C-reactive Protein In Blood Serum Research Articles

Correction of Nitrosative Stress During Reparative Regeneration of the Nasal Cavity Mucosa in an Experimental

Introduction. Nitric oxide metabolites play an important role in prolongation of the inflammatory reaction, disorders of epithelial regeneration in diseases of the upper respiratory tract. One of the promising approaches to regulating the bioactivity of nitric oxide is the use of antioxidants.The objective of the study is to evaluate the effectiveness of antioxidant therapy for the correction of nitrosative stress during reparative regeneration of the nasal mucosa in an experiment.Methods. A preclinical randomized experimental study is conducted on 160 rats, divided into 4 groups. The control group (n = 40) consists of intact animals. Animals in experimental group 1 (n = 40) do not receive treatment aſter injury; in group 2 (n = 40) anti-inflammatory treatment is prescribed. The third group consists of laboratory rats (n = 40), which are additionally injected into the nasal cavity with an antioxidant — a 15 % solution of 1,1-dimethyl-3-oxobutylphosphonic acid dimethyl ester. On days 2, 5, 10, and 14 of observation, the concentration of nitrates and nitrites and C-reactive protein in the blood of animals are determined.Results. In group 3, aſter an increase in the level of nitric oxide metabolites on day 2 aſter injury on day 5, a significant (p < 0.05) decrease was noted in comparison with other groups, and by day 10— normalization of the indicator. An increase in the level of C-reactive protein in blood serum correlated with the concentration of nitric oxide metabolites.Discussion. The optimal therapeutic effect when taking antioxidants develops when administered in the first hours aſter injury to reduce the excessive formation of reactive nitrogen radicals. However, the duration of administration should not exceed 4–5 days to avoid a significant decrease in the level of nitric oxide metabolites and deterioration of mucosal regeneration.Conclusions. Assessment of nitric oxide metabolitesin the blood at different times aſter injury is an important marker of inflammatory activity. The use of antioxidants helps to reduce the concentration of active nitrogen radicals.

THE VALUE OF HOLTER MONITORING AND THE LEVEL OF SYSTEMIC INFLAMMATION IN PATIENTS WITH STABLE ISCHEMIC HEART DISEASE COMBINED WITH TYPE 2 DIABETES, DEPENDING ON THE NUMBER OF AFFECTED CORONARY ARTERIES

Diabetes mellitus (DM) is one of the significant medical and social problems of modern society, which is due to high morbidity and prevalence, frequent occurrence of chronic micro- and macrovascular complications. Coronary heart disease (CHD) in patients with type 2 diabetes is 2-4 times more common than in people of the same age without diabetes [1]. In the absence of apparent signs of atherosclerosis, the risk of developing coronary artery disease in the next 10 years is 30% [2]. To date, the course and prognosis of this group of patients have not been sufficiently studied, objective clinical and diagnostic criteria for the development of complications of myocardial infarction have not been developed, and the problem of choosing pathogenetically based methods of treatment of CHD in combination with type 2 diabetes remains unresolved [3].The aim of the work was to investigate the informativeness of Holter monitoring (HM), the correlation of HM indicators, C-reactive protein (CRP) and carbohydrate metabolism in patients with stable coronary heart disease (CHD) in combination with type 2 diabetes for the prognosis of the course of this pathology, timely individual treatment and prevention occurrence of endpoints.Material and methods. The study involved 95 patients with coronary heart disease with angina pectoris functional class (FC) III and heart failure (HF FC III with a preserved left ventricular ejection fraction (LVEF); of them, 60 patients had concomitant type 2 DM in the compensation stage.Results. In patients with comorbidity (a combination CHD and type 2 diabetes), episodes of ST depression/elevation, tachycardia, and extrasystoles were more often registered in patients with multivessel lesions of CA (р<0.05), according to HM; the content of CRP in blood serum increased in proportion to the severity of the course of the disease, which depended on the number of affected CA.Conclusions. The nature and severity of the course of CHD correlate with comorbid pathology and the number of CAs affected by atherosclerosis. In the case of multivessel damage, according to the data of clinical, functional and laboratory research, an aggressive progression of cardiac pathology was noted.

