neurological and cognitive status of pa-tients can shed light on the pathogenesis of late pathology and serve as important markers in differential diagnosis.