Povezanost tipa preloma i formiranja kalusa sa koncentracijom proinflamatornih citokina kod dece sa prelomima dugih kostiju

  • Zoran Paunović Institute for Health Protection of Mother and Child of Serbia “Dr. Vukan Čupić“, Belgrade, Serbia
  • Sanja Milutinović University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Nikola Stanković Institute for Health Protection of Mother and Child of Serbia “Dr. Vukan Čupić“, Belgrade, Serbia
  • Džihan Abazović Emergency Medical Center of Montenegro, Podgorica, Montenegro
  • Ivan Stanojević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Mia Rakić University of Nantes, Faculty of Dental Surgery, Nantes, France
  • Mirjana Djukić Faculty of Pharmacy, Belgrade, Serbia
  • Gordana Šupić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Danilo Vojvodić University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
  • Dušan Marić University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia
  • Wasim S Khan University of Cambridge, Addenbrooke's Hospital, Division of Trauma and Orthopedic Surgery, Cambridge, United Kingdom
  • Srdjan Starčević University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP190526078P
Ključne reči: fractures, bone, fracture healing, child, adolescent, bony callus, interleukin-1beta, tumor necrosis factor-alpha, monocyte chemoattractant protein-1, interleukin-8, prognosis

Sažetak


Uvod/Cilj. Inflamatorni odgovor je od izuzetne važnosti u zarastanju koštanih preloma, iako je precizna uloga ćelija i citokina nejasna. U našoj studiji ispitivali smo povezanost vrednosti interleukina-1β (IL-1β), faktora nekroze tumora-alfa (TNF-α), monocitni hemoatraktantni protein-1 (MCP-1) i interleukina-8 (IL-8) sa konfiguracijom preloma i formiranjem kalusa. Metode. Serumska koncentracija citokina određivana je kod 78 negojazne dece sa prelomom dugih kostiju (grupa 1), 10 dece sa prelomom prstiju (grupa 2) i 10 zdrave dece (grupa 3 ‒ kontrolna grupa). Uzorci krvi kod dece sa prelomima kostiju uzimani su odmah po prijemu u bolnicu (grupe 1 i 2). Razlike u koncentracijama citokina su analizirane između grupa i kategorisane prema konfiguraciji preloma i formiranju kalusa. Rezultati. Vrednosti IL1-β i TNF-α bile su niže kod bolesnika sa nedovoljno formiranim kalusom u odnosu na one sa kompletnim kalusom. Iznenađujuće, prosečna IL1-β koncentracija bila je najveća u kontrolnoj grupi. Jedina značajna korelacija između IL1-β i TNF-α bila je u grupi sa intermedijarno formiranim kalusom. MCP-1 je imao povišene vrednosti kod svih bolesnika u odnosu na kontrolnu grupu, bez međusobnih razlika. Prosečna vrednost IL-8 pokazala je jasan pad u grupi sa nekompletno formiranim kalusom u odnosu na grupu sa kompletno formiranim kalusom i kontrolnu grupu, ali bez značajne razlike. Deca sa epifiziolizom imala su najmanje koncentracije citokina u poređenju sa svim drugim tipovima preloma. Takođe smo detetkovali značajno niže koncentracije IL-1β i MCP-1 kod bolesnika sa manjim stepenom dislokacije u odnosu na veće dislokacije fragmenata. Zaključak. Sistemski inflamatorni odgovor je važan u fiziološkom zarastanju kostiju. Visoka rana produkcija IL1-β, TNF-α i MCP-1 je udružena sa boljim formiranjem kalusa i boljim zarastanjem kostiju, dok je povećana IL-8 koncentracija udružena sa lošim formiranjem kalusa i lošim zarastanjem kostiju. Naši rezultati su pokazali da su epifizioliza i veći stepen dislokacije fragmenata udruženi sa odloženim zarastanjem fraktura.

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Objavljeno
2021/05/10
Broj časopisa
Vol. 78 Br. 4 (2021): Vojnosanitetski Pregled
Rubrika
Originalni članak