Serological markers of sarcopenia in ages 65 and over

Aim. To determine serological markers of sarcopenia (SP) for use in general medical practice in people aged 65 years and older living independently.Materials and methods. The study included 230 people aged 65 years and older (70 men and 160 women, median age 75 [68; 79] years) were consulted in a medical institution in St. Petersburg. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determine the level of 25(OH)D, parathyroid hormone (PTH), C-reactive protein (CRP).Results. The risk of SP increased at levels 25(OH)D less than 21 ng/mL (odds ratio 4.989; 95 % confidence interval 1.321–12.626; р = 0.0420), total protein less than 65 g/l (OR 8.567; 95 % CI 2.658–27.617; р = 0.00032), serum CRP 6 mg/l or more (OR 14.279; 95 % CI: 3.511–58.071; р = 0.00020) and decrease in the estimated glomerular filtration rate (eGFR) less than 62 ml/min/1.73 m2 (OR 12.108; 95 % CI 3.944–37.170; р = 0.00001). Conclusion. Serological markers of SP, such as vitamin D, total protein, C-reactive protein in blood serum and eGFR can be used in general medical practice.

Особливості лікувальної тактики за неонатального сепсису залежно від запальної відповіді організму

Purpose - to conduct a comparative analysis of the effectiveness of etiotropic treatment and supporting therapy of infants with neonatal sepsis with an alternative content of C-reactive protein in the blood serum to improve individualized therapy of generalized infectious and inflammatory diseases in the newborn period. Materials and methods. A comprehensive examination of 56 newborns suffering from neonatal sepsis the 1st, 3rd and 7th days of the disease. The Group I included 25 patients with neonatal sepsis with a serum C-reactive protein level <20 mg/l, and the Group II included 31 newborns with sepsis with a serum C-reactive protein level >20 mg/l. Determination of the content of C-reactive protein in blood serum (mg/l) was carried out by the method of immunoenzymatic analysis on the «StatFax 303 / Plus» device. The obtained results were analyzed by methods of descriptive statistics, biostatistics and clinical epidemiology. Fisher’s exact test (Pφ) and Student’s test were used for statistical processing; the results were significant at p<0.05 with a tendency to significance - at p=0.05-0.1. Results. It was established that in 20.0% of newborns of the Group I and in 11.4% of patients of the Group II (Рφ>0.05), etiotropic treatment was changed due to insufficient effectiveness of the previous two courses. Patients of the Group I had a higher risk of needing to re-review the composition of antibiotic therapy: odds ratio (OR) = 1.9 (95% confidence interval (95% CI): 0.8-4.3), attributive risk (AR) = 16.0%. Practically all patients of the Group I were on oxygen support, the risk of this event was significantly higher for them compared to children of the Group II: OR=2.7 (95% CI: 1.2-6.6). Newborns of the Group II compared to babies of the Group I received inpatient treatment for less time, their chances of being discharged from the hospital before the 20th day were probably higher: OR=5.7 (95% CI: 1.85-17.32). The better effectiveness of the standard treatment of sepsis of newborns in the Group II in terms of the frequency of discharge from the hospital up to 20 days is demonstrated by a decrease in the AR of event realization, which is 15.4%. Conclusions. Patients of the Group I twice as often received the third course of antibiotic therapy. Infants of the Group II more often needed combined antibacterial therapy with a slightly shorter course and also recovered faster with discharge of every fifth baby by the 20th day. Against the background of a relatively higher content of C-reactive protein in blood serum, the standard treatment of newborns is more effective and allows for a 79.3% increase in the relative risk of rapid recovery at the same time, the minimum number of treated patients - 1.3. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. The informed consent of the children's parents was obtained for the conducting the studies. No conflict of interests was declared by the authors.

Comparative evaluation of osseointegration of new percutaneous implants made of Ti Grade 4 ultrafine‑grained alloy

