RESUMEN
We studied disturbances of cellular energy exchange as one of the leading factors in the development of chronic inflammation in asthma. Comparison of the indicators of mitochondrial respiration and glycolysis in lymphocytes of children with bronchial asthma of different severity, children from the group of frequently ill, and conditionally healthy children showed that the degree of impaired energy metabolism correlates with the severity of the disease. In mild and compensated course of bronchial asthma, as well as in the group of frequently ill children, an increase in the activity of oxidative phosphorylation was observed, which was also accompanied by support in the form of glycolysis activation. This suggests that the energy supply mechanisms are preserved. In more serious cases (moderate bronchial asthma), mitochondrial respiration was hyperactivated with suppression or even absence of glycolysis in some cells. In children with severe bronchial asthma, depression of all studied dehydrogenases was observed, which is probably an unfavorable prognostic sign. These results make it possible to determine the indications for the choice of basic therapy drugs and can serve as a prognostic marker of the severity of the course of the disease.
Asunto(s)
Asma , Niño , Humanos , Asma/metabolismo , Linfocitos/metabolismo , Bronquios , InflamaciónRESUMEN
Today, Nd:YAG laser goniopuncture (LGP) is considered a mandatory non-penetrating deep sclerectomy adjuvant procedure. However, its indications and timing remain debatable. PURPOSE: To evaluate the effect of Nd:YAG laser goniopuncture on the long-term hypotensive effectiveness of non-penetrating deep sclerectomy. MATERIAL AND METHODS: The study included 114 patients after non-penetrating deep sclerectomy (NPDS). In the control group (n=58), Nd:YAG laser goniopuncture was performed within 3.4±1.9 (1.5-6.7) months, and in the main group (n=56) - within 1.12±0.08 (0.9-1.5) months after the surgery. Ultrasound biomicroscopy (UBM) was used to evaluate the semiotics of trabecular-Descemet's membrane (TDM), intrascleral canal (ISC) and filtering bleb. The follow-up period was 5 years. RESULTS: According to UBM data, the thickness (0.10±0.009 mm) and density (50±6%) of TDM (p=0.0001) increased before LGP in the control group, the height of ISC decreased to 0.49±0.19 (0.20-0.40) (p=0.03), the height of UBM scan - to 1.49±0.05 (1.41-2.9) (p=0.0001); IOP (P0) was 18.48±4.7 (11.2-22.9) mmHg (p=0.001). In the main group before LGP, TDM thickness was 0.08±0.006 mm, density was 40±5%, and IOP (P0) was 15.7±4.1 (9.1-18.5) mm Hg. Complete hypotensive success was achieved in 83.6% of cases in the control group and 96.2% in the main group in 6 months; 68.07% and 92.59% in 12 months; 41.3% and 75.8% in 24 months; 15.25% and 48.93% in 36; 15% and 34.8% in 60 months after the surgery, respectively (p=0.0001, 95% confidence interval). CONCLUSION: TDM is an additional level of retention of aqueous humor and plays key role in the formation of outflow pathways after NPDS. Performing LGP in the early postoperative period is an effective and safe adjuvant option, which excludes the influence of TDM on the formation of aqueous humor outflow pathways and significantly increases the long-term hypotensive efficacy of non-penetrating deep sclerectomy.
