Functional State Of Endothelium Research Articles

ФУНКЦИОНАЛЬНОЕ СОСТОЯНИЕ ЭНДОТЕЛИЯ У БОЛЬНЫХ ПСОРИАЗОМ

Abstract. Introduction. Psoriasis is an independent risk factor for cardiovascular diseases, accompanied by an increased risk of mortality from cardiovascular diseases, as compared with the population, which is mainly associated with chronic systemic inflammation (increased levels of C-reactive protein, fibrinogen, and homocysteine) and with the accumulation of conventional cardiovascular risk factors, such as dyslipidemia, obesity, decreased physical activity, and arterial hypertension. There are only few studies evaluating the link between psoriasis, inflammation, and cardiovascular disease. Our aim was to study the relationship between pro-inflammatory mediators and the endothelium functional state indicators of the in patients with psoriasis. Materials and Methods. We examined 116 patients with verified psoriasis, aged 19-62 years. The control group consisted of 25 comparably aged and practically healthy individuals. The diagnosis was made considering the psoriasis clinical form, stage, seasonality, type, and severity. All patients underwent a standard laboratory and instrumental examination. The levels of pro-inflammatory markers (IL-6, VEGF,CRPvh) were determined by enzyme-linked immunosorbent assay using commercial ELISA-BEST kits manufactured by OOO Vector-Best, Novosibirsk, Russia. The endothelial function was assessed by using the Biomedical ENDOTELIN test system by BioKhimMak JSC to measure the quantitative content of endothelin-1, a characteristic of the vasomotor function of endothelium, determined by ultrasound according to the method proposed by Celermajer D. et al. Results and Discussion. The study revealed a high incidence of the disease in people of working age and a slight predominance among male patients. In 55.2% of patients, classic atherosclerosis risk factors were identified: Arterial hypertension, smoking, low physical activity, alcohol abuse, and improper nutrition. 33.6% of patients were overweight; 24.1% had obesity I-II degree, and 39.7% with abdominal obesity. According to the findings of the study of pro-inflammatory markers in the blood serum, there is a significant increase in their levels as compared with the control group indicators, which correlates with the severity of psoriasis and a decrease in the ratio of IL-6/CRPvh. Endothelial dysfunction was characterized by a statistically significant increase in endothelin-1 and a significant increase in the content of vascular endothelial growth factor (VEGF) in the blood serum of psoriasis patients. Percentage increase in the brachial artery diameter on the endothelium-dependent stimulus was reduced and averaged 9.14% in the group of patients with psoriasis. Conclusion. A high comorbidity of psoriasis and cardiovascular diseases has been established. A significant increase in the levels of systemic immune inflammation mediators IL-6 and C-RBhv and a decrease in the ratio of IL-6/C-RPhvh were identified, which correlates with the severity of the disease and the presence of cardiovascular diseases. Vascular endothelium dysfunction is characterized by an increase in the content of ET-1 and VEGF in the blood serum and a decrease in the flow-mediated dilatation of the brachial artery.

Functional state of the endothelium in men after mine-explosive injury during the war in Ukraine

Mine-explosive trauma (MET) is the most common trauma type and one of the main disability causes of the able-bodied contingent. Among the mechanisms of the cardiovascular and cerebrovascular disorders development after MET, endothelial dysfunction (ED) plays an important role. The study aims - to assess the functional state of the microvessels and large arteries endothelium in men after a mine-explosive injury. Materials and methods: the functional state of the skin microvessels endothelium was determined using a two-channel laser Doppler flowmeter BLF-21D "Transonic Systems Inc" (USA) during the test with the creation of reactive hyperemia. The function of the large arteries endothelium was determined using the D.S. Celermajer test, with post-occlusion reactive hyperemia according to the generally accepted method on the Nemio XG device, SSA-580A (Toshiba) with a high-frequency linear sensor with a central frequency of 7 MHz. We examined men with mild MET (average age 37.7 ± 1.5 years). The control group was represented by 43 practically healthy men without MET (average age 41.8 ± 2.1 years). Results: dysfunction of the microvessels endothelium was found in most persons with MET (69.1%), compared to men without MET (41.9%). Dysfunction of the large vessels endothelium was found in 40.4% of examined persons with MET. Persons with MET have a combination of large and small vessel endothelial dysfunction in 23.4% of cases, at the same time persons without MET have a higher proportion of isolated microvessel endothelial dysfunction (34.9%). Conclusions: men with MET often have arterial endothelial dysfunction with microvascular endothelial dysfunction together, whereas men without MET have predominantly isolated microvascular endothelial dysfunction. ________________________________________________________________________________________ Keywords: mine-explosive injury; functional state of the endothelium; microcirculation.

