HISTOLOGICAL AND MORPHOLOGICAL CHANGES IN THE LYMPHOID STRUCTURES OF THE GASTRIC MUCOUS MEMBRANE IN WHITE RATS WITH THE ADMINISTRATION OF SODIUM GLUTAMATE.

OBJECTIVE: The aim: To determine the histological and morphological changes of the lymphoid structures of the stomach in male rats under the influence of oral sodium glutamate at the rate of 15 mg/kg of body weight. PATIENTS AND METHODS: Materials and methods: The scientific experiment was performed on 20 white non-linear male rats of reproductive age (4-5 months). The experimental animals were divided into two groups (10 rats in each group), which were orally received monosodium glutamate at a dose of 15 mg/kg body weight every day. We studied the effect of 2 and 4 weekly administration of monosodium glutamate at a dose of 15 mg/kg body weight, respectively, in the I and II groups of experimental animals (depending on the week of their decapitation). Rats of the control groups (n=10) were injected with a placebo for 2 and 4 weeks, namely 0.5 ml of dechlorinated tap water at room temperature. Intact control animals were also divided into two groups, 5 rats each, depending on the week of decapitation: respectively, III group - decapitation on the 2nd week of the experiment; IV group - decapitation on the 4th week of the experiment. After the experiments were completed, animals were decapitated under light ether anesthesia. According to the purpose of the study, pieces of rat stomach measuring 1.0 x 1.0 cm were taken from the front wall of the bottom of the stomach near the great curvature, cardiac and portal parts of the organ. Histological preparations were examined using a MICROmed SEO SСAN light microscope and a Vision CCD Camera. Morphometric studies were carried out according to the method of S. B. Stefanov, using grids No. 3/16. For electron microscopic examination, pieces of the stomach wall of rats were fixed in a 2.5% solution of glutaraldehyde in a 0.1 M phosphate buffer (pH 7.2-7.4) with subsequent fixation in a 2.0% solution of osmium tetroxide. After dehydration in alcohols and acetone, the material was embedded in eponaraldite. Sections were made on an LKB-8800-III ultramicrotome and studied using a JEM - 100-V microscope. To study the structural components of the lymphoid formations of the mucous membrane of different parts of the stomach of rats, semi-thin sections were made for the purpose of sharpening the blocks, which were stained with methylene blue. RESULTS: Results: The analysis of the obtained data of the conducted experiment indicates that the administration of monosodium glutamate in a dose of 15 mg/kg of body weight to rats already after 14 days leads to an increase in the density and size of the lymphoid structures of the GMM. The number of immunocompetent cells between the fundus of the gastric glands and the muscle plate increases in the diffuse lymphoid tissue of the gastrointestinal tract of rats in all its parts, both in the I and II groups of experimental animals. These changes are most pronounced in the cardiac and portal parts of the stomach. In both groups of experimental animals, the migration of interepithelial lymphocytes, macrophages, plasma cells, and tissue basophils to the surface epithelium increases. In both groups of experimental animals (and the II group of rats), lymphoid nodules and lymphoid pre-nodules of the gastric mucous membrane (GMM) are located between the bottom of the gastric glands and the muscular plate of the GMM. A gradual increase of medium lymphocytes in the GMM was established both in animals of I and II groups, while large lymphocytes increased in almost the same amount in experimental animals of both groups. Similar changes occur in the characteristics of the number of plasma cells, macrophages and tissue basophils in the lymphoid pre-nodules of GMM. CONCLUSION: Conclusions: Administering monosodium glutamate to rats at a dose of 15 mg/kg of body weight for 2 weeks leads to an increase in the density and size of lymphoid structures of the mucous membrane in all parts of the stomach with a predominant increase in the number of immunocompetent cells between the bottom of the gastric glands and the muscle plate. At the same time, more pronounced changes were found in the number of small lymphocytes, which tend to decrease by the 2nd week of the experiment, and vice versa - their density increases by the 4th week of monosodium glutamate administration.

CHANGES IN SERUM SOMATOSTATIN AND GASTRIN LEVELS IN PATIENTS AFTER CHOLECYSTECTOMY AND GASTROESOPHAGEAL REFLUX DISEASE.

