Характер клинических проявлений ожогов глаз у пациентов с различным фенотипом ацетилирования при нормализованном внутриглазном давлении

PURPOSE: To study the character of clinical manifestations of ocular burns in patients with normal IOP and different acetylation phenotypes (APh).METHODS: We examined 103 patients with ocular burns (141 eyes) during their primary visit to the Republican Clinical Eye Hospital of the Ministry of Health of Uzbekistan, on different time-points during therapy (on days 2, 5, 7, 12 after the beginning of treatment) and then during an active clinical examination 30 days and 4 months after discharge. 44 patients were examined 1-2 years after suffering a burn injury in order to identify the later post-burn complications and their interpretation according to the patient’s APh. 52 (69 eyes) patients out of 103 examined patients (141 affected eyes) had a slow acetylation phenotype (SA) and 51 patients (72 eyes) — a fast acetylation phenotype (FA).RESULTS: The results of these studies allow us to assert that patients with SA phenotype develop deeper ocular burns, with eye tissue damages less prone to treatment than in FA patients, where less pronounced changes lead to faster process normalization. APh determines the course of the manifestations, their severity and risk of complications in ocular burns patients. Fast acetylation phenotype may serve as a prognostic marker of faster pathological changes regression in ocular tissues, whereas the slow acetylation phenotype suggests the development of more severe disease forms, often requiring a prolonged and complex therapy. ЦЕЛЬ. Изучить характер клинического течения поражения глаза при химических ожогах в зависимости от фенотипа ацетилирования (ФА) при нормализованном внутриглазном давлении (ВГД).МЕТОДЫ. Были обследованы 103 больных с ожогами глаз (141 глаз): при первичном обращении, на этапах терапии (2, 5, 7, 12 сутки от момента обращения в клинику) и при активной диспансеризации в сроки 30 дней и 4 мес. после выписки. Через 1-2 года после перенесенной ожоговой травмы с целью выявления поздних послеожоговых осложнений и их интерпретации с учетом ФА также были обследованы 44 пациента. Из общего числа 103 обследованных лиц (141 пораженный глаз) — 52 (69 глаз) больных были с медленным типом фенотипа ацетилирования (МА) и 51 больной (72 глаза) — с быстрым типом ацетилирования (БА).РЕЗУЛЬТАТЫ. Результаты проведенных исследований позволяют утверждать, что при ожогах глаз при МА развиваются более глубокие, тяжело поддающиеся лечению деструктивные нарушения в тканях глаза, при БА — менее выраженные изменения, которые в дальнейшем быстрее приводят к нормализации процесса. ФА определяет характер течения, тяжесть и риск развития осложнений при ожогах глаз. БА может служить прогностическим маркером к более быстрой регрессии патологических изменений в тканях глаза, МА предполагает к развитию более тяжелых форм с затяжным и осложненным течением, трудно поддающихся традиционной терапии.

Fibrin Clot Structure and Properties are Altered in Systemic Lupus Erythematosus

© 2016, Springer Science+Business Media New York.Thrombotic complications in systemic lupus erythematosus contribute significantly to the morbidity and mortality rates. Abnormal formation and structure of fibrin clots add substantially to hypercoagulability and thrombosis. We used dynamic turbidimetry to assess in vitro the kinetics of fibrin polymerization and t-PA-induced fibrinolysis in recalcified plasma of patients with systemic lupus erythematosus compared to healthy subjects. Fibrin structure was studied using scanning electron microscopy. Clots from the pathological plasma samples polymerized significantly slower, resulting in formation of fibrin with a higher optical density and less compact fibrin networks with larger pores. These changes were associated with a prolonged clot lysis time and reduced lysis rate. The results show that in the blood of patients with systemic lupus erythematosus fibrin clots have a pro-thrombotic phenotype that comprises an important mechanism underlying lupus-related thrombophilia

Hyperfibrinogenemia and Increased Stiffness of Plasma Clots in the Active Systemic Lupus Erythematosus

© 2017, Springer Science+Business Media, LLC. Systemic lupus erythematosus (SLE) is an autoimmune disease associated with an increased risk of thrombosis. We hypothesized that inflammation-associated hyperfibrinogenemia can contribute to the prothrombotic phenotype of fibrin clots by changing their mechanical properties. Twenty-eight SLE patients were categorized based on their disease activity scores (SLEDAI) into the groups with inactive (SLEDAI   4, n = 14) forms of the disease. Clots from individual platelet-free plasma samples were probed using shear rheometry and viscoelastic properties of the fibrin gels were determined as the storage (G′) and loss (G″) moduli. A significant increase of G′ was revealed in the clots from the plasma of active SLE patients over inactive SLE, which correlated with elevated fibrinogen levels. Clots from the plasma of inactive SLE patients had the elasticity and fibrinogen levels indistinguishable from those in control plasma from healthy subjects. Thus, inflammatory hyperfibrinogenemia in the active SLE form makes fibrin clots stiffer which has been previously shown to be associated with a higher incidence of thrombotic disorders

