THE ROLE OF ENTEROVIRUSES IN THE DEVELOPMENT OF ISCHEMIC STROKE AND ITS OUTCOMES.

OBJECTIVE: The aim: To study the role of enteroviruses (EV) in the development of ischemic stroke and its outcome. PATIENTS AND METHODS: Materials and methods: The main group (MG) included 72 patients with acute cerebrovascular disorders were examined using the National Institutes of Health Stroke Scale and Barthel Index. The comparison group (CG) included 35 patients without cerebrovascular disease. Viruses were isolated from patients' sera and identified in neutralization test. EV genomes were detected in polymerase chain reaction (PCR). Serological diagnosis was performed by enzyme-linked immunosorbent assay. RESULTS: Results: EV genomes were more frequently detected in the patients' sera in MG than in CG (23.6 ± 5.9% and 2.9 ± 2.8%, p <0.05). The greater level of neurological deficits was in patients with positive PCR test results comparatively with patients with negative PCR test results (11.76 ± 0.31 and 10.97 ± 0, 27, p = 0.040). The regression of neurological deficit during the treatment was a worse in patients with positive PCR test results and presence of specific IgG compared with patients with positive PCR test results and absence of specific IgG (11.2 ± 2.6% and 19.6 ± 2.4%, p = 0.031). CONCLUSION: Conclusions: The trigger role of EV in the development of IS is established. PCR is recommended for diagnosis of EV in patients with IS.

Research of biological properties of enterovirus strains associated with ischemic stroke.

OBJECTIVE: Introduction: The research of biological properties of enteroviruses associated with ischemic stroke (IS) allows us to identify their intratypic differences. The aim: to identify genetic markers of strains of enteroviruses associated with IS. PATIENTS AND METHODS: Materials and methods: 11 strains of enteroviruses isolated from the serum of patients with IS were identified in the virus neutralization test. Genetic markers of isolated strains (Abent, marker S, marker rct40) were determined. RESULTS: Results: Eleven strains of enteroviruses were isolated from the serum of patients with IS. Eight viruses: Coxsackie B viruses (serotypes 2, 3, 4) and ECHO viruses (serotypes 6, 9, 27 (two strains), 29) were identified in these strains. Other three strains of enteroviruses were unidentified. Different combinations of genetic markers were found. Seven strains of enteroviruses (Coxsackie B2, B3, ECHO 6, ECHO 9, ECHO 27 (two strains) and one unidentified virus) had virulence markers: Abent-, rct40+ and S-. Three strains (Coxsackie B4, ECHO 29, one unidentified virus) had markers: Abent-, rct40+, S+. Another one unidentified virus had markers: Abent+, rct40+, S -. CONCLUSION: Conclusions: All 11 isolates of enteroviruses associated with IS had rct40+ marker, 10 of the 11 isolates had marker Abent- and 8 of 11 isolates had marker S-. The research of genetic markers allows to perform typic and intratypic differentiation of strains of enteroviruses associated with the IS.

The role of the persistent enterovirus infection in development of acute stroke.

INTRODUCTION: The role of enteroviruses in development of dilated cardiomyopathy, myocardial infarction, myocarditis, pericarditis is known. THE AIM: To examine the role of chronic enterovirus infections in development of acute stroke. MATERIAL AND METHODS: Blood samples from 72 patients with acute stroke (study group) and 35 patients without vascular disease (control group) were investigated by reverse transcription polymerase chain reaction for the presence of enterovirus RNA, by using virological method to detect enteroviruses, by ELISA for the levels of IgM and IgG antibodies to enteroviruses. RESULTS: The enteroviruses genomes were detected significantly often in the serum of patients with stroke (23,6 ± 5,9%) than in control group (2,9 ± 2,8%). The viruses were isolated and were identified as Coxsackie B (serotypes 2, 3, 4) and ECHO (serotypes 6, 9, 27 (two strains), 29), three strains have not been identified in study group. IgM to enteroviruses were not found in the sera of both groups of patients. IgG to enteroviruses were detected in 17 patients in study group (23,6 ± 5,9%) and 2 patients in control group (5,7 ± 3,9%). The presence of enteroviruses genomes and IgG in sera of patients in control group (11,1 ± 3,7%) indicate the persistence of enteroviruses. The proportion of patients with IgG to enteroviruses in sera is higher in study group (12,5 ± 3,9%) than in control group (5,7 ± 3,9%). CONCLUSION: The enterovirus infections play trigger role in development of acute stroke.

Changes of lipidic and the immunological state at patients with a metabolic syndrome in Ukraine.

INTRODUCTION: The metabolic syndrome has become pandemic nature and tends to rejuvenation in the world. Elucidation of the pathogenic mechanisms on membrane-cell level will optimize the treatment of patients with metabolic syndrome and prevention of metabolic syndrome on the level of pre-clinical manifestations. AIM: to study the immunological status and lipid metabolism in the patients with metabolic syndrome and the pathogenetic mechanisms of metabolic syndrome were established. MATERIAL AND METHODS: There were 4 groups of pacients (110) with: metabolic syndrome, ischemic heart disease and hypertension, hypertention; control group. General clinical, instrumental, laboratory and statistical methods were used. RESULTS: The levels of immune factors - interleukin-6 in supernatants of mononuclear cells by 65%, sICAM-1 by 20% is elevated in patients with metabolic syndrome compared with the control group. The increasing of the content of saturated fatty acids by 9.4% and polyunsaturated fatty acid by 36.6% lead to fundamental breach of structural and functional properties of membranes. There is significant common carotid artery intima media thickness on average twice at the patients with metabolic syndrome and with ischemic heart disease and hypertension. CONCLUSIONS: The immunoinflammatory reactions were more revealed in the group of patients with metabolic syndrome than in other groups. The lipid state at patients with metabolic syndrome was changed more than in patients with hypertension or patients with ischemic heart disease and hypertension both. Moreover our data indicate the presence of structural changes in the vessel wall in patients with metabolic syndrome.