Levels of cytokines in extended purulent peritonitis and methods of immunocorrection

Abstract

Objective. Comparative studying of the cytokines secretion dynamics in extended purulent peritonitis in postoperative period on background of the standard basic therapy and its combination with cytokinotherapy.
 Materials and methods. The levels of anti-inflammatory cytokines IL-2, IL-6, IL-8 and TNF-α in the blood of 97 patients, suffering extended purulent peritonitis of various genesis and various severity degree, were determined. Depending on kind of therapy conducted, the patients were divided into two Groups: the first one - 52 patients, obtaining standard basic therapy and the second - 45 patients, to whom cytokinotherapy was prescribed additionally to standard basic therapy.
 Results. In the Group II patients the levels of IL-2, IL-6, IL-8 and TNF-α were raised significantly in reactive phase in 2.1 (p=0.035), 2.4 (p=0.002), 2.0 (p=0.004) and 3.5 (p=0.001) times, accordingly; toxic - in 5.1 (p<0.001), 5.6 (p<0.001), 2.4 (p<0.001) and 6.6 (p<0.001) times, accordingly; terminal - in 8.7 (p<0.001), 8.7 (p<0.001), 4.7 (p<0.001) and 8.6 (p<0.001) times, accordingly, comparing with control. On the tenth postoperative day the concentration of proinflammatory cytokines have lowered significantly in comparison to preoperative data.
 Conclusion. In all the patients, owing various degrees of the extended purulent peritonitis severity, preoperatively a statistically significant raise of concentration of proinflammatory cytokines IL-2, IL-6, IL-8 and TNF-­α, comparing with indices in healthy persons, was noted. Targeted immunocorrection, using combined cytokinotherapy on background of complex basic treatment measures, normalizes a cytokinic balance.