Immunological context of brain injury

The parameters of several populations of immune cells (T cell populations, macrophage subpopulations) in peripheral blood and brain were studied in a clinically significant model of mild traumatic brain injury among rats. The population of resident cells of innate immunity of microglia and brain astrocytes with local tissue damage is involved in the implementation of the inflammatory response, it is also shown that in case of trauma, blood leukocytes can overcome the blood-brain barrier and penetrate the brain parenchyma. The methods of flow cytometry and immunofluorescence were used. An increase in the number of monocytes and neutrophils up to 1 day, after a mild traumatic brain injury (TBI) with a subsequent decrease to the end of the observation period was noticed. It was determined, that the number of CD45+ cells, CD3+T cells decreased at 1 days post-injury (dpi), and rose slightly by 14 dpi, the percentage of CD4+T cells continuously declined from 7 to 14 dpi, while the percentage of CD8+T cells increased from 7 to 14 dpi. With mild traumatic brain injury in animals, a significant (3-10 times) decrease in the number of microvessels with a positive reaction to the presence of SMI 71 on the 8th and 14th day after head injury was observed. Intensive staining of SMI 71 microvessels was sometimes observed with an increase in the area of a positive reaction. Thin positive deposits of the reaction product are observed in the brain of healthy animals around the wall of the microvessel. In the damaged brain, CD45high/CD11b+ positive macrophages of the M1 subpopulation appeared in the brain tissue on the 2nd day after TBI and a significant amount was observed on the 8-14th day. In the corpus callosum and ipsilateral region of the striatum, the content of cells expressing CD16/11b+ reached a maximum 8 days after TBI, which correlated with a decrease in the positive response to the presence of endothelial antigen SMI 71. Thus, in the acute period of mild TBI, the presence of neuroimmunopathological processes is determined in the brain, which can subsequently result to the dysregulation of neuroimmune connections

Вопросы контроля над частотой обострений хронической обструктивной болезни легких при сочетании с патологией ЛОР-органов

