[Prospects of Application of Remote Preconditioning at Heart Revascularization].

Remote ischemic preconditioning of the heart exerts anti-necrotic, antiarrhythmic, inotropic effects that have been demonstrated in clinical trials in cardiac surgery both in adults and children. However, so far there is no consensus between cardiologists regarding the impact of remote preconditioning on the incidence of intraoperative myocardial infarctions and mortality in the postoperative period. Until now there is no unanimity concerning choice of remote preconditioning protocol and timing of its application before cardiac surgery.

[PROBLEM OF END EFFECTOR OF ISCHEMIC PRECONDITIONING OF THE HEART].

An analysis of the literature data performed by the authors shows that the main contenders for the role of the end effector of ischemic preconditioning of the heart are: (1) MPT pore (2) nexuses (3) cytoskeleton. Thus, almost all of the known intracellular molecular cascades eventually converge on MPT pore, on the components of the cytoskeleton and nexuses.

[SIGNIFICANCE OF OPIOID RECEPTORS IN THE CYTOPROTECTIVE ACTION OF CHRONIC HYPOXIA DURING ANOXIA-REOXYGENATION OF CARDIOMYOCYTES].

It was investigated the role of δ-, µ- и κ-opioid receptors (ORs) in the development of cytoprotective effect of chronic normobaric hypoxia (CNH) using anoxia/reoxygenation of isolated cardiomyocytes. Adaptation to CNH was achieved by the maintenance of rats for 21 days at atmosphere containing 12% O2. Anoxia/reoxygenation of isolated cardiomyocytes of intact rats evoked a death of 23% cells and enhancement of lactate dehydrogenase (LDH) release from cells. Anoxia/reoxygenation of isolated cardiomyocytes of adapting rats induced a death of only 2.5% cells and LDH release decreased by 25%. Preliminary incubation of cells with the OR blocker naloxone (300 nM) or the δ-OR antagonist TIPP(ψ) (30 nM) or the selective δ2-OR antagonist naltriben (1 nM) or the µ-OR antagonist CTAP (100 nM) 25 min prior to anoxia abolished adaptive enhancement of cell survival and a decrease in LDH release. The blocking of δ1-OR by BNTX (1 nM) or κ-OR by nor-binaltorphimine (3 nM) not affected on the cytoprotection at CNH. Consequently, cardiac cell δ2- and µ-opioid receptors are involved in the cytoprotective effect of chronic normobaric hypoxia.

[Etoricoxib in the treatment of active sacroiliitis in patients with axial spondyloarthritis, including ankylosing spondylitis].

AIM: To study a trend in active sacroiliitis (ASI) in patients with axial spondyloarthritis (axSpA) during different short-term regimens using etoricoxib (ET) 90 mg. SUBJECTS AND METHODS: Forty patients with axSpA, including 30 with ankylosing spondyloarthritis), and ASI (sacroiliac joint (SIJ) osteitis as evidenced by magnetic resonance imaging) were examined and then randomized to 2 groups: 1) 20 patients who took ET 90 mg four days or more a week; 2) 20 patients who received ET 90 mg 3 days or less a week. Osteitis was measured in 4 quadrants of each SIJ (0-3 scores). Its main criterion was considered to be a decrease in total osteitis activity (TOA) 12 week later. RESULTS: In all the patients (n = 40), TOA decreased from 6.5 (4; 9) to 2 (0; 5) scores (p < 0.0001). In Group 1 (n = 20), that reduced from 6.5 (4; 8.5) to 0 (0; 3) scores (p < 0.0001). In Group 2 (n = 20), that did from 6.5 (4; 10) to 4 (1; 8) scores (p = 0.49). At 12 weeks, in in Groups 1 and 2, the difference in final TOA achieved no statistical significance (p=0.056). In these groups, there were 19 (95%) and 14 (70%) treatment-responsive patients, respectively. CONCLUSION: The intake of ET 90 mg for 12-weeks is associated with a reduction in the degree of ASI in patients with axSpA. The use of ET 4 times or more a week is more effective in diminishing osteitis than that of ET 3 days or less.