[Biomarkers of brain damage and inflammation in patients with acute cerebral ischemia]. / Biomarkery povrezhdeniya mozga i vospaleniya u patsientov s ostroi tserebral'noi ishemiei.

OBJECTIVE: To study the pathogenetic and clinical significance of factors of hypoxic brain damage and inflammatory mediators in the development of stroke, to improve the diagnosis using laboratory markers of brain damage and inflammation in patients with acute cerebrovascular accident. MATERIAL AND METHODS: We examined 55 people with stroke of the ischemic type at the age of 74 (67; 80) years, the comparison group consisted of 25 volunteers at the age of 65.0 (62.0; 66.5) years. Depending on the outcome of ischemic stroke, patients were assigned to the discharged group or to the deceased group. Blood serum and cerebrospinal fluid (CSF) S100b protein, glial fibrillar acidic protein and interleukin-6 (IL-6); blood serum neurospecific enolase, and cortisol and C-reactive protein (CRP) were determined. Clinical blood test and assessment of fibrinogen content were performed on days 1, 3 and 10 of stroke. RESULTS: There is an increase in the levels of markers of brain tissue damage and systemic inflammation in the blood and CSF in response to cerebral ischemia that reflects the synergy of these pathological processes in patients with stroke, their association with the severity of stroke and its outcome. CONCLUSION: The results indicate that the postischemic release of neurospecific proteins, an increase in the content of IL-6, CRP, and cortisol make it possible to additionally characterize the severity of stroke and the body's response to damage, and predict the outcome of the disease.

[Matrix metalloproteinase-1, -8, -9 and the risk of cardiovascular complications in patients with CHD before and after myocardial revascularization].

There is still a great need for detection of biomarkers for early prediction and diagnosis of cardiovascular complications (CVC) in patients with CHD. Objective: To determine the role of MMP-1, 8, 9 in the risk of CCO in patients with CHD before and after coronary artery bypass grafting (CABG). Methods. The study included 75 patients with coronary heart disease before and after myocardial revascularization by CABG, including 40 men and 35 women aged from 45 to 74 years. Patients were divided into two groups: I group - 25 patients with CVC registered after CABG (acute myocardial infarction, ischemic stroke, pulmonary thromboembolism Branch); II group - 50 patients with coronary heart disease without complications after myocardial revascularization. Blood sampling was performed the day before surgery, on the 1st, 3rd and 10th days after CABG. Determining the level of MMP-1, 8, 9 in the serum was performed by ELISA using reagents specific «RD Diagnostics Inc.¼, USA. Results are expressed in ng/ml. Data are presented as medians and quartiles of two (Me, Q25, Q75). Within and between-group differences were evaluated using the Mann - Whitney, Spearman correlation coefficient and c2 test within the application program SPSS №16. Statistically significant differences between the indicators considered when you reject the hypothesis and significance level of p<0,05. Results. A statistically increased concentration of MMP-1 and MMP-8 in patients in group I. Undetermined significant dynamics of MMP-9 in patients after myocardial revascularization. Conclusion. The results indicate that the level of MMP-1, 2.5 ng/ml or more in patients with CAD is a diagnostic criterion for the risk of TE complications. No association between high content of MMP-8 and the presence of complications in patients after surgery. There were no significant dynamics of MMP-9 in patients after myocardial revascularization.

Assessing the level of matrix metal proteinases 1,8,9, their tissue inhibitor, type I, in cases of odontogenic phlegmons.

The article considers the measured values of the level of MMP-1, MMP-8 and MMP-9, and of their tissue inhibitor Type I (TIMP-1) in the blood serum and mixed saliva samples of 78 patients (31 women - 36.2 %, 47 men - 63.8 %) suffering from odontogenic phlegmons in the oral and maxillofacial region. The study indicators were assessed through the enzyme-linked immunosorbent assay using diagnostic sets RandD Diagnostics Inc. (USA). An uncontrolled hyperactivation of metal proteinases as one of the components of the systemic inflammatory response in case of phlegmon-related complications in the oral and maxillofacial region, as well as development of the sepsis syndrome were studied and it was determined that it results in distortion of the processes of reparative hystogeny and compel us to employ new approaches to the treatment of this type of patients (Tab. 2, Fig. 1, Ref. 13).

[The cytokines profile at the enterobacter pneumonia during experiment].

Distinctions between system and local levels of cytokines and dynamics of their development depending on ethiology of pneumonia were established during experiment. It proved that the enterobacter pneumonia is accompanied by raised systematic IFNgamma production and essentially increased IL-10 production, whereas with the pneumonia caused by E. coli, the IFNgamma production level differs little from control values, and IL-10 is statistically more less its values in intact animals blood. The local level of cytokines at the pneumonia caused by Enterobacter spp. is characterized by the early significant IL-10 production activation and expressed IFNgamma production depression a fortmight later two weeks after infection. Increasing local IL-10 production prevalence is registered when mice contaminating with E. coli. Thus, the experimental pneumonias caused by Enterobacter spp. and E. coli are characterized by cytokines' system disbalance that renders expressed immunodepressive influence on pulmonary factors of protection and it's necessary for choosing methods pneumonia's pathogenetic therapy.

[Immune mechanisms of comorbidity of HIV infection and pulmonary tuberculosis].