Introduction It has been shown that titanium implants with a structured surface provide an increased rate of osseointegration what makes their application quite promising.The purpose of this work was to conduct a comparative evaluation of the efficiency of osseointegration of new percutaneous implants for prosthetics made of ultrafine-grained Ti Grade 4 alloy.Materials and methods The study was carried out on 12 male rabbits of the Soviet Chinchilla breed. Six rabbits of the control group had implants made of Ti6Al4V powder using selective laser sintering technology that were osseointegrated into the tibia, 6 rabbits of the experimental group had implants made of Ti Grade 4 by equal channel angular pressing. The formation of the "bone-implant" block was examined 26 weeks after the implantation.Results Histologically, after 26 weeks of the experiment, porous changes, enlargement of the Haversian canals, and pronounced osteoclastic resorption were not detected in the animals of the experimental group throughout the stump in the compact plate. Around the implant, a bony case repeating the bone shape was formed, represented by lamellar bone tissue. Using X-ray electron probe microanalysis, it was found that in the substrate formed on the surface of the implant in rabbits of the experimental group, there was significantly more calcium in all areas over the implant relative to the animals of the control group. In the control group, relative to the experimental group, an increased level of C-reactive protein in blood serum was retained longer. Complications and significant clinical and laboratory abnormalities were not found in both groups during the entire experiment.Discussion Our data are consistent with the results of other experimental studies, which unambiguously noted that titanium implants with a structured surface show increased osseointegration characteristics in comparative studies relative to implants without modification of the structure of the material of the threaded surface. The absence of complications and undesirable reactions of the animal organism also indicates the acceptable safety of the tested products.Conclusion Osseointegration of a percutaneous implant that has a mixed nanocrystalline and ultrafine-grained structure was more effective than the reference implant. This makes the use of such implant promising for solving clinical problems in prosthetics.

THE ROLE OF ENDOTOXICOSIS AND INFLAMMATION IN DEEPENING THE PANCREATIC FUNCTIONAL INSUFFICIENCY IN CHRONIC PANCREATITIS IN COMBINATION WITH TYPE 2 DIABETES.

Aim: To analyze the state of parameters of inflammation, endotoxicosis, and their influence on the functional capacity of the pancreas in the comorbid course of chronic pancreatitis and type 2 diabetes mellitus (DM2). Materials and methods: 115 patients with CP in the phase of mild therapeutic exacerbation in combination with DM2 in the stage of subcompensation were examined. To assess the impact of comorbid DM2 on the clinical condition of patients with CP, a comparison group of 25 patients with CP in the exacerbation phase was included in the study. The assessment of the presence and depth of pancreatic exocrine insufficiency (PEI) was carried out according to the "gold standard" - determination of the content of fecal α-elastase-1, which was determined by the method of enzyme immunoassay using standard kits. As the main criterion for diagnosis and monitoring of DM, the measurement of HbA1c was used, which was determined by the method of ion exchange chromatography. C-reactive protein (CRP) was determined by the immunoturbidometry method by photometric measurement of the antigen-antibody reaction to human CRP antibodies; reference values of CRP in blood serum are up to 3 mg/l. Endogenous intoxication (EI) was assessed based on the levels of medium-mass molecules (MMM) - MMM1 and MMM2 at wavelengths 254 and 280 nm. The level of circulating immune complexes (CIC) was determined by the method of selective precipitation in 3.75% ethylene glycol followed by photometry. Results: Moderate and moderate inverse correlations were established between CRP and fecal α-elastase in CP and CP-DM2 comorbidity (r=-0.423 and r=-0.565, p<0.05). This proved a reliable influence of the depth of inflammation according to the content of CRP on the increase in PEI according to the level of fecal α-elastase, which was higher in the CP-DM2 comorbidity compared to CP. A deeper level of secretory insufficiency of the pancreas was established in CP with concomitant DM2, which deepened when the CRP level increased, compared to that in isolated CP: an increase in the strength of reliable direct moderate HbA1c-CRP correlations in patients with CP in combination with DM2 was proved in relation to such cases isolated CP (respectively r=0.313 and r=0.410, p<0.05). Conclusions: We proved a reliable influence of the index of endogenous intoxication on the level of PEI according to the level of fecal α-elastase, which was higher in the CP-DM2 comorbidity compared to isolated CP: moderate and medium-strength inverse correlations were established IEI-fecal α-elastase in patients with CP and CP-DM2 comorbidity (r=-0.471 and r=-0.517, p<0.05). An increase in the strength of reliable direct, moderate, and moderate correlations between the levels of HbA1c and the index of endogenous intoxication in patients with isolated CP and CP-DM2 comorbidity (r=0.337 and r=0.552, p<0.05), which proved a deeper level of secretory pancreas insufficiency with concomitant DM2, which worsened with increasing endotoxicosis according to the value of the index of endogenous intoxication.

