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Khirurgii

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Year 2017 Vol. 25 No 4

GENERAL & SPECIAL SURGERY

K.M. KURBONOV, K.R. NAZIRBOEV

ENDOTOXICOSIS AND INDICATORS OF CYTOKINE LEVEL IN PATIENTS WITH NON-TUMOR OBSTRUCTIVE JAUNDICE

Avicenna Tajik State Medical University, Dushanbe,
The Republic of Tajikistan

Objectives. To study some indices of endtoxicosis and the level of cytokines in blood serum and bile in patients with non-tumor obstructive jaundice.
Methods. The studies are based on a comparative analysis of indicators of endotoxemia and cytokine profile in the blood serum and duct bile in 38 operated patients. Patients on the basis of the severity of obstructive jaundice (OJ) were divided into 3 groups according to the classification of E.I. Galperin et al. There were 12 patients with OJ in mild form (31,6%), with moderate severity – 14 (36,8%) and with severe form of OJ – 12 (31,6%). To diagnose the severity of OJ, laboratory studies of endotoxemia indices and cytokine concentration in the blood serum and duct bile were performed, and morphological data of the liver biopsy samples were also studied.
Results. Analysis of the study results has shown the concentration of the proinflammatory cytokine IL-6 in OJ of medium severity is 50,4% higher than normal, and at a severe degree in the blood serum it turns out to be the highest in case of OJ complicated by purulent cholangitis – by 2,4 times. The concentration of proinflammatory cytokine IL-6 in the bile has been found to be elevated in patients with OJ (a moderate severity) and OJ (severe form).
During the study, the concentration of proinflammatory cytokine IL-4 in the blood serum in OJ of a mild degree was 27% higher than normal, and in patients with OJ of a moderate severity – 67,3% higher. However, the concentration of IL-4 in the bile appeared to be elevated in case of the initial forms of the disease compared with patients with OJ of a moderate severity against the destructive cholecystitis.
Conclusion. The results of a comprehensive study of patients with OJ have revealed significant changes in indices of the cytokine status and endotoxemia in the blood serum and bile as well as morphofunctional changes in the liver.

Keywords: cholelithiasis, choledocholithiasis, obstructive jaundice, endotoxemia, cytokines, bile, liver
p. 359-364 of the original issue
References
  1. Maiorov MM, Driazhenkov IG. Mekhanicheskaia zheltukha kal'kuleznoi etiologii: patogenez, oslozhneniia i lechebnaia taktika [Mechanical jaundice of calculous etiology: pathogenesis, complications and therapeutic tactics]. Klin Meditsina. 2012;(5):12-16.
  2. Brown KT, Covey AM. Management of malignant biliary obstruction. Tech Vasc Interv Radiol. 2008 Mar;11(1):43-50. doi: 10.1053/j.tvir.2008.05.005.
  3. Gal'perin EI, Akhaladze GG, Kotovskii AE, Glebov KG, Chevokin AIu, Momunova ON. Patogenez i lechenie ostrogo gnoinogo kholangita [Pathogenesis and treatment of acute purulent cholangitis]. Annaly Khirurg Gepatologii. 2009;(4):13-21.
  4. Ioffe IV, Poteriakhin VP. Pechenochnaia nedostatochnost' u bol'nykh s mekhanicheskoi zheltukhoi neopukholevogo geneza [Liver failure in patients with mechanical jaundice of non-tumor origin]. Ukr Zhurn KlÑ–n ta Lab Meditsini. 2009;4(3):130-32.
  5. Koshevskii PP, Alekseev SA, Bovtiuk NIa. Sindrom sistemnogo vospalitel'nogo otveta i endogennaia intoksikatsiia u patsientov s mekhanicheskoi zheltukhoi i kholangitom neopukholevogo geneza [Syndrome of systemic inflammatory response and endogenous intoxication in patients with mechanical jaundice and cholangitis of non-tumor origin]. Med Zhurn. 2012;(4):50-55.
  6. Bolevich SB, Stupin VA, Gakhramanov TV, Khokonov MA, Silina EV, Men'shova NI, i dr. Osobennosti techeniia svobodnoradikal'nykh protsessov u bol'nykh s mekhanicheskoi zheltukhoi i metody ikh korrektsii [Features of the flow of free radical processes in patients with mechanical jaundice and methods for their correction]. Khirurgiia Zhurn im NI Pirogova. 2010;(7):65-70.
  7. Stupin VA, Laptev VV, Tskaev AIu, Givirovskaia NE. Pokazateli immunnoi sistemy pri mekhanicheskoi zheltukhe dobrokachestvennogo geneza [The indices of the immune system with mechanical jaundice of benign genesis]. Annaly Khirurg Gepatologii. 2008;13(2):69-75.
  8. Badger SA, Jones C, McCaigue M, Clements BW, Parks RW, Diamond T, et al. Cytokine response to portal endotoxaemia and neutrophil stimulation in obstructive jaundice. Eur J Gastroenterol Hepatol. 2012 Jan;24(1):25-32. doi: 10.1097/MEG.0b013e32834b0dd3.
  9. Katz SC, Ryan K, Ahmed N, Plitas G, Chaudhry UI, Kingham TP, et al. Obstructive jaundice expands intrahepatic regulatory T cells, which impair liver T lymphocyte function but modulate liver cholestasis and fibrosis. J Immunol. 2011 Aug 1;187(3):1150-6. doi: 10.4049/jimmunol.1004077.
  10. Koshevskii PP, Alekseev SA, Bovtiuk NIa, Kartun LV. Korrektsiia endotoksikoza i disbalansa protivovospalitel'nykh tsitokinov v rannem posleoperatsionnom periode u patsientov s mekhanicheskoi zheltukhoi i zhelchnoi gipertenziei neopukholevogo geneza [Correction of endotoxicosis and imbalance of anti-inflammatory cytokines in the early postoperative period in patients with mechanical jaundice and biliary hypertension of non-tumor origin]. Med Zhurn. 2014;(1):74-78.
  11. Gal'perin EI, Momunova ON. Klassifikatsiia tiazhesti mekhanicheskoi zheltukhi [Classification of severity of mechanical jaundice]. Khirurgiia Zhurn im NI Pirogova. 2014;(1):5-9.
  12. Gadzhiev DN, Tagiev EG, Gadzhiev ND. Sostoianie tsitokinogo statusa u bol'nykh s mekhanicheskoi zheltukhoi dobrokachestvennogo geneza [Status of cytokine status in patients with mechanical jaundice of benign origin]. Khirurgiia Zhurn im NI Pirogova. 2015;(5):56-58.
  13. Smirnova OV, Titova NM, Manchuk VT, Elmanova NG. Osobennosti tsitokinovoi reguliatsii u bol'nykh mekhanicheskoi zheltukhoi razlichnogo geneza [Features of cytokine regulation in patients with mechanical jaundice of different genesis]. Sovrem Problemy Nauki i Obrazovaniia. 2015;(4):425.
Address for correspondence:
734003, Republic of
Tajikistan, Dushanbe,
Rudaki Ave., 139,
The Tajik State
Medical University
named after Abuali ibni Sino,
Department of Surgical
Diseases N 1,
Tel .: +992 93 405-44-04,
E-mail: dr.hero85@mail.ru,
Kahramon R. Nazirboev
Information about the authors:
Kurbonov K.M. Academician of the Academy of medical sciences of the Republic of Tajikistan , Honored Worker of Science and Technology of RT, MD, Professor, Head of department of surgical diseases N1, Avicenna Tajik State Medical University.
Nazirboev K.R. PhD, Assistant of department of surgical diseases N1, Avicenna Tajik State Medical University.
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