The disorders of blood oxygen transport function, hemostasis indicators and endothelium functional state in patients with ruptured arterial aneurysms and the development of delayed cerebral ischemia

Introduction. Rupture of cerebral aneurysms (CA) with the development of intracranial hemorrhage (ICH), complicated in some cases by vascular spasm and delayed cerebral ischemia (DCI), is due to the complex multifactorial genesis of the disease, including changes in the blood oxygen transport function (BOTF), activation of endothelial cells with a release of vasoregulators, reactive oxygen species, inflammatory proteins, as well as disturbances in the hemostasis system.Purpose – to study the indicators of BOTF, primary and secondary hemostasis and the content of some vasoregulatory metabolites in the pre- and postoperative periods in patients with ruptured CA with the development of DCI and without DCI.Materials and methods. The group with DCI included 45 patients; in the group without DCI were 14 people. Clinical-neurological and neuroimaging examinations were carried out, and parameters of BOTF, primary and secondary hemostasis, nitrate/nitrite, angiotensin-converting enzyme (ACE), and PAI-1 concentrations in venous blood were studied before and on days 10–12 after microsurgical clipping of the CA.Results. We diagnosed mild neurological disorders according to the NIHSS scale, confirmed by neuroimaging studies of the brain in the group of DCI patients. It was shown an increase in thrombin-dependent platelet aggregation velocity to 30.6 (24.3; 32.4) AU/min at norm 21.8 (20.3; 24.9) (U, p=0.009) before surgery; and after surgery it was up to 37.4 (30; 44.7) relative to the norm (U, p=0.001). Before surgery, the following was observed: PT shortening to 11.6±0.7 sec at norm 13.2±1.1 (t, p˂0.001), fibrinogen concentration increasing to 4.35 (3.8; 4.8) g/L at norm 3.9 (3.6; 4.1) g/L (U, p = 0.01) and PAI-1 up to 3.9 (2.6; 4.8) ng / mL at norm 2 .7 (2.2; 4.1). After surgery, PT was 11.9±1.1 (t, p˂0.001); fibrinogen - 4.4 (3.9; 4.8) (U, p=0.024), PAI-1 - 4.6 (4.1; 6.7) (U, p=0.0004) respectively. Before surgery, p50 was increased to 28.1 (26.2; 31.6) mm Hg at norm 25.2 (24.3; 26.8) (U, p=0.025); after surgery, it was up to 28.5 (26.8; 30.7) (U, p=0.03) and the ratio of nitrates/nitrites to ACE was reduced to 0.12 (0.08; 0.15) at norm 0.22 (0.15; 0.32) (U, p˂0.001); after - up to 0.11 (0.08; 0.19) (U, p˂0.001) respectively.Conclusion. There has been revealed significant disorders of primary and secondary hemostasis with fibrinolysis inhibition, a decrease in the affinity of hemoglobin to oxygen at the p50 rate and an imbalance of the content of vasoregulatory metabolites in patients with DCI before and after aneurysm clipping, which can be considered as significant factors in the development of DCI after aneurysmal ICH.

Positive effects of Quercetin, Iron Oxide Nanoparticles and Ascorbic Acid composition in the treatment of women with metabolic syndrome

