В работе представлены данные о нарушениях иммунного статуса на системном и локальном уровнях у больных хроническим сальпингоофоритом в стадии ремиссии до и после оперативного вмешательства. Определена недостаточная эффективность использования традиционной комплексной терапии у больных хроническим сальпингофоритом и обоснована необходимость применения дополнительно иммуномодулирующих препаратов.
In admitted patients with purulent salpingoperitonitis in blood the maintenance of CD95 is raised and the same of CD4, CD16and CD25-cells is lowered, in blood plasma the concentration of TNFα, IL-1β, IL-6, IL-8, С3 and С4-components of complement systems, activity of oxygen systems of neutrophils is raised, the concentration of IL-4, activity and intensity of phagocytosis of neutrophils is lowered. The given disturbances of the immune status are aggravated after operation. The given changes of the immune status in patients with chronic salpingophoritis correlate with disturbances of structural and functional properties of erythrocytes. Therefore it is necessary to use in treatment of such patients the preparations, which influence on phospholipids of cell membranes.
In the research the immune and metabolic effects of proteolytic enzymes (papain and terrilytinum) and liposoluble vitamins (menadionum, retinolum acetate and tocopherol acetate) are established in the experimental acute bleeding. It has been established, that the immunomodulating effects of applying terrilytinum and liposoluble vitamins in norm and in the acute bleeding are mediated by erythrocytes.
The medical-diagnostic laparoscopy and traditional pharmacotherapy do not correct enough the disturbed parameters of the immune status and lipid peroxidation in patients with chronic salpingo-oophoritis. The additional use of Imunofan or Glutoxim in combination with Mexidol in those patients renders the expressed clinical and immunocorrective effects. The use of Imunofan with Mexidol is more effective than the application of Glutoxim and Mexidol in correction of the disturbed parameters of immunity and lipid peroxidation.
Abstract. A number of studies provide evidence for significant disturbances of immune, cytokine and antioxidant conditions in the patients with chronic salpingoophoritis. The own studies of combined effects produced by some medications, with respect to correction of altered laboratory parameters in such patients, have shown higher efficiency of ridostine/lipoic acid combination, as compared to derinate/tocopherol treatment. The revealed correlations between the clinical signs and immune status of the patients with a salpingoophoritis, suggest that only some of immunological parameters could be used for predictive purposes. The established positive influence of studied drugs on the disturbed functions of immune and antioxidant systems suggests a need to introduce immunocorrector drugs and antioxidants into complex therapy of the patients by chronic salpingoophoritis.
Acute hemorrhage leads to a decrease in the phagocyte number and index, the NBT test parameters, and the NADPH oxidase activity and to an increase in the Ca2+ ATPase activity in polymorphonuclear leukocytes on the peripheral blood. Lysozyme produces effective correction of the above parameters of the functional-metabolic activity of these cells. The drug effect is mediated by cytokines of splenocytes sticking to the glass.
Hemorrhage and toxic lesions of hemopoietic tissues inhibit the development of various types of immune response and induce immunosuppressive properties in light erythrocytes, while not influencing the immunological activity of heavy erythrocytes. The immunomodulant action of pyridoxine, folate and cobalamin in various cases of anemia was observed for the joint (but not for separate) administration of two vitamin preparations; the most pronounced increase in the immune reactivity taking place upon the joint administration of cobalamin and folate.
Lysozyme injections (1 or 5 mg/kg) produced marked immunomodulating, antioxidant and hepatoprotective effects in Wistar rats which had lost much blood (3% body mass). Lysozyme action is mediated by heavy erythrocytes and glass-adherent splenocytic cytokines the production of which is provoked by these erythrocytes.
The role of erythrocytes in realization of interrelation of the immunomodulating effects of lysozyme and naphthoquinones in normal and under conditions of acute hemorrhage was studied. Interaction of lysozyme and menadione at the level of intact erythrocytes and their stroma resulted in formation of highly efficient immunomodulating factors. The effect of such factors under conditions of acute hemorrhage was mediated by cytokines of the spleen macrophagael cells.
Effect of animal erythrocytes incubated with glycosaminoglycanes and menadion on the immune response of mice and rats with acute hemorrhage was investigated. The results of the study proves the interest in elaboration of the methods to produce erythrocytes stroma incubated extracorporately with menadion and glucosaminoglycanes. This preparation may be useful for immunomodulating effect in the case of acute hemorrhage and also in other stress situations, connected with changes of erythrocytes properties and activity.
Naphthoquinones such as phylloquinone, menadione and vicasol normalized or increased the immune response in rats after intensive physical load. The most marked immunomodulating effect was induced by phylloquinone. The naphthoquinones induced the development of immunostimulating properties in heavy red blood cells by the direct action on the cell membranes or indirectly through proteolytic enzymes secreted by hepatocytes. The proteolytic enzymes secreted to the vascular channel in physical load increased the susceptibility of heavy red blood cells to phylloquinone. Glycosaminoglycans accumulating in the vascular channel in physical load increased the resistance of heavy red blood cells to phylloquinone. Heavy red blood cells of physically loaded animals treated in succession with hyaluronidase and phylloquinone and red blood cells of intact rats after the incubation in the presence of trypsin and phylloquinone proved to be effective immunomodulators in physical load.