Acute Phase Proteins and Procalcitonin in the Modeling of Infectious Arthritis

Background. Acute phase proteins – ceruloplasmin, haptoglobin, C-reactive protein (CRP) – are markers that characterize the inflammatory process. C-reactive protein is one of the major components of the acute phase (AF) and is a generally accepted indicator of inflammatory processes.&#x0D; Objective: to determine the level and specificity of acute-phase proteins (CRP, haptoglobin, ceruloplasmin), as well as procalcitonin in the modeling of infectious arthritis.&#x0D; Materials and Methods. Experimental studies were carried out on 31 white male Wistar rats. The model of infectious arthritis was created during three days by daily injection of 0.02 ml of S.aureus 108 No. 209 into the knee joint of a rat. The animals were divided into groups, of which group I was the vivarium control. The following model of drug administration was used for the experimental groups: a single daily injection of 0.02 ml of flosteron into the knee joint for three days (group II); daily single administration for three days of 0.02 ml of S.aureus 108 No. 209 (group III); daily one-time alternating (every other day) administration for three days of 0.02 ml of flosteron and 0.02 ml of S.aureus 108 No. 209 into the knee joint (group IV). The effectiveness of the drugs was observed 3 and 14 days after administration.&#x0D; Results. It was established that the concentration of haptoglobin probably increased in the blood serum of rats after 3 days only under the conditions of alternating three-time administration of flosterone and S.aureus 108 No. 209. After 14 days, when the inflammatory progress progressed, this indicator increased in all studied groups of animals, and most of all (by analogy with observations after three days) with the combined effect of flosterone and S.aureus 108 No. 209. The concentration of ceruloplasmin in blood serum increased in all experimental rats both after 3 days and after 14 days in the group after administration of flosterone. The content of C-reactive protein in blood serum increased in all studied groups of rats without exception, which proves its high specificity for detecting inflammatory processes of various severity. The concentration of procalcitonin in the experiment did not reliably change in the blood serum of rats of any experimental group after 3 days. However, significant changes occurred 14 days after the introduction of flosterone and with the combined effect of flosterone and S.aureus 108 No. 209.&#x0D; Conclusions. Determining the content of haptoglobin is not highly effective in early detection of the inflammatory process. At the same time, the synthesis of ceruloplasmin increases precisely during the first three days of the infectious process, which turns it into an effective marker for detecting early infectious complications. The dynamics of changes in the level of C-reactive protein in blood serum demonstrated the highest correlation with the activity of the infectious process, which proves its high specificity for detecting inflammatory processes of various severity. The greatest deviations were observed in rats, which were injected three times alternately (every other day) with flosterone and S. aureus 108 No. 209 into the knee joint. Such changes suggest that the hormonal drug flosteron contributed to the intensification of the inflammatory process.

ЕFFICIENCY OF DETERMINATION OF ACUTE PHASE PROTEINS AND PROCALCITONIN UNDER THE CONDITIONS OF SIMULATING INFECTIOUS ARTHRITIS

Acute phase proteins ceruloplasmin, haptoglobin, C-reactive protein (CRP) and procalcitonin are markers that characterize the inflammatory process. C-reactive protein is one of the central components of the acute phase (AF) and is a generally accepted indicator of inflammatory processes. Aim. Determination of the level and efficiency of determination of acute-phase proteins (CRP, haptoglobin, ceruloplasmin), as well as procalcitonin under the conditions of modeling infectious arthritis. Materials and methods. Experimental studies were conducted on 52 white male Wistar rats. A model of infectious arthritis was created for seven days by daily injection of 0.02 ml of S.aureus 108 No. 209 into the knee joint of a rat. The animals were divided into groups - and vivarium control. The following model of drug administration was used for the experimental groups: a single daily injection of 0.02 ml of flosteron into the knee joint for seven days (group II); daily single administration for seven days of 0.02 ml of S.aureus 108 No. 209 (III group); daily one-time alternating (every other day) administration for seven days of 0.02 ml of flosteron and 0.02 ml of S.aureus 108 No. 209 into the knee joint (group IV). The effectiveness of the drugs was observed 3 and 14 days after administration. Results. It was established that the concentration of haptoglobin was significantly increased in the blood serum of rats both after 3 and 14 days in all studied groups of animals compared to the control. The greatest increase relative to the control values was noted 3 days after the seven-time injection of S.aureus 108 #209 into the knee joint. However, after 14 days it was already not so significant and significantly lower (by 85.33%) compared to the measurement after three days. Only in rats after a 14-day alternating (every other day) injection of 0.02 ml of flosteron and 0.02 ml of S.aureus 108 No. 209 into the knee joint was observed a probable increase in the level of haptoglobin by 775.08% (Р&lt;0.05) compared to the control and 77.78% reduced compared to the measurement after three days. The concentration of ceruloplasmin in blood serum increased in all experimental rats during the entire observation period and differed little between 3 and 14 days. The content of C-reactive protein in blood serum increased in all studied groups of rats without exception, which proves its high specificity for detecting inflammatory processes of various severity. The concentration of procalcitonin was most likely to increase by 235.0% 3 days after alternating (every other day) administration of 0.02 ml of flosterone and 0.02 ml of S.aureus 108 No. 209. It was slightly lower by 120.0% under the same conditions experiment after 14 days. This indicator probably increased by 65% 14 days after the 7-time introduction of S.aureus 108 #209. In the rest of the experimental animals, the PCT concentration did not change. Conclusions. The determination of haptoglobin reflects, first of all, the primary activation of the inflammatory process, which was enhanced by the hormonal drug flosteron. However, its determination can be effective over a longer period of time, as several factors lead to a bacterial infection, reinforcing each other. At the same time, the synthesis of ceruloplasmin increases precisely during the first three days of the infectious process, which turns it into an effective marker for detecting early infectious complications. The dynamics of changes in the level of C-reactive protein in blood serum showed the highest correlation with the activity of the infectious process, which proves its high efficiency for detecting inflammatory processes of various severity, choosing adequate treatment and predicting the course of the disease.