Fibrin Clot Structure and Properties are Altered in Systemic Lupus Erythematosus

© 2016, Springer Science+Business Media New York.Thrombotic complications in systemic lupus erythematosus contribute significantly to the morbidity and mortality rates. Abnormal formation and structure of fibrin clots add substantially to hypercoagulability and thrombosis. We used dynamic turbidimetry to assess in vitro the kinetics of fibrin polymerization and t-PA-induced fibrinolysis in recalcified plasma of patients with systemic lupus erythematosus compared to healthy subjects. Fibrin structure was studied using scanning electron microscopy. Clots from the pathological plasma samples polymerized significantly slower, resulting in formation of fibrin with a higher optical density and less compact fibrin networks with larger pores. These changes were associated with a prolonged clot lysis time and reduced lysis rate. The results show that in the blood of patients with systemic lupus erythematosus fibrin clots have a pro-thrombotic phenotype that comprises an important mechanism underlying lupus-related thrombophilia

Fibrin Clot Structure and Properties are Altered in Systemic Lupus Erythematosus

© 2016, Springer Science+Business Media New York.Thrombotic complications in systemic lupus erythematosus contribute significantly to the morbidity and mortality rates. Abnormal formation and structure of fibrin clots add substantially to hypercoagulability and thrombosis. We used dynamic turbidimetry to assess in vitro the kinetics of fibrin polymerization and t-PA-induced fibrinolysis in recalcified plasma of patients with systemic lupus erythematosus compared to healthy subjects. Fibrin structure was studied using scanning electron microscopy. Clots from the pathological plasma samples polymerized significantly slower, resulting in formation of fibrin with a higher optical density and less compact fibrin networks with larger pores. These changes were associated with a prolonged clot lysis time and reduced lysis rate. The results show that in the blood of patients with systemic lupus erythematosus fibrin clots have a pro-thrombotic phenotype that comprises an important mechanism underlying lupus-related thrombophilia

Fibrin Clot Structure and Properties are Altered in Systemic Lupus Erythematosus

© 2016, Springer Science+Business Media New York.Thrombotic complications in systemic lupus erythematosus contribute significantly to the morbidity and mortality rates. Abnormal formation and structure of fibrin clots add substantially to hypercoagulability and thrombosis. We used dynamic turbidimetry to assess in vitro the kinetics of fibrin polymerization and t-PA-induced fibrinolysis in recalcified plasma of patients with systemic lupus erythematosus compared to healthy subjects. Fibrin structure was studied using scanning electron microscopy. Clots from the pathological plasma samples polymerized significantly slower, resulting in formation of fibrin with a higher optical density and less compact fibrin networks with larger pores. These changes were associated with a prolonged clot lysis time and reduced lysis rate. The results show that in the blood of patients with systemic lupus erythematosus fibrin clots have a pro-thrombotic phenotype that comprises an important mechanism underlying lupus-related thrombophilia

Hyperfibrinogenemia and Increased Stiffness of Plasma Clots in the Active Systemic Lupus Erythematosus

© 2017, Springer Science+Business Media, LLC. Systemic lupus erythematosus (SLE) is an autoimmune disease associated with an increased risk of thrombosis. We hypothesized that inflammation-associated hyperfibrinogenemia can contribute to the prothrombotic phenotype of fibrin clots by changing their mechanical properties. Twenty-eight SLE patients were categorized based on their disease activity scores (SLEDAI) into the groups with inactive (SLEDAI   4, n = 14) forms of the disease. Clots from individual platelet-free plasma samples were probed using shear rheometry and viscoelastic properties of the fibrin gels were determined as the storage (G′) and loss (G″) moduli. A significant increase of G′ was revealed in the clots from the plasma of active SLE patients over inactive SLE, which correlated with elevated fibrinogen levels. Clots from the plasma of inactive SLE patients had the elasticity and fibrinogen levels indistinguishable from those in control plasma from healthy subjects. Thus, inflammatory hyperfibrinogenemia in the active SLE form makes fibrin clots stiffer which has been previously shown to be associated with a higher incidence of thrombotic disorders

RELATIONSHIP OF INFLAMMATORY ACTIVITY AND KIDNEY DAMAGES IN SYSTEMIC LUPUS ERYTHEMATOSUS

To solve the problems in the surveyed 45 patients: examination, laboratory complex, immune and instrumental methods. All 45 patients with SLE kidney disease manifested itself in the form of lupus nephritis. Syndrome hypertension met in 35.5% of cases, the syndrome of chronic renal failure in 37.7% of cases. Urinary syndrome characterized by moderate proteinuria (75.5%), hematuria (73.3%) and leukocyturia (73.3%). Positive correlation of tumor necrosis factor α, C-reactive protein level of creatinine, urea, ESR and SLE activity, which confirms the participation of the factors described in the immune process lupus inflammation