Immunological features of psychological adaptation in professional education of military doctors

Adequate adaptation and functioning in a distinct environment proceed with integration of the nervous, endocrine and immune systems. Assessing the changes of immune response formed under disturbed psychoemotional state which may serve as predictors of emerging immune pathology is of particular interest. These studies may find the greatest practical application when observing a cohort of young, practically healthy adults during their professional development. The aim of our work was to reveal the adaptive resources of immune system among military medical students in the course of the educational process. The survey included students of the military training center (MTC) during their 1^st (18 persons), 3^rd (n = (31), and 6^th academic year (n = 34), assigned to the 1^st health group. Psychological testing was carried out using the method of Ch.D. Spielberger (Russian adaptation, Yu.L. Khanin) applied for differential measuring of situational and personal anxiety degree accepted as an index of resistance to stress factors. To assess the features of socio-psychological adaptation to learning environment, we used the questionnaire by K. Rogers and R. Diamond, calculating the integral adaptation index (IAI). The immune status was assessed using standard methodology in ordwer to evaluate the systemic and functional characteristics of innate and adaptive immune response. The hormonal pattern in blood serum (testosterone, cortisol, TSH, total T3, free T4) was estimated by the ELISA method. The integral IAI coefficient reflected a gradual improvement in adaptability to the study environment. Complete adaptation was revealed only in 40% of first-year students; in 80% of third-year students, and in 100% in the sixth year. Comparison of immune parameters with reference values of practically healthy people showed compliance in all examined groups by most criteria except of the first-year students, where a decrease in the number of cytolytically active forms of natural killers was revealed: % Gr⁺CD16⁺ (min-max) = 1-10 versus 3-15 in controls, as well as a decreased proportion of TLR4-expressing monocytes: CD14⁺CD284⁺ (min-max) = 5-22%, versus 10-25% in controls). Statistically significant differences in hormone profile were noted between the observed groups, i.e., a predominance of testosterone and triiodothyronine levels in first-year students, whereas cortisol, thyroxine and thyroid-stimulating hormone levels were at similar level in students from different years. The time period of psychological adaptation to educational process at a Medical University is less successful for the first-year MTC students in comparison with other observation periods: in this group we revealed a decrease in immune indices responsible for the primary immune response, thus forming pre-requisites for the development of clinically sound immune dysfunction.