Changes in the number of white blood cells and non-specific markers of inflammation in the body of rabbits in experimental osteoarthritis of the knee joint

Osteoarthritis is the most common joint disease in animals, which is not always treatable. Both in veterinary and in human medicine, laboratory research methods are used to effectively diagnose this pathology. The purpose of this study was to establish the dynamics of markers of the acute phase of inflammation in the blood using experimental modelling of knee osteoarthritis in rabbits. Artificial reproduction of the pathological process in the knee joints of animals was performed by intra-articular administration of Yellow peel 2*5 ml. The BC-2800Vet automatic haematology analyser (China) was used to calculate the number of white blood cells and their subpopulations in the blood. The content of C-reactive protein in blood serum was found using enzyme-linked immunosorbent assay. The rate of erythrocyte sedimentation in the blood was investigated according to the Panchenkov method. Thus, on Day 7, a sharp increase in the number of white blood cells (2.7 times) and their subpopulations was noted in sick rabbits, which indicates an active inflammatory process of a systemic nature. On Day 14, their number in the blood of sick animals was characterized by a tendency to decrease, but it had not yet reached the values of the control group. On Days 21 and 28, all the indicators under study tended to decrease in sick animals. Specifically, the number of white blood cells and their subpopulations acquired reference values. The content of C-reactive protein significantly increased by 40.8 times in sick animals on Day 7 of the study and decreased by 1.7 times on Day 14 compared to its values at the previous stage. At the same time, on Day 28, this indicator increased by 19.3 times compared to the indicators of the control group of animals. The rate of erythrocyte sedimentation in the blood of sick rabbits significantly increased by 2.3 times compared to the control group. On Day 21, this indicator in the blood of sick rabbits decreased by 1.4 times compared to its values on Day 14 of the experiment. On the other hand, on Day 28, its value increased by 1.7 times compared to the control (4.3 mm/h). The results obtained will contribute to further targeted laboratory diagnostics of knee osteoarthritis in animals, which will ensure the proper effectiveness of therapeutic and preventive measures and improve their overall health

Microbiological Profile of the Implantation Zone under Different Mechanical Compression of Percutaneous Implants: Experimental Study

Background. Infection of percutaneous implants in patients with limb amputation is the most common complication.&#x0D; Aim of the study evaluation of the microflora in the implantation zone depending on the mechanical compression of the implant in conditions of its additional external fixation.&#x0D; Methods. The study was performed on 36 male rabbits. The tibia of all the rabbits was sawn at the border of the upper and middle parts. The medullary canal was reamed and a percutaneous implant was placed in the tibial stump. The segment and the implant were fixed with an Ilizarov apparatus. An additional compression device was installed in 30 animals. We used 5 compression modes, accordingly, 6 experimental groups were formed, 6 animals in each: group 1 without compression, group 2 compression on the implant with force of 0.053 N/mm2, group 3 compression on the implant with force of 0.105 N/mm2, group 4 compression on the implant with force of 0.158 N/mm2, group 5 compression on the implant with force of 0.211 N/mm2, group 6 compression on the implant with force of 0.263 N/mm2. The restraint was removed 6 weeks after implantation for a total follow-up of 26 weeks. The microflora of the place where the implant enters the skin (the implant / skin interface) was investigated, the level of blood leukocytes and the level of C-reactive protein in blood serum were determined.&#x0D; Results. On days 9-10 after implantation, significant differences in the microbial landscape were found at the site of the exit of the metal implant in animals of different groups. The largest number of strains was found in animals of groups 1, 5 and 6, the smallest in groups 2 and 3. The most frequently detected strains: S. saprophyticus and Enterococcus spp. It was found that the greatest statistically significant increase in the level of CRP in the blood serum was observed in animals of group 6. The level of leukocytes in animals of all groups did not change statistically significantly relative to preoperative values. Animals with better osseointegration (groups 2 and 3 no cases of implant loss) showed a minimal number of growing strains.&#x0D; Conclusions. The microbiological profile of the implantation zone of percutaneous implants changes depending on the amount of mechanical compression. The optimal mode is 0.053-0.105 N/mm2.