Relevance of study. Metabolic syndrome (MS) increases the risk of atherosclerotic cardiovascular disease and type ІІ diabetes. Correction of the MS manifestations is important for reducing cardiovascular risk. Aim - to study the effects of using a composition consisting of quercetin (Q), polyvalent iron oxide nanoparticles (IONs) and ascorbic acid (AA) in women with MS. Materials and methods. 60 women with MS took part in the study. They were divided equally into two groups. The control group patients received a placebo for one month, and the main group received a composition of Q, IONs and AA for one month too. Anthropometric parameters, fasting plasma glucose level and standard oral glucose tolerance test (OGTT), serum lipid concentration, and microvascular endothelial function in a sample with reactive post-occlusion hyperemia were determined. Results. The use of the composition led to a decrease in the glycemia level of both on an empty stomach and after 2 hours of SGTT, the concentration of total cholesterol and low-density lipoproteins in blood serum in atherogenic dyslipidemia patients. At the same time, there was an improvement in the endothelium functional state of the microvessels, as evidenced by an increase in the maximum volume velocity of skin blood flow in the reactive hyperemia test. Conclusion. It was found that the use of a composition Q, IONs and AA had a positive effect on cardiovascular risk factors in MS patients. _________________________________________________________________________________________ Keywords: iron oxide nanoparticles; quercetin; metabolic syndrome; glucose and blood lipids; the microvascular endothelium function.

Age features of functional condition of microvessel endothelia

Our research aimed to investigate age-related changes in the functional state of the microvascular endothelium.Матеріали та методи. 390 people were surveyed, divided by age into the following groups: 20-29 (n = 31), 30-39 (n = 22), 40-49 (n = 45), 50-59 (n = 72), 60- 69 (n = 129) and 70-79 years (n = 91). The functional state of the microvascular endothelium was studied by laser Doppler flowmetry (LDF) on the BLF-21D (Transonic Systems Inc, USA) in the middle third of the inner surface of the forearm. The turbidimetric method studied platelet aggregation activity on a two-channel laser platelet aggregation analyzer 23 LA (Biola, Russia). Blood viscosity was determined using a rotary viscometer AKR-2 (Russia) at shear rates of 10-200 s-1 with the calculation of the deformation index (IDE) and erythrocyte aggregation index (IAE). As a result of the research, it was found that there was a statistically significant decrease in the cutaneous rate of skin blood flow volumetric velocity (SBF) at rest and at the peak of post-occlusive reactive hyperemia, as well as a reduction in the recovery time of the CMT to baseline. indicating endothelial dysfunction with ageing from the age of 50-59 years. In persons older than 60 years there is an increase in endothelial dysfunction, which is accompanied by deterioration of hemostasis: increased blood viscosity, increased both spontaneous and induced platelet aggregation activity. Blood viscosity increases statistically significantly from the age of 40. We have drawn the following conclusions: the development of endothelial dysfunction with ageing is characterized by changes in the vasomotor function of the endothelium, its antiplatelet, antiadhesive and antithrombotic properties, which leads to the development of vascular pathology in the elderly. Keywords: functional state of the endothelium; platelet aggregation

The use of microvascular endothelial function indicators to calculate functional age of the microcirculation system

Aim. To find out the possibility of using microvascular endothelial function indicators to determine the biological age (BA) of a person. Materials and methods. 390 patients aged 20–29 years (n = 31), 30–39 (n = 22), 40–49 (n = 45), 50–59 years (n = 72), 60–69 years (n = 129) and 70–79 years (n = 91) were examined. The functional state of the microvascular endothelium was analyzed by laser Doppler flowmetry on a BLF-21D (Transonic Systems Inc, USA) at the internal surface of the middle third of the forearm. Platelet aggregation activity was measured on a two-channel laser platelet aggregation analyzer 23 LA (Biola, Russia) by turbidimetric method, blood viscosity – using a rotational viscometer AKR-2 (Russia) at a shear rate of 10–200 s-1 with the deformation index and erythrocyte aggregation index calculation. Results. There was a statistically significant decrease in the volumetric rate of the skin blood flow (SBF) at rest and at the peak of post-occlusion reactive hyperemia, a reduced recovery time of SBF to baseline values from the age of 50–59 years, indicating endothelial dysfunction with aging. A progression of endothelial dysfunction in persons older than 60 years was accompanied by hemostatic parameters deterioration: increased blood viscosity, increased both spontaneous and induced platelet aggregation activity. Blood viscosity was statistically significantly increased from the age of 40. The formula for calculating BA using indicators of the microvascular endothelium functional state, platelet aggregation capacity and anthropometric indicators was obtained. Conclusions. The formula for calculating human BA using indicators of the microvascular endothelium functional state, platelet aggregation capacity and anthropometric indicators has been developed. Sufficiently high accuracy determination of the microcirculation system functional age based on the developed method has been shown.