OBJECTIVE: The aim: To study of changes in the level of serum gastrin (GN) and somatostatin (SST) in patients with GERD after ChECT and determined their characteristics from clinical forms of GERD. PATIENTS AND METHODS: Materials and methods: 64 patients with different clinical forms of GERD were examined. The patients with GERD were divide into 2 clinical groups. Group 1 included 34 patients with GERD after ChECT, among them there were 14 males (41.2 %) and 20 females (58.8 %), with the average age of 40.2 ± 3.2 years. Group 2 consisted of 30 patients with GERD without ChECT. Among them there were 18 males (60.0 %) and 12 females (40.0%), with the average age of 38.9 ± 4.7 years. All patients were tested for serum SST and GN level by enzyme-linked immunosorbent assay (ELISA). RESULTS: Results: In all patients with GERD of both group there was a significant increase in the level of serum SST. At the same time, a more higher indicators have been established in 2 Group of patients (increase up to 0.702 ± 0.029 pg / ml - p <0.01). Noteworthy is the change in the level of SST in the serum in both groups of the examined patients depending on the clinical form of GERD, with the maximum increase in patients with atypical manifestation of GERD. The analysis of the level of GN in blood serum indicates its decrease in the examined patients. In this case, the most pronounced changes were found in patients with extraesophageal clinical signs of GERD. CONCLUSION: Conclusions: 1. In patients after ChECT gastroesophageal reflux disease often has atypical symptoms (mostly cardiac and bronchopulmonary forms in 45.0% and 25.0 % of examend patients). 2. There was detected an increase in the level of blood SST of patients with GERD while there was observed a decrease in the GN indicator in the serum, especially in its atypical forms. 3. Duodenogastric reflux is often diagnosed during endoscopic examination of patients with GERD after cholecystectomy. At the same time, its severity correlates with the level of SST in blood serum (r=0.76; p<0.01 in the typical form and r= 0.72; p<0.05 in the atypical clinical form of GERD).

CHANGES IN SERUM GHRELIN AND ITS RELATIONSHIP WITH OF BODY MASS INDEX IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE AND SPONDYLOARTHRITIS.

OBJECTIVE: The aim: To determine the features of changes in serum ghrelin levels and its relationship with the body mass index in patients with GERD and spondyloarthritis (SpA) with lesions of the cervical and thoracic spine. PATIENTS AND METHODS: Materials and methods: The examined patients included 80 patients with SpA with cervical and thoracic spine lesions in combination with GERD. The examined patients with SpA with predominant cervical and thoracic spine lesions were divided into two groups depending on the clinical course of GERD, namely: group I included 33 (41.2%) patients with typical esophageal manifestations of GERD (13 males (39.4%), 20 females (60.6%)), and group II consisted of 47 (58.8%) patients with atypical extraesophageal manifestations of GERD (among them were 17 (36.2%) males and 30 (63.2%) females). RESULTS: Results: All patients were tested for serum ghrelin by enzyme-linked immunosorbent assay. Analysis of clinical manifestations of atypical GERD (group II patients) revealed that most often patients with SpA of the cervical and thoracic spine were diagnosed with dental and otolaryngological masks of reflux disease (40.4 % and 25.5 % of patients, respectively). Maximum serum ghrelin levels were detected in patients with SpA with cardiac GERD (355.02 ± 4.75 ng/ml), while minimum values were found in patients with dental signs of reflux disease (298.17 ± 5.16 ng/ml - p <0.05). CONCLUSION: Conclusions: 1. In patients with SpA with cervical and thoracic spine lesions, GERD often has atypical symptoms (mostly dental and otolaryngological forms in 40.4% and 25.5% of patients). 2. In patients with SpA with esophageal clinical signs of GERD, normal weight or underweight is more common, while in patients with extraesophageal forms of GERD overweight or obesity of varying severity prevails. 3. In patients with SpA and GERD, an increase in serum ghrelin levels was found in patients with cardiac manifestations of reflux disease (355.02 ± 4.75 ng/ml). 4. The relationship between BMI changes in patients with SpA and GERD and increased serum ghrelin levels was found, namely: in group II patients with overweight and obesity a direct correlation was found, and in group I patients with underweight an inverse correlation was fund.

PECULIARITIES OF CHANGES IN HOMOCYSTEINE LEVELS DEPENDING ON VITAMIN STATUS IN PATIENTS WITH CHRONIC PANCREATITIS AND TYPE 2 DIABETES.

OBJECTIVE: The aim: To determine the peculiarities of changes in the homocysteine levels in the patients with chronic pancreatitis and type 2 diabetes blood serum depending on the vitamin status. PATIENTS AND METHODS: Materials and methods: We investigated 36 patients with chronic pancreatitis and type 2 diabetes, who were included in the first group of the patients examined; Group 2 consisted of 34 patients with chronic pancreatitis; and Group 3 of the patients examined consisted of 40 patients with type 2 diabetes. RESULTS: Results: All patients examined were diagnosed with type 2 diabetes mellitus of moderate severity. Also, the diagnosis of chronic pancreatitis was confirmed in all patients with type 2 diabetes, which was manifested by exocrine pancreatic insufficiency according to the results of clinical, laboratory and instrumental methods of examination. There was a significant decrease in the level of all B vitamins and 25-(OH)D in patients with chronic pancreatitis and type 2 diabetes (Group I). An increase in the concentration of homocysteine in the serum in all examined groups of patients was established, with the maximum deviation from the norm in patients with chronic pancreatitis and type 2 diabetes (up to 32.7 ± 0.8 µmol / L <0.01). The correlation analysis revealed a strong direct relationship between the level of homocysteine and vitamins B12, B6, 25-(OH)D and an inverse correlation between vitamin B9 in the group of patients with chronic pancreatitis and type 2 diabetes. CONCLUSION: Conclusions: Patients with chronic pancreatitis and type 2 diabetes have a decreased levels of B vitamins (B1, B6, B9, B12) and 25-(OH)D, which is accompanied by an increase in serum homocysteine. In patients with chronic pancreatitis and type 2 diabetes, the level of homocysteine in the blood serum directly depends on the decrease in the levels of vitamins B6, B12 and 25-(OH)D in blood serum, as well as inverse depends on vitamin B9 levels in these patients.

