Abstract
Objective. To study the cytokines and antimicrobial peptides concentrations in patients with cholelitiasis during 1 year treatment before and after the surgery.
 Materials and methods. 38 patients with a cholelithiasis were examined and operated in the Educational-Surgical Clinic of the Azerbaijan Medical University. According to the treatment regimen after the operation the patients were divided into two groups: patients of the 1st group (n = 17) received standard treatment; patients of 2nd group (n = 21), in addition to standard treatment hepatoprotectors, combined enzyme preparations, pre- and probiotics were prescribed. The control group consisted of 14 apparently healthy individuals. The levels of inflammatory cytokines (interleukin-6 and tumor necrosis factor-α) in the blood and antimicrobial peptides (zonulin, calprotectin, and lactoferrin) in feces we studied with enzyme immunoassay method.
 Results. In patients with cholelithiasis of the 1st group, the concentration of interleukin-6 was significantly increased by 5 times (p <0.001), the concentration of tumor necrosis factor-α - by 3.5 times (p <0.001), of zonulin - by 2.2 times (p = 0.012), of calprotectin - by 5.8 times (p <0.001, the concentration of lactoferrin - by 60 times (p <0.001), and in the 2nd group - by 4.8 times (p <0.001), by 3.1 times (p <0.001), on 91.7% (p = 0.011), by 5.8 times (p <0.001) and by 52.8 times (p <0.001) respectively in comparison with the control.
 Conclusions. Standard postoperative treatment supplemented by hepatoprotectors, combined enzyme preparations, pre- and probiotics prescription leads to a positive dynamics of inflammatory mediators concentration and its normalization.
Highlights
The concentration of cytokines in the blood of patients and the concentration of antimicrobial peptides (AMP) in the feces of patients were studied by method of enzyme immunoassay in the dynamics of treatment: before and after surgery
In the 1st group, the concentration of IL-6 was increased by 5 times (p
In group 2, IL-6 concentration was on average (15,4 ± 1,3) pg/ml, and it was a statistically significant increased in this index in 4.8 times (p
Summary
Patients, who took part in the study, were selected among those, examined and operated on for gallstones in the Educational–Surgical Clinic of the Azerbaijan Medical University. The concentration of cytokines (interleukin-6 - IL-6 and tumor necrosis factor-Į-TNF-Į) in the blood of patients and the concentration of AMP (zonulin, calprotectin and lactoferrin) in the feces of patients were studied by method of enzyme immunoassay in the dynamics of treatment: before and after surgery (after 3, 6 months and 1 year). In this case, reagent kits from «Vector Best» (Russian Federation) were used to determine the concentration of cytokines and from «Immun Diagnostic» (Germany) to determine the concentration of AMP. The statistical significance of differences in the normal distribution was assessed using the Student's t-test, and in the case of an abnormal distribution, Wilcoxon signed-rank test was used
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