FEATURES OF THE UBIQUITIN-PROTEASOME SYSTEM IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 5D.

The aim of the study was to assess the activity of the ubiquitin-proteasome system in patients with chronic kidney disease stage 5D (CKD5D) and its relationship with clinical and laboratory parameters. We examined 80 patients with CKD5D on hemodialysis (HD). The mean age was 51.7±11.6 years, the duration of HD was 33.5 (19.7; 58.25) months. All patients underwent physical examination, bio-impedancemetry. Hypoxia-inducible factor 1-alpha (HIF-1α) and 20S-proteasome (20S-PSM) levels were determined in the blood by ELISA. The hemoglobin level as well as its fluctuation over the preceding 12 months did not differ in the groups with normal and elevated 20S-PSM levels, however, there were some features of ferrokinetics depending on the level of serum transferrin (p=0.04), its fluctuations over the preceding 12 months (p=0.03) and its saturation (p=0.03). It was shown that as the level of 20S-PSM in the blood increases, the probability of detecting protein-energy wasting (PEW) increases (χ2=4.8, p=0.029). This is probably due to the implementation of the catabolic link of protein metabolism involving the ubiquitin-proteasome system. There was a strong negative correlation between the HIF-1a and 20S-PSM parameters (r=-0.86, p<0.05), which was confirmed when building the logistic regression model (χ2=65.9, p<0.0001). Depending on the level of hemoglobin and HIF-1a, we divided all patients into groups with hemoglobin and hypoxia-dependent 20S-PSM increase mechanisms. The found interrelations of these molecular markers with ferrokinetics parameters, features of renal replacement therapy (RRT) require additional study.

[Morphological characteristics and intracellular electrolytic composition of blood cells at surgeries on lower extremities arteries].

Morphological characteristics and trace and macroelement composition of blood cells flowing out of ischemic lower limb before, during and after reconstructive surgeries under different type of anesthesia. A total of 102 male patients aged 45 to 60 years with atherosclerotic occlusions of the arteries of the femoral-popliteal zone were included into the study. According to anesthesia type all the patients were divided into 3 groups: group 1 consisted of 34 patients operated under spinal anesthesia, 37 patients of group 2 underwent surgery under combined anesthesia (spinal anesthesia with intravenous sedation), 31 patients of group 3 - under total intravenous anesthesia with myoplegia and artificial pulmonary ventilation. All the blood examinations were carried out with scanning electron microscope XL-30 ("Philips") and X-ray spectrum microanalyzer Edax ( "Edax International", USA). It is demonstrated that in spinal and combined anesthesia morphological characteristics of blood cells normalized due to optimization of intraerythrocytic and intrathrombocytic electrolytic homeostasis unlike total intravenous anesthesia, when intracellular imbalance of trace and macroelements progresses and ultrastructural cellular alterations persist.

[Oxygen transport and immune status in patients with congenital valvular heart disease]. / Osobennosti transporta kisloroda i immunogo statusa u bol'nykh vrozhdennymi porokami serdtsa.

Oxygen transport, its metabolic maintenance and immune status were studied in 17 patients with congenital valvular heart disease (CVD) having compensated (n = 8, group 1) and decompensated (n = 9, group 2) defects of hemodynamics. CVD patients with decompensated central hemodynamics and progressing hypoxia had impaired compensatory rearrangement of oxygen transport system. Accumulation of intracellular lactate, low activity of basic energetic cycles of blood cells most evident in decompensated CVD was observed in both the groups. In conditions of severe energy-structural deficiency and impaired function of oxygen transport systems, CVD patients develop secondary immune deficiency presenting with depression of basic immunoregulatory subpopulations of T- and B- cellular immunity (CD2, CD3, CD4, CD5, CD8, CD16, CD22).