Медицинская иммунология (Mar 2019)
THE RELATIONSHIP OF IMMUNOLOGICAL DISTURBANCES, HYPOXIA AND LIPOPEROXIDATION IN EROSIC AND ULCEROUS DEFENSE IN THE DUODENAL TREAT IN CONDITIONS OF COMORBID PATHOLOGY
Abstract
The aim of the work was to assess the role of immunological disorders, hypoxia and lipoperoxidation in the development and progression of erosive-ulcerative lesions of the duodenum against the background of chronic cerebrovascular accident. 125 patients with erosive and ulcerative lesions of the duodenum associated with chronic cerebral circulation disorders, aged from 48 to 74 years old, who were on outpatient treatment in the Federal Budget Institution of Health and Social Development of the city of Saransk in 2015-2018 were studied. The comparison group consisted of 39 patients with chronic impairment of cerebral circulation, who did not have erosive and ulcerative lesions of the stomach and duodenum at the time of the study. Patients received classical anti-ulcer therapy for 14 days. The cytokine profile, indicators of hypoxia and lipid peroxidation in serum were evaluated. Studies have shown that with erosive and ulcerative lesions of the duodenum, in association with chronic impairment of cerebral circulation throughout the observation period there was an increase in the level of pro-and anti-inflammatory cytokines, which indicates the formation of an imbalance in the immunoregulatory system. The development of hypoxic changes in the blood plasma was observed, which was confirmed by an increase in the content of lactic and pyruvic acids, as well as the hypoxia coefficient at all stages of observation. Under the conditions of the formation of this pathology, lipid peroxidation processes are also activated, as evidenced by the increase in the content of diene conjugates, triene conjugates and the malonic dialdehyde level on admission on the 7th and 14th day of observation and a decrease in the antioxidant potential of blood plasma, estimated by the superoxide dismutase index. Only by the 30th day of observation, there was a tendency to a decrease in the indices of diene conjugates, triene conjugates, malonic dialdehyde and an increase in the level of superoxide dismutase. Hypoxia and lipid peroxidation act as predictors of chronic inflammation. In the pathogenesis of erosive-ulcerative lesions of the duodenum, associated with chronic impairment of cerebral circulation, a significant value has the formation of an imbalance of pro-inflammatory and anti-inflammatory cytokines and chronic hypoxia. Under such conditions, oxidative stress is observed with a shift of equilibrium towards prooxidants, and the possibilities of the antioxidant defense system are exhausted. Taken together, these disorders determine the pathogenetic mechanisms of damage that occur with erosive and ulcerative lesions of the duodenum, associated with chronic cerebrovascular accident, which have a mutual influence as the disease progresses.