Changes in the level of α1-antitrypsin in patients with non-alcoholic fatty liver disease.

OBJECTIVE: The aim: To investigate changes in the level of α1-antitrypsin (A1AT) in blood and in stool and their diagnostic value in patients with NAFLD and with impaired carbohydrate metabolism at different stages of liver damage. PATIENTS AND METHODS: Materials and methods: 34 patients with non-alcoholic fatty hepatosis (NAFH) and 40 patients with non-alcoholic steatohepatitis (NASH) were examined. Enzyme-linked immunosorbent assay for all patients with serum and coli was performed by determining the level of A1AT. RESULTS: Results: In patients with NAFLD, in combination with IR, the level of A1AT in the blood plasma is only 1.6 times higher than that of the control group (p <0.05), and in the case of combination of NAFH and type 2 diabetes mellitus (T2DM) - it is 2 times higher (p <0.05). In patients with NASH in combination with insulin resistance (IR), the level of A1AT in the serum was 4.1 times higher than in the control group, and for NASH and type 2 diabetes - 4.2 times. CONCLUSION: Conclusions:The level of A1AT in the blood plasma increases proportionally to the degree of progression of liver damage (from the minimum values at NAFH to the maximum at NASH), regardless of the type of carbohydrate metabolism disturbance. The combination of NAFLD and T2DM is accompanied by a more pronounced increase in A1AT in stool and α1-antitrypsin clearance than the combination of NAFLD and IR.

DYNAMICS OF GASTRIN LEVEL IN PATIENTS WITH DIABETES MELLITUS 2 TYPE AND CHRONIC GASTRITIS AFTER HELICOBACTER PYLORI ERADICATION THERAPY.

OBJECTIVE: The aim: To study the gastrin level dynamics in patients with diabetes mellitus (DM) 2 type and chronic gastritis (CG) on the background of antihelicobacter therapy (AHT). PATIENTS AND METHODS: Materials and methods: 60 patients with DM type 2 and HP-associated CG underwent examination. Patients were divided into two groups of 30 patients each: group 1 included patients who received only standard AHT, group 2 - patients who in addition to standard AHT received the drug SB (Normagut, company Mega) 2 capsules 2 times/day. RESULTS: Results: According to our study results yeast SB, not only increase the HP eradication rate but together with the standard AHT contribute to the serum gastrin reduction, which is a gastric acid stimulator, which in turn leads to an improvement in the CG clinical course. CONCLUSION: Conclusions: Patients with DM type 2 and CG associated with HP should include yeast SB to standard AHT as they reduce side effects from this treatment (by an average of 20%), increase the eradication frequency (by 10%), and also lead to significant decrease in serum gastrin (up to 82.15 ± 2.47 pg/ml).A decrease in serum gastrin levels in patients with HP-associated CG and DM type 2 leads to an improvement in the clinical course of the diseases, namely a decrease in nausea, diarrhea, abdominal pain, and discomfort incidence.

Effect of kallistatin and ghrelin on the formation of endothelial dysfunction in patients with chronic pancreatitis and atherosclerosis.

OBJECTIVE: Introduction: The article is devoted to the optimization of complex diagnosis of endothelial dysfunction in patients with a combination of chronic pancreatitis and atherosclerosis. The aim: To study the level and effects of kallistatin and ghrelin on the formation of endothelial dysfunction in patients with chronic pancreatitis and atherosclerosis. PATIENTS AND METHODS: Materials and methods: 54 patients with chronic pancreatitis were examined. The serum kallistatin level was determined by immunoassay using the Human Serpin A4 ELISA Kit from RayBiotech according to the application method. The serum ghrelin level was determined by immunoassay using the Human/Mouse/Rat Ghrelin Enzyme Immunoassay Kit from RayBiotech. Endothelial dysfunction was determined by the method proposed by D.Celermajer. RESULTS: Results: The study of endothelial-dependent and endothelial-independent vasodilatation is indicative of the presence of a pronounced ndothelial dysfunction in patients with chronic pancreatitis and atherosclerosis, which was manifested by a decrease in their level to 8.7±0.4% and 16.8±0.7%, respectively. The level of kallistatin and ghrelin in patients with chronic pancreatitis and atherosclerosis (15.44 ± 3.97 ng/ml and 276.69 ± 10.06 ng/ml respectively) also confirmed their important role in the formation of еndothelial dysfunction in these patients. CONCLUSION: Conclusions: The study of ghrelin and kallistatin level in serum can serve as a criterion for determining the severity of chronic pancreatitis and atherosclerosis, the development of endothelial dysfunction, and be a marker for predicting their future course.