OBJECTIVE:To identify the likelihood of developing systemic inflammation (SI) as a general pathological process in severe haemorrhagic intracerebral stroke with and without the phenomenon of ineffective cerebral blood flow.MATERIAL AND METHOD:Three groups were examined: 1) 89 blood donors (controls), 2) 15 patients with severe haemorrhagic stroke without the phenomenon of ineffective brain blood flow; 3) 26 patients with severe haemorrhagic stroke with ineffective cerebral blood flow. Ineffective cerebral blood circulation was recorded on the basis of transcranial Doppler ultrasound data; 87% of patients had clinical signs of brain death. All patients in the groups with haemorrhagic stroke had signs of multiple organ dysfunction according to the Sepsis-related Organ Failure scale, all of them received intensive care. An integrated scale based on the determination of plasma concentrations of cytokines (IL-6, IL-8, IL-10, TNF-α), procalcitonin, cortisol, D-dimers, myoglobin, troponin I was used to verify systemic inflammation.RESULTS AND CONCLUSION:Systemic inflammation or borderline state (pre-SI) was identified in all patients of the second group both on 1-3 days from the onset of haemorrhagic stroke, and on 5-8 days. On the contrary, in the third group, there were no signs of SI on 1-3 days. On 5-8 days, signs of SI and pre-SI were recorded only in 18.2% of patients. Apparently, the reason for these differences is the blockade of the passage of tissue decay products and other pro-inflammatory factors into the bloodstream from the damaged brain in the third group.

Abstract. Fourteen groups of patients have been investigated and divided into 2 classes. The first class included the following cohorts of patients: relatively healthy persons, age 18 to 55 yrs (n = 50); elderly persons 60 yrs old, as well as senior persons (n = 22); persons with chronic adnexitis, women in their 1st trimester of pregnancy (n = 16); climacteric syndrome (n = 16); autoimmune thyroiditis (n = 29). The second class of patients included following cohorts: elderly persons with chronic cardiac insufficiency (CCI) II-III stage (n=49); valvular cardiac disease (rheumatism, n = 15); psoriatic arthritis (n = 12); reactive arthritis (n = 17); antiphospholipid syndrome, a sub-group in the 1st trimester of pregnancy (n = 5); systemic lupus erythematosus (n=49); decompensated atherosclerosis of femoral artery (n = 38); end-stage renal disease (n = 42). Plasma cytokines (TNFαα, IL-6, IL-8, IL-10), acute-phase C-reactive protein (CRP), cortisol, troponin I, myoglobin, D-dimers, interleukin-2 soluble receptor (IL-2sR), and eosinophil cationic protein (ECP) were determined in all the patients, by means of immune chemiluminescent technique (Immulite; Siemens Medical Solutions Diagnostics, USA). The integral indices of systemic inflammatory reaction (SIR) have been calculated, i.e., a Reactivity Coefficient (RC) and a Reactivity Level (RL). In the patients belonging to Class 1 cohorts, an absence of chronic systemic inflammation features was revealed, despite of some signs of systemic inflammatory response. Meanwhile, a majority of Class 2 patients have shown the signs of chronic systemic inflammation stage I to III.

Agaricus blazei: Murill used for treatment tissue inflammation in alternative medicine was selected for immunopharmacologica1 activity test.The effects of 4-Hydroxy-17-methylincisterol (4-HM; C 21 H 33 O 3 ; M.W. 333) isolated from A. blazei on human peripheral blood mononuclear cells (PBMC) proliferation were determined by tritiated thymidine uptake.The results showed that 4-HM suppressed PBMC proliferation stimulation with phytohemagglutinin (PHA) with an IC 50 3.16 mM.Cell cycle analysis indicated that 4-HM arrested the cell cycle progression of activated PBMC from the G1 transition to the S phase.In an attempt to localize the point in the cell cycle where arrest occurred, a set of key regulatory events including gene expression of interleukin-2 (IL-2), interferon-g (IFN-g) and cyclins, activation of NF-AT, NF-kB, and Ca 2+ mobilization was examined.4-HM suppressed, in activated PBMC, the production and mRNA expression of IL-2 and IFN-g in a dose-dependent manner.Levels of cyclin protein in activated PBMC were reduced by 4-HM.The data indicated that 4-HM blocked NF-kB and NF-AT translocation in PBMC activated with PHA.The Ca 2+ mobilization in PHA treated PBMC was decreased by 4-HM.Thus, the suppressant effects of 4-HM on proliferation of PBMC activated by PHA appeared to be mediated, at least in part, through inhibition of Ca 2+ mobilization, NF-AT, and NF-kB activation, early transcripts of PBMC, especially those of important cytokines, IL-2, IFN-g, and cyclins, and arresting cell cycle progression in the cells.We predict that 4-HM may be an immunomodulator.

Study goal: to assess expression of particular and integral indices of systemic inflammation reaction in patients with end-stage renal disease (ESRD) receiving replacement therapy by haemodialysis. Material and methods: 42 patients with ESRD caused by chronic glomerulonephritis (n=22), chronic pyelonephritis (n=12) and diabetic nephropathy (n=8) were studied. All patients received replacement treatment by programmed haemodialysis for 12 hours per week. Control group 68 healthy persons (18-84 years). Levels of CRP, IL-6, IL-8, IL-10, TNF-ƒ in blood plasma were measured before and after haemodialysis by the immunochemiluminescent method (Immulite, «SIEMENS», USA). Results: In patients with ESRD an acute phase response and hypercytokinemia (most of all due to TNF-ƒ and IL-8) was noted. Its rate was reduced due to haemodialysis. Integral indices of cytokinemia (reactivity coefficient and level of reactivity RC and RL) are the most informative characteristics of the systemic inflammatory reaction. Conclusion: The phenomenon of the systemic inflammatory reaction plays a significant role in the pathogenesis of ESRD; the rate of the systemic inflammation reaction can be measured by using the integrated indices of cytokinemia.

Purpose of the study: to assess expression of particular and integral indicators of the systemic inflammatory reaction in patients with end-stage renal disease (ESRD) who receive replacement treatment by haemodialysis. Material and methods: 42 patients with ESRD caused by chronic glomerulonephritis (n=22), chronic pyelonephritis (n=12) and diabetic nephropathy (n=8) were studied. All patients received replacement treatment by programmed haemodialysis for 12 hours per week. Control group 68 healthy persons (18-84 years). Levels of CRP, IL-6, IL-8, IL-10, TNF-ƒ in blood plasma were measured before and after haemodialysis by immunochemiluminescent method (Immulite, «SIEMENS», USA). Results: In patients with ESRD an acute phase response and hypercytokinemia (most of all due to TNF-ƒ and IL-8) the rate of which reduced after haemodialysis were detected. Integral indices of cytokinemia (reactivity coefficient and level of reactivity RC and RL) are the most informative characteristics of systemic inflammatory reaction. Conclusion: The phenomenon of systemic inflammatory reaction plays a significant role in the pathogenesis of ESRD; the rate of the systemic inflammation reaction can be measured using the integrated indices of cytokinemia.