Биомаркеры острого респираторного дистресс-синдрома: проблемы и перспективы их применения

The review analyzes the results of modern clinical and experimental studies on the search and informative value of biomarkers for acute respiratory distress syndrome (ARDS). It describes ARDS biomarkers of the main morphological changes in the lungs and severity of the systemic inflammatory response syndrome. Biomarkers of injury of bronchial epithelium, alveolar epithelium, vascular endothelium and pulmonary extracellular matrix were analyzed to determine the most informative indicators of ARDS of different etiology. It was found that for diagnosis and prognosis of the course of ARDS, the following biomarkers were the most informative: interleukin-6, a soluble form of the receptor for advanced glycation end products (sRAGE), surfactant protein D, protein KL-6, vascular endothelial growth factor, and angiopoietin-2. Using a multimarker panel for simultaneous determination of these indicators can promote rapid diagnostics of ARDS.В обзоре проведен анализ результатов современных клинических и экспериментальных исследований, посвященных поиску и оценке информативности биомаркеров острого респираторного дистресс-синдрома (ОРДС). Приведены сведения о биомаркерах ОРДС, характеризующих основные морфологические изменения легких и степень выраженности синдрома системного воспалительного ответа. С целью определения наиболее информативных показателей ОРДС различной этиологии проанализированы данные о биомаркерах, свидетельствующих о повреждении бронхиального эпителия, альвеолярного эпителия, эндотелия сосудов и экстрацеллюлярного матрикса легких. Установлено, что для диагностики и прогноза течения ОРДС наибольшим потенциалом обладают: интерлейкин-6, растворимая форма рецептора конечных продуктов гликозилирования (sRAGE), сурфактантный белок D, белок KL-6, фактор роста эндотелия сосудов, ангиопоэтин-2. Для экспресс-диагностики ОРДС следует считать перспективным одновременное определение перечисленных показателей, которое может быть реализовано в виде мультимаркерной панели

Biomarkers of acute respiratory distress syndrome: problems and prospects of their application

The review analyzes the results of modern clinical and experimental studies on the search and informative value of biomarkers for acute respiratory distress syndrome (ARDS). It describes ARDS biomarkers of the main morphological changes in the lungs and severity of the systemic inflammatory response syndrome. Biomarkers of injury of bronchial epithelium, alveolar epithelium, vascular endothelium and pulmonary extracellular matrix were analyzed to determine the most informative indicators of ARDS of different etiology. It was found that for diagnosis and prognosis of the course of ARDS, the following biomarkers were the most informative: interleukin-6, a soluble form of the receptor for advanced glycation end products (sRAGE), surfactant protein D, protein KL-6, vascular endothelial growth factor, and angiopoietin-2. Using a multimarker panel for simultaneous determination of these indicators can promote rapid diagnostics of ARDS

PUlmonotoxicyty Of syNThETIC POLYMERS combustion products

Pulmonotoxicants are the substances causing structural and functional disorders of respiratory system. The main sources of pulmonotoxicants in the environment are thermal decomposition of synthetic polymeric materials in fires. The possibility of formation of pulmonotoxicants during the combustion of synthetic polymers of different composition with regard to the conditions of combustion (temperature, time, sufficient oxygen) was analyzed. The risk of lung damage has been considered taking into account the duration of exposure to the toxicant. In addition to general toxic carbon monoxide and cyanide, the products of thermal destruction of halogen-containing and nitrogen-containing substances pose a great danger in case of fire due to their high pulmonotoxicity. The lung damage risk is considered with account for toxicants exposure duration. The pulmonotoxicants classification has been proposed according to their hazard in relation to their concentration in the air. Main mechanisms of effect of pulmonotoxicants formed during the pyrolysis of various polymeric synthetic materials have been proposed. The description of clinical manifestations as the result of intoxication with these materials under various toxodoses effect has been shown. The hazardous risk spectrum has changed depending on the toxic exposure duration that determines the variance of treatment approaches: from possible etiotropic treatment to pathogenetic therapy of toxic pulmonary edema