THE IMPORTANCE OF THE FUNCTIONAL STATE OF THIOL-DISULFIDE UNIT OF THE ANTIOXIDANT SYSTEM IN THE ACUTE BACTERIAL DYSENTERY IN THE FORECAST OF THE COURSE AND THE SELECTION OF THE TREATMENT REGIMEN

Abstract

The goal was to optimize the treatment of shigellosis patients on the basis of an evaluation of the functional state of the thiol-disulfide unit of the antioxidant system (AOS) on a background of various treatment methods. Materials and methods. 400 patients with acute bacterial dysentery of varying severity of the course were observed; Shigella Flexner was isolated in 324(81%) cases, Shigella Sonne - in 76(19%) cases. The determination of sulfhydryl (SH-) groups and disulfide bonds (SS-) was carried out by the direct and reverse amperometric titration with the use of silver nitrate and unithiol in hemolysate. Three groups separated by random sampling were considered. In group I (122 patients), basic therapy was prescribed, including etiotropic and pathogenetic treatment. In group II (134 patients), pathogenetic treatment was prescribed in the combination with a complex of natural cytokines and antimicrobial peptides secreted by pig peripheral blood leukocytesa (»superlimph» preparation). In the third group (144 patients), the drug «superlimph» was prescribed along with etiotropic and pathogenetic treatment. Results. In acute bacterial dysentery disturbances of the redox balance were established to be correlated with the severity of the course in the form of a significant decrease in the level of SH-groups and the thiol-disulfide coefficient on the background of an increase in the level of SS-groups, which indicates to a decrease in the buffer capacity of the AOS. These data can serve as predictors of the nature of the course of dysentery. Comparative clinical evaluation of the effectiveness of various treatment methods revealed the most pronounced in severe disease advantages of complex therapy, including a combination of basic etiotropic, pathogenetic treatment with a complex of natural cytokines and antimicrobial peptides («superlimph»). Conclusion. The change in the ratio of oxidative processes to AOS occurs at any severity of dysentery, but in severe cases these changes acquire a qualitative character. In the survey standards for bacterial dysentery there is recommended to include the determination of indices of the thiol-disulfide unit, as an additional criterion for the severity of the course and the prognosis of the course of the disease. Exceeding the concentration of SS-groups of the concentration of SH-groups and the inversion of the thiol-disulfide coefficient as markers of the breakdown in AOS seem to be prognostically unfavorable factor. The severe course of acute bacterial dysentery is an indication for inclusion of antioxidant agents in the therapeutic complex. Based on the mechanism of revealed abnormalities in AOS, the use of a complex of natural cytokines and antimicrobial peptides («superlimph») can be considered as an immunocorrecting drug.