Abstract

The aim of the study was to determine efficiency of Glutoxim, aimed for correction of immune disorders. The drug was administered to the patients with chronic cerebral ischemia (CCI, Stage I and II) complicated by arterial hypertension. Increased contents of pro- and anti-inflammatory cytokines, IFNγ, IL- 2, G-CSF, and activation of the complement system have been revealed for these conditions, at both functional stages of the disease. The patients with stage II CCI showed elevated markers of oxygen-dependent activity in polymorphonuclear leukocytes (increased levels of spontaneous and stimulated nitroblue tetrazolium (NBT) reduction tests, phagocytic capacity and stimulation index of neutrophils). Stage I of chronic cerebral ischemia was characterized by normal values of NBT reduction tests and functional reserve of neutrophils, along with decreased stimulation index of neutrophils. Among 26 parameters of immune status, 73.1% and 80.8% of indices proved to be changed, respectively, in the patients with stage I and II CCI. 66.7% of immune indices appeared similar in magnitude and direction of changes, whereas the resting 33% are identical in orientation. Usage of Cereton and Actovegin in treatment of the stage I CCI caused normalization of 5.3% immune parameters, with partial normalization of 26.3% tests, and 68.4% of the indexes remaining unchanged or increased posttreatment. Inclusion of Glutoxim into the combined pharmacotherapy proved to be more effective since it totally normalized 52.6% of the indexes, along with partial normalization of 21.1%, while 26.3% of the indicators were not affected by the therapy. Administration of Cereton and Actovegin at the second stage of chronic brain ischemia was followed by partial normalization for 47,6% of the tests, while leaving unchanged or increased 52.4% of the indicators. Glutoxim Use fully normalize 19.0% and partially normalizes 57.1% of immune parameters.

Highlights

  • Иммунитет и ишемия мозга Immunity and cerebral ischemia кроме вазотропной терапии, устранению причин микроангиопатий, коррекции эндотелиальной дисфункции оксидантного стресса, обеспечению нейропротекции, на повестку дня выступает применение иммуномодуляторов для устранения иммунных нарушений на ранних стадиях заболевания [2, 9, 17]

  • Note. * – p < 0.05; figures marked with an asterisk beside – with respect to which group indexes are given to these differences

  • Karaulov A.V., PhD, MD (Medicine), Professor, Full Member, Russian Academy of Sciences, Head, Department of Clinical Immunology and Allergology, First Moscow I.M. Sechenov State Medical University, Moscow, Russian Federation

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Summary

КОРРЕКЦИЯ ИММУННЫХ НАРУШЕНИЙ ПРИ ХРОНИЧЕСКОЙ ИШЕМИИ ГОЛОВНОГО МОЗГА

Целью исследования было определение эффективности применения глутоксима в коррекции иммунных нарушений у больных с первой и второй стадией хронической ишемии головного мозга на фоне гипертонической болезни. Из 26 исследованных параметров иммунного статуса у пациентов с первой и второй стадией хронической ишемии головного мозга оказались измененными от значений здоровых доноров, соответственно, 73,1% и 80,8% показателей, из которых 66,7% параметров у больных с обеими стадиями заболевания оказались одинаковыми по величине и по направленности изменений, еще 33,3% идентичны по направленности. Использование в лечении хронической ишемии головного мозга первой стадии церетона и актовегина нормализует 5,3% измененных на начало лечения параметров иммунного статуса, корригирует 26,3% и оставляет без изменения или повышает в еще большей степени 68,4%. Применение при второй стадии заболевания церетона и актовегина корригирует 47,6% измененных до лечения параметров иммунного статуса.

Материалы и методы
Показатели Indicators Единицы измерения Units of measure Здоровые
Хроническая ишемия головного мозга II Chronic cerebral ischemia II
Findings
Схемы фармакокоррекции
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