[Endogenic antimicrobial peptides and cytokines in calculous cholecystitis]. / Antimikrobnye peptidy i tsitokiny pri ostrom kal'kuleznom kholetsistite.

AIM: To analyze concentration of some antimicrobial peptides and cytotoxins in acute calculous cholecystitis regarding gallbladder inflammation grade. MATERIAL AND METHODS: There were 69 patients with catarrhal (29), phlegmonous (24) inflammation and gangrenous phlegmon (19). Some antimicrobial peptides (HNP-α, BPI, endotoxin, neutrophil elastase, lactoferritin, hepcidin) and cytokines (TNF-α, IL-6, 8, 10) in blood serum as well as hepcidin, TNF-α and IL-6 in hepatic biopsy samples were assessed. RESULTS: Significantly increased concentration of all antimicrobial peptides and cytokines was observed in all patients at admission compared with healthy persons. Changes depended on severity of gallbladder inflammation. There was a positive correlation of antimicrobial peptides and TNF-α, IL-6, IL-8. CONCLUSION: The use of antimicrobial peptides as the most informative biomarker for early diagnosis of destructive acute cholecystitis reduces postoperative morbidity.

[The effect of cytokine therapy on the results of surgical treatment of patients with acute ulcerative gastroduodenal bleeding].

AIM: To improve the results of surgical treatment of patients with acute ulcerative gastroduodenal bleeding using immune correction with ß-leukin. MATERIAL AND METHODS: Urgent and elective operations were performed in 120 patients with gastroduodenal ulcers. Patients of the main group (n=63) received systemic cytokine therapy with ß-leukin in addition to conventional treatment. Pre- and postoperative immune correction was absent in the comparison group. RESULTS AND DISCUSSION: There was preoperative imbalance of antiphlogistic and proinflammatory cytokines in comparison group. Severity of this process depended on blood loss. Therapy with interleukin decreased severity of cytokine imbalance.

[Serum and bile cytokines dynamics in patients with non-tumoral obstructive jaundice and suppurative cholangitis]. / Dinamika tsitokinov v syvorotke krovi i zhelchi u patsientov s mekhanicheskoi zheltukhoi i gnoinym kholangitom neopukholevogo geneza.

AIM: To study serum and bile cytokines dynamics in patients with non-tumoral obstructive jaundice and suppurative cholangitis. MATERIAL AND METHODS: Comparative study of serum and bile cytokines in 49 operated patients with biliary pathology was performed. Patients were divided into 3 groups. The first group included 24 patients with acute calculous cholecystitis (ACCh), the second group consisted of 12 patients with chronic calculous cholecystitis (CCCh) and the third group included 13 patients with choledocholithiasis complicated by obstructive jaundice and suppurative cholangitis. RESULTS AND DISCUSSION: All patients had increased level of TNF-α, IL-4 и IL-6. There was augmentation of biliary cytokines in patients with obstructive jaundice compared with those with acute and chronic calculous cholecystitis. In patients with obstructive jaundice and suppurative cholangitis the highest levels of cytokines were observed. Patients with obstructive jaundice (OJ), suppurative cholangitis (SCh) and chronic calculous cholecystitis had higher levels of cytokines in both blood and bile than in those with OJ, SCh and acute calculous cholecystitis that is explained by development of purulent inflammation on background of previous cytokines imbalance and chronic inflammation. In general, patients with acute calculous cholecystitis had higher levels of TNF-α and IL-6 in blood serum and IL-4 in bile. Patients with chronic calculous cholecystitis had higher concentration of TNF-α and IL-4 in bile and IL-6 - in blood serum. CONCLUSION: Both forms of cholecystitis and their complications are associated with increased cytokines in serum and bile. The level of augmentation depends on the type of inflammation and complications. Comparative study of cytokines can be the most informative criterion to monitor the postoperative period.