СОВРЕМЕННЫЙ КЛИНИЧЕСКИЙ ПОРТРЕТ ПАЦИЕНТА С ФЕНОТИПОМ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНИ ЛЕГКИХ БЕЗ ЧАСТЫХ ОБОСТРЕНИЙ

Introduction. According to current data, the COPD phenotype without frequent exacerbations is frequently encountered and requires close attention. However, in the course of a literary search, it was possible to find only isolated scientific works with a generalized description of the features of this phenotype. Aim. The aim of the study is to compile a typical clinical portrait of a patient with the COPD phenotype without frequent exacerbations based on the analysis of clinical, laboratory and functional parameters. Material and methods. The study included 45 patients aged 57.2±1.1 years with a diagnosis of COPD without frequent exacerbations in age. In all patients, the concentration of proinflammatory cytokines, C-reactive protein in blood serum was determined by immunoferment analysis. Results and discussion. Males (93.3%) with a smoker index of 33.7± 2.5 packs/years and a disease duration of more than 10 years dominated the studied cohort. The average score on the CAT test was 10.32±0.05 points, on the mMRC scale more than two points. The post - bronchodilation value of FEV1 corresponded to the average severity of obstructive disorders in 91.1% of individuals. Among the examined patients, persons with bronchitic type of COPD predominated (53.3%). The concentration of inflammatory biomarkers determined in the blood serum significantly exceeded the levels of the reference values. Also, patients with COPD with the studied phenotype was found to have low adherence to treatment and dispensary observation and late visit to the doctor. Conclusions. The obtained results of the study made it possible to draw up a clinical portrait of the patient with the COPD phenotype without frequent exacerbations.

DYNAMICS OF CHANGES OF C-REACTIVE PROTEIN LEVEL IN BLOOD SERUM IN THE DEVELOPMENT AND COURSE OF EXPERIMENTAL PERIODONTITIS AND THEIR CORRECTION BY FLAVONOL

The aim: To study the value of C-reactive protein in the experimental animals blood serum with bacterial-immune periodontitis and its correction with quercetin. Materials and methods: Modeling of periodontitis was performed by the following method: after thiopental anesthesia (at a dose of 40 mg / kg intramuscularly) rats were fixed. A subcostal injection of 0.01 ml of egg protein with cultures of Streptococcus hemolytic and Staphylococcus aureus at a dose of 4 CFU was performed in the area of periodontal tissues of the lower incisor as an initiating inflammatory factor. To enhance the immune process, a complete Freund’s adjuvant was introduced into the animal’s hind limb at the same time. Results: Analysis of the results of the study of the content of C-reactive protein in the blood serum of animals with experimental bacteria and immune periodontitis, receiving injections of quercetin, showed a significant decrease by 1.31 times, compared with animals with this simulated pathology on the 14th day of the experiment without the use of flavonol. When comparing this indicator on the 14th day of development of experimental periodontitis with correction, it was found that it remained slightly higher than the indicators of the intact group of rats. Conclusions: The level of C-reactive protein in the blood serum of experimental animals is an important indicator of the immune-inflammatory response, which increases its activation of the inflammatory system. The administration of flavonoid quercetin for 7 days helps to reduce the level of C-reactive protein in the blood serum of animals with experimental bacterial and immune periodontitis.

The state of C-reactive protein in patients with allergic dermatoses

The article provides data on studying the content of C-reactive protein in blood serum in patients with allergic dermatoses, taking into account their clinical course. The results of the study showed that in patients with allergic dermatoses, an increase in the concentration of C-reactive protein is noted in 58,9 % of cases, characterized by an increase in concentration by 4.7 times compared with the indicators of the control healthy group, which indicates the progression of the inflammatory process in the body.