​Circulating Cytokines in Myocardial Infarction Are Associated With Coronary Blood Flow.

BackgroundThe level of systemic inflammation correlates with the severity of the clinical course of acute myocardial infarction (AMI). It has been shown that circulating cytokines and endothelial dysfunction play an important role in the process of clot formation. The aim of our study was to assess the concentration of various circulating cytokines, endothelial function and blood clotting in AMI patients depending on the blood flow through the infarction-related artery (IRA).MethodsWe included 75 patients with AMI. 58 presented with ST-elevation myocardial infarction (STEMI) and 17 had non-ST-elevation myocardial infarction (non-STEMI). A flow-mediated dilation test (FMD test), thrombodynamics and rotational thromboelastometry as well as assessment of 14 serum cytokines using xMAP technology were performed.FindingsNon-STEMI-patients were characterized by higher levels of MDC, MIP-1β, TNF-α. Moreover, we observed that patients with impaired blood flow through the IRA (TIMI flow 0-1) had higher average and initial clot growth rates, earlier onset of spontaneous clots, C-reactive protein (CRP) and IL-10 compared to patients with preserved blood flow through the IRA (TIMI flow 2-3). Patients with TIMI 2-3 blood flow had higher level of IP-10. IL-10 correlated with CRP and pro-inflammatory cytokines levels, initial clot growth rate and clot lysis time in TIMI 0-1 patients. All these differences were statistically significant.InterpretationWe demonstrated that concentrations of the inflammatory cytokines correlate not only with the form of myocardial infarction (STEMI or non-STEMI), but also with the blood flow through the infarct-related artery. Inflammatory response, functional state of endothelium, and clot formation are closely linked with each other. A combination of these parameters affects the patency of the infarct-related artery.

Arterial hypertension in perimenopause: effects of lisinopril and Femo-Clim combination on the hypotensive effect, functional state of endothelium, cardiac remodeling and quality of life

Arterial hypertension in perimenopause: effects of lisinopril and Femo-Clim combination on the hypotensive effect, functional state of endothelium, cardiac remodeling and quality of life

Changes in biomarkers of endothelial function in the blood after intracerebral hemorrhage in rats with type 2 diabetes mellitus

Clinical evidence suggests that type 2 diabetes mellitus can increase the risk of intracerebral hemorrhage and provocation of neurodegeneration. This study was aimed at evaluating biomarkers of glycemic control, lipid profile, oxidative modification of proteins, as well as the functional state of endothelium in Wistar rats with type 2 diabetes mellitus complicated by intracerebral hemorrhage. Experimental type 2 diabetes mellitus was induced by intraperitoneal injection of streptozotocin (65 mg/kg) and nicotinamide (230 mg/kg). The intracerebral hemorrhage was induced by microinjection of sterile saline containing 0.2 IU bacterial collagenase into the striatum. Assessed biomarkers included the area under glycemic curve, glycated hemoglobin, total cholesterol, triglyceride, high-density lipoprotein, advanced glycation end products, markers of oxidative modification of proteins – aldehyde- and ketonephenylhydrazones, and markers of endothelial dysfunction – homocysteine, endothelin-1, von Willebrand factor and asymmetric dimethylarginine in blood serum. Both rats with type 2 diabetes mellitus and rats with intracerebral hemorrhage and diabetes had a significant elevated glycemic control as compared to intact animals. But combined pathology was additionally characterized by an impairment of lipid profile (increased triglyceride level and decreased as total cholesterol and high-density lipoprotein) resulting in a rise in the atherogenic index of plasma. A significant increase in the content of the markers of oxidative modification of proteins was observed in both experimental groups. But the rats with intracerebral hemorrhage and diabetes only had higher levels of advanced glycation end products in comparison with intact animals. The highest levels of endothelin-1, as a biomarker of endothelial dysfunction, were observed in animals with intracerebral hemorrhage and diabetes. Homocysteine and von Willebrand factor were elevated in rats with type 2 diabetes mellitus, while acute intracerebral hemorrhage did not potentiate the further growth in its levels. Such effect was not accompanied by a marked increase of asymmetric dimethylarginine level in blood serum, although there was a clear trend. In conclusion, the development of intracerebral hemorrhage in rats with type 2 diabetes mellitus can intensify the manifestations of oxidative stress, worsen lipid profile, and aggravate endothelial dysfunction. In this case, the pathological process may have the character of a “vicious circle”.