AIM: to study the immune system in patients with tuberculosis-associated HIV infection at different stages of disease and during antiretroviral therapy (ARVT). SUBJECTS AND METHODS: The study included 90 patients with tuberculosis-associated HIV infection; a control group comprised 117 HIV-infected patients. The total number of T lymphocytes and their subpopulations (CD3+, CD4+, and CD8+) and the levels of the cytokines TNF-alpha, IL-6, and their soluble receptors SRp55 of TNF-alpha (type I), SRp75 of TNF-alpha (type II), and SR of IL-6 in the serum. RESULTS: T-cell immunodeficiency was detected at all stages of HIV infection accompanied by CD3+ and CD4+ cell deficiency and decreased immunoregulatory index. The cytokine profile changes were indicative of a more noticeable reduction in the functional activity of T helper cells type I in patients with HIV-associated tuberculosis. CONCLUSION: The efficiency of ARVT in patients with HIV-associated tuberculosis was confirmed by a lower viral load and higher CD4+ cells. Heterodirectional changes in the content of cytokines and their receptors characterized by a considerable increase in the levels of TNF-alpha, IL-6, SR of TNF-alpha and a drastic reduction in the level of SR of IL-6 may be considered as a marker of immune recovery.

[The cytokine profile in patients with chronic type C hepatitis].

The purpose of the study was to perform complex evaluation of cytokine status in patients with type C chronic hepatitis (CCH), taking into account its system and local parameters and their correlation with peculiarities of clinical and morphological parameters. The study revealed a significant increase of concentrations of cytokines Th-2, interleukins (IL-4, IL-10), and proinflammatory cytokines (IL -1alpha, IL -12p40, IL -12p70), as well as a significant decrease of Th1-cytokine (IL-2 and interferon-gamma) levels, both in blood and in the supernatant of hepatic tissue samples. The study also found an increase of serum and local tumor necrosis factor (TNF) -alpha and established a correlation between the levels of the system and local cytokines under study, on the one part, and clinical, laboratory and morphological parameters, on the other, which evidences their significant role in CCH immunopathogenesis. The most significant from the clinical point of view are serum and local levels of TNF-alpha, IL-4, IL-12p40; the most important parameters for determination of inflammatory activity of the pathologic process and fibrosis stage are concentrations of IL-4, IL-10, and IL-12p70 in serum and the supernatant of hepatic tissue samples.

[Treatment of acute destructive pancreatitis with recombinant interleukin-2].

Twenty-nine patients with acute destructive pancreatitis received combined therapy including recombinant interleukin-2 (ronkoleukin). Treatment with this interleukin led to a decrease of hypercytokinemia, reduced rate of purulent -- septic complications and surgical operations because of these complications.

[Clinical and immunological effect produced by vaccination with "Pneumo 23" of children with atopic bronchial asthma].

A total of 45 children aged 4-16 years with atopic bronchial asthma of different severity level-resulted from a past case of outhospital pneumonia, received vaccine "Pneumo 23" ("Aventis Pasteur", France). The vaccine was found to be well tolerated, no cases of the exacerbation of the atopic process were registered. A reliable Increased level of specific antibodies to the mixture of polysaccharides, contained in the vaccine "Pneumo 23", was found to occur. The tendency towards decreased level of serum IgE was established.

[Local cytokine levels and morphological parameters in chronic viral hepatitis C].

The association of the level of local cytokines, such as interleukin (IL)-1alpha, IL-2, IL-4, tumor necrosis factor-alpha (TNF-alpha), and gamma-interferon (gamma-INF) was studied in the liver biopsy specimens from patients with chronic hepatitis C (CHC) with clinical and morphological indices and biochemical and virological findings. There was a polymorphism of clinical symptoms, as well as extrahepatic manifestations in the group that had significantly elevated levels of IL-1alpha, IL-4, and TNF-alpha, as well as decreased concentrations of IL-2 and gamma-INF. The activity of necrotic inflammatory manifestations in the liver in CHC is also associated with a more pronounced shift towards an increase in the levels of IL-1alpha, IL-4, and TNF-alpha, and a decrease in those of IL-2 and gamma-INF.

[Leukinferon in the treatment of patients with sepsis and multiple organ dysfunction syndrome]. / Leikinferon v lechenii septicheskikh bol'nykh s sindromom poliorgannoi nedostatochnosti.

Dynamics of clinical signs, blood formula and some cytokins in serum samples of the patients with sepsis complicated by multiorgan disfunction syndrome (as a rule kidney and liver were involved) were investigated. Etiotropic therapy was combined with immunocorrecting treatment with leukinferone Combined regime provided positive results in clinical symptoms, in lymphocytes number normalization (abs. and per cent), stimulated T lymphocytes differentiation and facilitated intoxication finishing according to LII). Immunocorrection practically had no effect on TNF-alpha, IL-1 alpha, IL-6, and stimulated IL-8 secretion more effectively than etiotropic therapy. IF-gamma level enhanced along with stopped IL-10 production. As a result ratio of IF-gamma/IL-10 enhanced from 0.56 to 1.0, in the case of etiotropic therapy this ratio diminished from 0.48 to 0.3. It is concluded that immunocorrecting therapy provided positive dynamics in the ration IF-gamma/IL-10, recurring cell immune reactions. The recurrence period was shortened and lethality level was substantially lower (2.5 times).