Biomarkers of Myopic Choroidal Neovascularization in Women, Determining the Clinical Course and Response to Anti-VEGF Therapy

Aim: to identify clinical and laboratory biomarkers that determine the nature of the course of myopic choroidal neovascularization (mCNV) and the response to anti-VEGF therapy in women.Material and methods. A prospective non-randomized study was conducted in 52 patients (52 eyes) with active mCNV, treated with ranibizumab intravitreally, 0.5mg. After 12months, the suppression of CNV activity, the number of injections and the fellow eye inclusion in the pathological process were taken into account. There were 2 groups: with a favorable clinical course (n = 31, age – 33,0 ± 5,1 years, anterior-posterior axis (APA) 28,5 ± 0,3 mm) and an unfavorable clinical course (n = 21, age – 34,0 ± 4,1 years, APA – 29,01 ± 0,1 mm). Structural retinal changes, choroid thickness, retinal blood flow, and heart rate were evaluated using OCT and OCTA protocols (Optovue XR Avanti, USA). Studies were conducted before the start of therapy and then one time per month. The concentration of sex and pituitary hormones (ELISA analyzer “Immunohem-2100”), lipoprotein A, Apo B/Apo A (Accent 200 Cormay, Poland), coagulogram data (Helena C-2, UK), and the concentration of highly sensitive C-reactive protein in blood serum before the start of antiangiogenic therapy were studied once.Results. In the first group, 1.4 ± 0.7 ranibizumab injections were administered to suppress the CNV activity. In the opposite group – 3.5 ± 2.1 injections, in 73.7 % of cases, relapses were diagnosed, in 3 cases – primary CNV in the fellow eye. Clinical and laboratory biomarkers of the unfavorable clinical course of mCNV were identified: extreme choroidal thinning, highly organized membranes of a large area, dome-shaped deformation of the posterior pole, excess of the reference values of lipoprotein A, fibrinogen and highly sensitive C-reactive protein by two or more times, an imbalance of sex and pituitary hormones (excess of the reference values of prolactin, follicle stimulating hormone, cortisol, progesterone concentration decrease), a predominant change in the menstrual-ovarian cycle according to the type of amenorrhea and opsomenorrhea.Conclusion. Myopic CNV biomarkers in women allow predicting the response to anti-VEGF therapy, the formation of relapses and the inclusion of the fellow eye in the pathological process.

The role of CRP in the diagnosis of postoperative complications in rectal surgery.

Postoperative complications of rectal resections classified as grade III or higher according to Clavien-Dindo system, which also include anastomotic leaks, are usually life-threatening conditions. Delayed diagnosis may account for almost 18% of deaths. Due to nonspecific clinical signs in the early postoperative period, diagnosing these complications may truly be a challenge for clinicians. Nowadays, with the implementation of the ERAS protocol (enhanced recovery after surgery) and efforts concentrated on quickly delivered treatment to patients suffering from the above-mentioned complications, an appropriate marker with high specificity is required. Postoperative levels of C-reactive protein in blood serum seem promising in this aspect. The presented study aimed to determine the cut-off level of serum C-reactive protein as a possible predictive factor for early diagnosis of serious postoperative complications associated with rectal resections. This could also lead clinicians to the diagnosis of anastomotic leak after other possible options are ruled out. This study is a retrospective observational analysis of patients who underwent open resection of rectal cancer during a one-year period. Collected data included risk factors (age, gender, BMI, bowel preparation), record of complications and C Reactive Protein (CRP) serum levels. The study included 162 patients. Uncomplicated postoperative course was observed in 58 patients (35.8%). Complications were present in 104 cases (64.2%), including surgical site infections (16.7%) and anastomotic leak (9.9%). The mortality rate was 2.5%. Serum CRP threshold predicting relevant complications reached a sensitivity of 83.3% and specificity of 82.7% on POD 4, with a 175.4 mg/L cut-off value, burdened with a 95.7% negative predictive value. Postoperative serum C-reactive protein may be used as a good predictor of infectious complications, including anastomotic leaks. Measuring CRP levels in the early postoperative period may facilitate identification oflow-risk patients ensure early and safe discharges from hospital after rectal resections.