Functional state of endothelium and additional possibilities of its correction with the use of ethylmethylhydroxypyridine succinate in patients with arterial hypertension

Functional state of endothelium and additional possibilities of its correction with the use of ethylmethylhydroxypyridine succinate in patients with arterial hypertension

Endotheliumprotectiv and antihypoxic properties of quercetin in elderly patients with metabolic syndrome

Aim: To investigate the effectiveness of course quercetin in improving functional state of the microvascular endothelium and to determine the possibility of using quercetin to increase body resistance to hypoxia in the elderly. Materials and methods. The effectiveness of quercetin in improving the functional state of the endothelium and increasing body resistance to hypoxia was studied in 110 elderly patients with metabolic syndrome, who were divided equally into the main and control groups. Patients in the main group received quercetin at a daily dose of 240 mg for 3 months, and patients in the control group received placebo for the same period. Before and after treatment, the microvascular endothelial function was studied by laser Doppler flowmetry using the post-occlusive hyperemia test. Acute hypoxic test was performed under isocapnicnormobaric hypoxia, during which the followings were recorded: blood saturation (SpO2), heart rate and diastolic blood pressure (BP). Results. In the group of patients receiving quercetin, there was an improvement in blood flow to the skin, as evidenced by a statistically significant increase in the maximum volumetric rate of cutaneous blood flow and the duration of the recovery period of OSHSK to baseline in the post-occlusive hyperaemia. The course of quercetin also led to a less significant decrease in SpO2 during hypoxic test and to a decrease in the absolute values of systolic and diastolic blood pressure, while reducing an increase of the systolic blood pressure on the 20th min of the hypoxic test. Conclusions. In elderly patients with metabolic syndrome (within a 3 month course) the use of quercetin has improved the microvascular endothelium functional status and increased the resistance to hypoxia.

Features of dyslipidemia and its influence on endothelium functional state in patients with rheumatoid arthritis and arterial hypertension

Purpose of the study. Was to identify the features of blood lipid spectrum and endothelium functional state in patients with rheumatoid arthritis (RA) and arterial hypertension (AH).
 Materials and methods. 83 patients were examined (40 with RA combined with AH, 23 with RA and 20 with AH). The blood lipid spectrum and endothelial function were studied in all patients.
 Results. The analysis of blood serum lipid parameters demonstrated that in patients with RA, regardless of the presence of AH, there was a significant increase of proatherogenic lipid profile parameters in comparison with those in healthy subjects. It was shown, that lower concentrations of high-density lipoproteins and higher atherogenic coefficient indices was a characteristic feature of the lipid profile in RA patients both with and without AH – in contrast to the same parameters of the lipid spectrum in patients with AH without RA. In the groups of patients with RA a significant increase of the brachial artery diameter at rest and decreased indices of endothelium-dependent vasodilation and endothelium-independent vasodilation were revealed. Subjects with RA in combination with AH had significantly lower indices according to the tests with both reactive hyperemia and nitroglycerin, while in patients with RA without AH, only NG-test was significantly lower.
 Conclusion. Dyslipidemia of atherogenic type and endothelial dysfunction develops at the initial stages of rheumatoid process and depends on the activity of the inflammatory process, the presence of extra-articular manifestations and rheumatoid factor seropositivity.

The relationship of endothelial dysfunction and metabolic manifestations of obesity

