CHANGES IN THE LEVEL OF INTERLEUKIN-4 AND INTERLEUKIN-6 IN RESPONSE TO ANGIOPROTECTIVE THERAPY IN CHILDREN WITH SEVERE BIRTH ASPHYXIA
Abstract
The development of clinical and laboratory criteria for diagnosis of systemic inflammatory response significantly expanded the employment of this concept in clinical practice. Correlation between the levels of anti-inflammatory and pro-inflammatory cytokines is an important aspect in regulation of the onset and development of systemic inflammatory response as its treatment is still an urgent problem in modern medicine. Treatment of systemic inflammatory response includes three main links: effect on the levels of endotoxin, cytokines and the state of endothelium. Currently there is no unified approach to the solution of this problem, which determines the relevance of the topic.
The aim of the research was to study the efficacy of Deproteinized hemodialysate from the blood of veal calves in systemic inflammatory response in newborns with severe asphyxia at birth.
The study involved examination of 16 newborns with severe asphyxia at birth, who received Deproteinized hemodialysate from the blood of veal calves as part of standard therapy from the first day of the disease at a dose of 0.5 ml / kg (study group), The study implied a follow-up assessment of interleukin-4 (IL-4), interleukin-6 (IL-6) levels. Sign test and Wilcoxon test were used for paired samples (time course of treatment); Kolmogorov-Smirnov and Mann-Whitney tests were used for non-paired samples (subgrouping by feature). To investigate the influence of the independent variable on the dependent variable we used Kruskal-Wallis and median tests as nonparametric analogs of the variance analysis.
At this stage a lot of attention is paid to investigating the ways of pharmacological correction of nitrogen oxide metabolism disturbances in endothelial dysfunction. There is evidence for positive effect of various pharmacological agents on functional state of endothelium. Deproteinized hemodialysate derived from the blood of veal calves is a vasoprotector and is a combination of a number of physiologically active ingredients stimulating oxygen utilization by tissues in hypoxic conditions, enhancing glucose transport through biological membranes, intensifying intracellular adenosine triphosphate synthesis, and increasing the proportion of aerobic glycolysis.
Administration of Deproteinized hemodialysate from the blood of veal calves in the treatment of systemic inflammatory response in newborns with severe asphyxia at birth exerts influence on biochemical pattern of systemic inflammatory response by reducing inflammation and reducing synthesis of cytokines.
References
Iarustovskiĭ MB, Abramian MV, Krotenko NP, et al. Experience of using endotoxin selective adsorption in patients with severe sepsis after open-heart surgery. Anesteziol Reanimatol 2014; (3): 39–46. (in Russian).
Kozlov IA, Poptsov VN, Alferov AV. Methylene blue as an inhibitor of endogenous nitric oxide overproduction in the correction of postperfusion vascular insufficiency. Annals of Critical Care 2002; (2): 7–12. (in Russian).
Khubutiia MSh, Abakumov MM, Aleksandrova IV, et al. Selective adsorption of endotoxin in the complex treatment of patients with severe sepsis. Anesteziol Reanimatol 2010; (5): 65-9. (in Russian).
Chukanova EI, A N Bogolepova AN. Perspectives of the use of solcoseryl in the therapy of ischemic encephalopathy. Zh Nevrol Psikhiatr Im S S Korsakova 2007; Suppl 21: 57-64. (in Russian).
Opal SM. The host response to endotoxin, antilipopolysaccharide strategies, and the management of severe sepsis. Int J Med Microbiol 2007; 297: 365–77.
Khoroshilov SY, Karpun NA, Polovnikov SG, Nikulin AV, Kuzovlev AN. Selective hemosorption of endotoxin in the treatment of abdominal sepsis. General Reanimatology 2009; 5: 83-7. (in Russian).
Dziak LA, Golik VA. Experience gained with Solcoseryl as treatment of patients with cerebral hemorrhage. Lik Sprava 2001; (4): 162-8. (in Russian).
Ashidkova NV, Volodin NN, Degtyareva MV, et al. The effectiveness of the drug recombinant human interleukin-2 in the treatment of neonatal sepsis and severe neonatal infections. Pediatrics 2009; 87: 80-6.
Malysh IR, Treshchinskiĭ AI, Shlapak IP, Zgrzheblovskaia LV. Effect of analgesic sedation on the cytokine profile in victims with severe polytrauma. Anesteziol Reanimatol 2007; (4): 30-3. (in Russian).
Novelli G, Ferretti G, Poli L, et al. Clinical results of treatment of postsurgical endotoxin-mediated sepsis with polymyxin-B direct hemoperfusion. Transplant Proc 2010; 42: 1021-4.
Kligunenko EN, Kozina OS. Influence of thromboprophylaxis with bemiparin on markers of inflammation. Pain Anesthesia and Intensive Care 2013; (3): 9-12. (in Russian).