CLINICAL LABORATORY AND IMMUNOLOGICAL CRITERIA FOR THE PROGNOSIS OF PREMATURE BIRTH IN CERVICAL INSUFFICIENCY

The high incidence of premature birth in cervical insufficiency (CVI) makes it relevant to search for markers of prognosis of labor up to 37 weeks in this pathology.Materials and methods. The prospective cohort study included 120 women: the main group – 53 women with CVI and premature birth, the comparison group – 47 patients with CVI and timely birth, the control group – 20 patients without CVI with normal pregnancy. The patients underwent clinical laboratory and immunological examination: general blood test, level of C-reactive protein in blood serum, examination of the total number of leukocytes in cervical mucus, indicators of functional activity and viability of neutrophils, MIP-1β, HMGB1, and MMP8.Results and discussion. The number of stab neutrophils and the level of C-reactive protein, the number of neutrophil extracellular traps (NET) and HMGB1 have predictive value in relation to premature birth in CVI.Conclusion. The criteria for the prognosis of premature birth in women with CVI were identified: an increase in stab neutrophils and C-reactive protein in the blood, the amount of NLV >18%, and the level of HMGB1 >10 ng/L in cervical mucus.

Cortisol and laboratory indicators of systemic inflammation in case of bacterial purulent meningitis and viral encephalitis in children

Pediatric bacterial purulent meningitis (BPM) and viral encephalitis (VE) are significant medical and social problems due to their course severity, high frequency of death cases, and formation of neurologic deficiency at the disease outcome. Activation of hormonal regulation and severity syndrome of systemic inflammatory response are important factors to evaluate the character of BPM and VE course.Objective.To study the level of cortisol and laboratory indicators of systemic inflammation in children with various variants of BPM and VE course depending on the period of the disease (acute period, reconvalescence) to specify their role in the pathogenesis of acute neuroinfections.Object and methods.There were investigated hematological indicators, the level of cortisol, C-reactive protein in blood serum of 60 children, 39 of them had BPM and 21 ones VE. The comparison group included 14 children aged from 1 to 14 years old who were undergoing rehabilitation care due to neurologic problems at the Federal State-Financed Institution Pediatric Research and Clinical Center for Infectious Diseasesunder the Federal Medical Biological Agency.Results.The patients were divided into some subgroups according to the severity of their condition at the moment of hospitalization, i.e. urgent condition or critical condition requiring organ replacement therapy. The maximum increase of cortisol level and laboratory markers of systemic inflammation during the acute period was revealed in case of BPM in comparison with VE with a subsequent normalization to the stage of reconvalescence. Thelevel of cortisol during the acute period of BPM was reliably higher in the subgroup with urgent conditions, whereas in case of VE in the subgroup with critical conditions. There were no significant differences in the laboratory indicators of systemic inflammation response among the subgroups. There was established a correlation interrelation of cortisol level and the content of granulocytes and blood lymphocytes.Conclusion.There were identified characteristic features of cortisol content in children with bacterial and viral neuroinfections depending on the course of the disease.

Динамика содержания C-реактивного белка в сыворотке крови при анестезиологическом обеспечении хирургических вмешательств

Динамика содержания C-реактивного белка в сыворотке крови при анестезиологическом обеспечении хирургических вмешательств

Экспериментальная модель криодеструкции кожи

We suggest the in vivo experimental model of skin cryodestruction, suitable for studying the processes, occurring after skin neoplasm cryosurgery. To develop the model we have used low-temperature exposure using a cryoprobe, providing the temperature below the tissue cryoresistance threshold in the area of contact between the applicator working surface and skin. The initiation of destructive and inflammatory processes, both local and systemic, was observed in this model. Local morphological manifestations corresponded to the first phase of wound–healing process. We noted the destructive and inflammatory signs accompanied by primary necrosis (due to direct thermal damage), and a leukocyte bank and secondary necrosis (resulting from hemodynamic disorders). The reparative processes in injured tissues were manifested in developed granulation tissue. At a system level, the tissue cryodestruction was accompanied by the oxidative stress development (an increased content of lipid peroxidation products, a suppressed enzymatic component of antioxidant defense system) and an increased content of cerulloplasmin and C-reactive protein in blood serum. Probl Cryobiol Cryomed 2019; 29(1): 088–101

SIGNIFICANCE OF INFLAMMATION MARKERS DETERMINED IN PREGNANT WOMEN WITH ANEMIC SYNDROME AND OBESITY

The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p &lt; 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p &lt; 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p &lt; 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p &lt; 0.05), or in pregnant women with anemia-free obesity (p &lt; 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p &lt; 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p &lt; 0.05), or IL-6 (r = 0.679, p &lt; 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.