Introduction . Over the past three decades, the prevalence of overweight and obesity in the world has grown by almost 30–50% among adults and children. A number of metabolic and hemodynamic disorders, as well as the pathology of many organs and systems are often associated with obesity. The aim of our study was to compare the functional state of the endothelium in various variants of complicated obesity (СO). Materials and methods . The study included 66 people with СO whose average age was 47.3 ± 9.9 years, from this group 3 groups were formed depending on the complications of obesity (dyslipidemia, hypertension and impaired glucose tolerance). To assess the functional state of endothelium, we used the method of wavelet analysis of skin temperature fluctuations during cooling of the limb; endothelin-1 (ET-1), albuminuria (AC), and vascular endothelial growth factor (VEGF) were determined as markers of endothelial dysfunction. Results . The levels of VEGF, ET-1 and AC in the groups with СO did not differ significantly, however, they were significantly higher than in the comparison group. The results of the cold test revealed the absence of restoration of the amplitudes of fluctuations in skin temperature equally in all groups with CO compared with the control group (post-cold vasodilation indices (IPV) in group 1 – 0.45 (0.38–0.69, in group 2 – 0.59 (0.41–0.83), in group 3 – 0.66 (0.53–0.79), in the Control group – 0.91 (0.86–1.06), p<0.05). Correlations between biochemical and instrumental markers of endothelial dysfunction and insulin resistance indices were obtained: ET-1 correlated with insulin (r=0.49; p=0.02), HOMA index (r=0.55; p=0.01); AU value correlated with glycemia (r=0.70; p=0.02); The IVC vasoconstriction index correlated with the HOMA-IR index (r=0.62; p=0.05); The IPV-1 index decreased with increasing VEGF (r=–0.86; p=0.002) and HOMA-IR (r=–0.86; p=0.002). The IPV-2 index inversely correlated with the level of postprandial glycemia (r=–0.87; p=0.05), systolic blood pressure (r=–0.55; p=0.04), OT (r=–0.57; p=0.04) and ET-1 (r=–0.58; p=0.04). Conclusion . The unified basis of the revealed disorders in СO allows us to conclude that the factors of insulin resistance are complex: hyperglycemia, dyslipidemia, and arterial hypertension, which makes it difficult to identify the leading factor in the formation of endothelial dysfunction.

Humoral markers of endothelial dysfunction in children of the first year of life born with intrauterine growth retardation syndrome

The article presents data on the functional state of endothelium in children of the first year of life, born with different variants of intrauterine growth retardation syndrome. The main group consisted of 60 full-term newborns with hypotrophic and hypoplastic variants of intrauterine growth retardation syndrome. The comparison group included 20 full-term newborns with normal anthropometric indicators. The examination was conducted on 7–10 days of life and at the age of 1 year of life. Newborns of the main group had deviations in health status: perinatal damage to the central nervous system, anemia, irregular colonization of the intestinal microflora, hyperbilirubinemia. Violations of the functional state of the endothelium was manifested by a change in the ratio of vasoconstrictors and vasodilators, in particular, a reduced content of endothelin-1 and nitric oxide in the blood and an increased content of renin and vascular endothelial growth factor. During the first year of life, all children were diagnosed with physical underdevelopment. Violation of the functional state of the endothelium was manifested by an increase in the level of endothelin-1, which is a vasoconstrictor. The results obtained allow to suggest that the identified changes contribute to the disruption of blood circulation and gas exchange in the organs and systems that ensure the growth and development of children.

Взаимосвязь маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи

Цель. Изучение взаимосвязи маркеров эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита на фоне обтурационной желтухи, выявление его раннего перехода в цирроз печени и оптимизация тактики лечения в до- и послеоперационном периоде с оценкой показателей исследуемых лабораторных тестов. Материалы и методы. Исследование проведено в отношении 15 больных с гнойным холангитом, из них у 9 больных был хронический гепатит, у 6 больных хронического гепатита не было. Из 9 больных с хроническим гепатитом 4 больным противовирусную терапию не проводили, 5 - проводили. Результаты. Непосредственные результаты проведенного лечебно-диагностического исследования свидетельствуют о сходных проявлениях эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита. Всем больным с гнойным холангитом выполняли декомпрессию желчных протоков, устраняли причины обтурации, проводили дезинтоксикационную терапию. По данным корреляционного анализа показателей функционального состояния эндотелия у больных с хроническим гепатитом, получавших противовирусную терапию, улучшение отметили на 10-е сут, через 1 мес оно было более выраженным, чем у больных, не получавших противовирусную терапию. У 6 больных с гнойным холангитом без хронического гепатита своевременное хирургическое, дезинтоксикационное лечение совместно с озонотерапией привело к улучшению показателей функционального состояния эндотелия на 10-е сут, через 1 мес они приблизились к норме. Выводы. Своевременное выявление эндотелиальной дисфункции при гнойном холангите у больных с хроническим гепатитом и без хронического гепатита способствует раннему прогнозированию его перехода в стадию цирроза печени и правильному выбору тактики лечения в до- и послеоперационном периоде. Подытожив полученные данные, можно сделать вывод о том, что при гнойном холангите у больных с хроническим гепатитом целесообразно проведение противовирусной терапии до и после операции.

