Медицинская иммунология (Jul 2014)
MAMMARY RECONSTRUCTIVE SURGERY FOLLOWING MASTECTOMY: EFFICIENCY AND PROSPECTIVES FOR IMMUNOTROPIC THERAPY
Abstract
Abstract. Immune status has been studied in 111 patients with breast malignancies following reconstructive surgery. Clinical and laboratory features of secondary immune insufficiency were determined during post-surgical period. The immune status of the studied patients was characterized by the marked absolute and relative lymphocytopenia associated with significantly decreased number of CD3+ and HLA-DR+ cells. Pronounced neutrophilia was accompanied by increased spontaneous NBT-reducing activity. Recombinant IL-1 (Betaleukin®) and a new synthetic dipeptide «Bestim» were used for immunotropic therapy. While studying clinical and immunological efficiency of the drugs, it was established that the patients receiving immunotherapy had significantly lower complication rates (resp., 13.33% and 17.64%) than the patients in comparison group (48.43%). A difference for the rates of purulent inflammatory complications was statistically significant. A trend to better survival of grafts and transplants was noted following the course of immunotherapy. Application of Betaleukin and «Bestim» in combined treatment protocols resulted into a significant reduction of hospital staying and decreased duration of antibacterial therapy. These drugs showed a pronounced immunostimulating effect: absolute and relative lymphocyte contents were increased, the number of CD3+ and CD4+ lymphocytes was maintained within the normal range, whereas a significant decrease of these key values was observed in the comparison group. Following a course of immunotherapeutic drugs, normal levels of certain cytokines were noted, some imbalance of cytokine values being observed in the comparison group. After treatment with «Bestim», increased IL-2 and decreased IL-4 levels were revealed. Hence, Betaleukin and «Bestim» display clinical and immunologic efficiency in management of the patients with malignant breast tumors following reconstructive surgery. (Med. Immunol., vol. 10, N 4-5, pp 449-454).
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