ABSTRACT
Gout is a serious medical, social and economic problem of today. The major factor in its pathogenesis is impaired purine metabolism, which leads to an increase in uric acid concentration and the development of monourate-induced inflammation. Disruption of thermoregulation and regional blood flow is an important clinical and pathogenic manifestation of gout, which can be evaluated by the registration of infrared radiation. Comprehensive treatment of patients aimed at different parts of the pathological process, but the effectiveness of enterosorbents in gout has not been investigated. Aim - to study the dynamics of cytokine system in the blood of patients with gout at the inclusion in the complex therapy of carbon enterosorbent "Carboline", as well as to evaluate the change of local temperature above the affected joints by means of thermography. 65 gout patients and 30 healthy people of representative age were examined. All surveyed were divided into two groups, patients of group I received only basic therapy, group II took basic treatment, received carbon enterosorbent "Carboline". The concentration of uric acid and IL-1ß, TNF-α, IL-10 in serum was determined. 47 patients underwent thermography of the affected joints before and after treatment. In the blood of patients with gout prior to treatment revealed an increase in uric acid (459,72±11,44 µmol/l), an increase in pro- and anti-inflammatory cytokines (IL 1ß - 5,56±0,14, TNF-α - 12, 47±0.28, IL-10 - 11.34±0.32 pg/ml) with a significant difference compared to the control (p <0.05). During the period of exacerbation of thermograms over the affected joints there was an area of intense hyperthermia with clear contours, which exceeded the visible hyperemia in size. Increased local temperature was found to be 4.30±0.13 ° C compared with the control group (p<0.05). There was a significant decrease in uric acid concentration, pro- (IL-1ß, TNF-α) and anti-inflammatory cytokine (IL-10) content after treatment in both groups, but more in patients who received carbon enterosorbent with basic therapy. Thermograms reduced the area and intensity of hyperthermia, and the clarity of the contours was lost. The decrease in local temperature was in both groups, but still exceeded the control (p<0.05), which indicated subclinical inflammation.