Nicotinamide riboside has protective effects in a rat model of mesenteric ischaemia-reperfusion.

Acute mesenteric ischaemia is a syndrome caused by inadequate blood flow through the mesenteric vessels, resulting in ischaemia and eventual gangrene of the bowel wall. Although relatively rare, it is a potentially life-threatening condition. The maintenance of haemodynamic stability, along with adequate oxygen saturation, and the correction of any electrolyte imbalance, are of the utmost importance. However, nicotinamide adenine dinucleotide (NAD) biosynthesis modulation by precursor introduction can also be a powerful tool for preventing injury. Nicotinamide riboside is a pyridine-nucleoside form of vitamin B3 that functions as a precursor to NAD+ . The present study investigated nicotinamide riboside's effect on endothelium functional state, microcirculation and intestinal morphology in acute mesenteric ischaemia and reperfusion. Mesenteric ischaemia was simulated after the adaptation period (15minutes) by occluding the superior mesenteric artery for 60minutes, followed by a reperfusion period of 30minutes. The functional state of intestinal microcirculation was evaluated by laser Doppler flowmetry. Endothelial functional activity was studied by using wire myography. Intestinal samples were stained with haematoxylin and eosin for histological analysis. The results revealed that nicotinamide riboside protects the intestinal wall from ischaemia-reperfusion injury, as well as improving the relaxation function of mesenteric vessels. Nicotinamide riboside's protective effect in small intestine ischaemia-reperfusion can be used to reduce ischaemia-reperfusion injury, as well as to preserve intestinal grafts until transplant.

Endothelium functional state and evaluation of tissue hypoxia in patients at the moment of the transitorial ischemic attacks development

Purpose. To study microcirculatory, metabolic disturbances and the possibility of their correction in patients with transient ischemic attacks (TIA) when used in the complex treatment of laser hemotherapy (LH). Material and methods. We studied the vasomotor function of the endothelium, the parameters of carbohydrate-energy metabolism and lipid peroxidation (LPO) in the blood. Results. Endothelial dysfunction, increased lactate/ pyruvate ratio, increased LPO, low activity of superoxidedismutase were established. The complex treatment improves microcirculatory and metabolic parameters. Conclusions. It is recommended to include LH in the complex treatment of patients with TIA.

The treatment of patients with asthma and comorbidity.

The increa­sing prevalence of asthma (A) and diabetes mellitus type 2 (DM2T) necessitates administration of the adequate antia­sthmatic long-term basic therapy with consideration of comorbid states. The purpose consisted in revealing the therapeutic potential of Tiotropium bromide (TB) and L-arginine (Tivortine) in patients having uncontrolled moderately severe asthma in combination with DM2T (A+DM2T). Forty seven A+DM2T patients underwent an in-depth study before and after their treatment. They were divided into 2 groups: treatment (group 1, n=28) and comparison (group 2, n=19). Both groups received the standard 2-component therapy: budesonide/formoterol fumarate dihydrate – 160/4.5µg by 2 breaths twice a day and metformin at a dose of 500 mg twice a day. The complex of their basic therapy for group 1 additionally included TB (18 µg a day) and arginine hydrochloride preparation (Tivortine® aspartate, Yuriya-Farm) orally by 15 ml twice a day during 3 months (90 days). The patients were followed up 3 months and one year later. Their general condition demonstrated positive dynamics in both groups, the number of exacerbations in group 1 reducing by a factor of 4. The complex use of L-arginine and TB preparations against a background of the basic therapy in A+DM2T patients produced a better control over the disease, a more rapid elimination of obstruction manifestations, achievement and prolongation of the clinical spirographic remission, an improvement of the quality of life, correction of disturbances in haemocoagulation, fibrinolysis and the functional state of endothelium.

Functional State of Endothelium in Aging

Functional State of Endothelium in Aging

Гипергомоцистеинемия и функциональное состояние эндотелия у пациентов с облитерирующим атеросклерозом нижних конечностей при артериальных реконструкциях

Гипергомоцистеинемия и функциональное состояние эндотелия у пациентов с облитерирующим атеросклерозом нижних конечностей при артериальных реконструкциях