Chronic obstructive pulmonary disease (COPD) is a disease holding a stable position in morbidity and mortality structure in patients aged over 40 years.The aim of the study was to evaluate the condition of otorhinolaryngological (ENT) organs in patients with the COPD at different disease periods with subsequent analysis of COPD exacerbation rate based on the results of therapy regimen change according to the established comorbidity.Materials and Methods. Examination of ENT organs was performed in patients with COPD (n = 99) Patients from group 1 (n = 50) were treated at Pulmonary Department of the Regional State Budgetary Health Institution "Vladivostok Clinical Hospital No.1" for disease exacerbation; outpatients from group 2 (n = 49) had stable COPD course. Control group (n = 50) included patients without history of smoking and without respiratory and hearing disorders. All patients were matched by age and sex. Repeated examination was conducted in patients (n = 72) with stable COPD after 6 months.Results. It was observed that patients from groups 1 and 2 had different severity of disease symptoms, but equally high (> 2) risk of COPD exacerbation within 1 year. 50.0 and 42.9% of patients actively complained about the ENT organ-related conditions during the periods of COPD exacerbation and stable course, respectively. Among ENT organ diseases the most frequent were laryngeal diseases reported in 84.0 and 73.5% of patients with COPD exacerbation and stable course, respectively. The chronic catarrhal rhinitis and pharyngitis were revealed in 26 and 30% of patients with COPD exacerbation (p < 0.01). According to the data of 6-month study, the number of COPD exacerbations in high-risk patients with COPD using personal treatment plan for ENT-organ diseases was reduced by half, which had a positive effect on the condition of ENT-organs.Conclusion. The study showed that patients with COPD often ENT-organ-related complaints – in the exacerbation period about 50% of patients, and at stable course – 43%. Patients most often complain on glottic incompetence with the most pronounced symptoms at COPD exacerbation. Decreased number of COPD exacerbations by 2 times in patients with high risk of their occurrence and improvement of ENT organ condition were noted if ENT diseases were timely treated. ENT specialist consultation should be provided at dispensary observation organization for patients with COPD in order to personalize the treatment plan depending on the clinical situation.Хроническая обструктивная болезнь легких (ХОБЛ) является заболеванием, сохраняющим устойчивые позиции в структуре заболеваемости и смертности у лиц старше 40 лет.Целью исследования явилась оценка состояния ЛОР-органов у пациентов с ХОБЛ в различные периоды течения заболевания с последующим анализом частоты обострений ХОБЛ по результатам изменения схемы терапии, согласно установленной коморбидной патологии.Материалы и методы. У больных ХОБЛ (n = 99) проведено обследование ЛОР-органов. Пациенты 1-й группы (n = 50) находились на лечении в пульмонологическом отделении Краевого государственного бюджетного учреждения здравоохранения «Владивостокская клиническая больница № 1» по поводу обострения заболевания; у амбулаторных больных 2-й группы (n = 49) отмечено стабильное течение ХОБЛ. Группу контроля (n = 50) составили никогда не курившие лица без заболеваний органов дыхания и слуха. Все обследованные были сопоставимы между собой по возрасту и полу. Через 6 мес. у пациентов (n = 72) с ХОБЛ стабильного течения проводилось повторное обследование.Результаты. Установлено, что пациенты 1-й и 2-й групп различались по выраженности симптомов заболевания, но имели одинаково высокий (> 2) риск обострений ХОБЛ в течение 1 года. В периоды обострений и стабильного течения ХОБЛ активно предъявляли жалобы на состояние ЛОР-органов соответственно 50,0 и 42,9% пациентов. Среди заболеваний ЛОР-органов наиболее частыми являлись заболевания гортани, обнаруженные у 84,0 и 73,5% пациентов при обострении и стабильном течении ХОБЛ соответственно. Хронический катаральный ринит и фарингит выявлены у 26 и 30% пациентов при обострении ХОБЛ (р < 0,01). Согласно данным 6-месячного наблюдения, при использовании у пациентов с ХОБЛ индивидуализированной программы лечения заболеваний ЛОР-органов в 2 раза уменьшилось число обострений ХОБЛ у лиц с высоким риском их возникновения, что положительно отразилось на состоянии ЛОР-органов.Заключение. По результатам исследования показано, что при ХОБЛ часто встречаются жалобы со стороны ЛОР-органов – в период обострения их предъявляют около 50% пациентов, а при стабильном течении – 43%. Чаще всего больных беспокоят нарушения голосовой функции с наиболее яркими проявлениями при обострении ХОБЛ. При своевременной терапии заболеваний ЛОР-органов отмечено 2-кратное сокращение числа обострений ХОБЛ у лиц с высоким риском их возникновения и улучшение состояния ЛОР-органов. При организации диспансерного наблюдения больных ХОБЛ с целью индивидуализации программы лечения в зависимости от установленной клинической ситуации необходимо предусмотреть консультацию врача-оториноларинголога.

Диагностика и мониторинг нейронального повреждения при тяжелой черепно-мозговой травме

Objective: to search for an accessible, valid, and easy-to-use method for the diagnosis and monitoring of a neuronal lesion in severe brain injury (SBI). Subjects and methods. Thirty-three patients aged 18—55 years with isolated SBI (the Glasgow coma scores for admission consciousness were 6±2) were examined; the serum content of neuron-specific protein S-100B was further analyzed. Results and discussion. The cell damage marker concentration was substantially increased in the acute period of brain injury. When the pathological process followed a favorable course, S-100B was considerably decreased just on day 2 of the disease. When the changes were negative, S-100B concentrations remained virtually unchanged or even increased, which was indicative of secondary brain reperfusion/ischemic lesions. The mean baseline marker level varied with the type of brain injury diagnosed by computed tomography; the highest figures being noted in the groups where significant brain tissue lesion was detected. Key words: severe brain injury, prognosis, S-100B protein.Цель исследования — поиск доступного, надежного и простого метода диагностики и мониторинга нейронального повреждения при ТЧМТ. Материалы и методы. Проведено обследование 33 пациентов с изолированной ТЧМТ в возрасте 18—55 лет (уровень сознания при поступлении в стационар 6±2 балла по ШКГ), с последующим анализом содержания нейронспецифического протеина S-100В в сыворотке крови. Результаты и обсуждение. Концентрация маркера клеточного повреждения значительно повышалась в остром периоде черепно-мозговой травмы. При благоприятном течении патологического процесса уровень S-100В значительно снижался уже на 2-е сутки болезни. При отрицательной динамике концентрация S-100В оставалась практически неизменной или даже повышалась, что свидетельствовало о вторичных реперфузионных повреждениях головного мозга. Показано, что средние значения начального уровня маркера различались в зависимости от вида ЧМТ, диагностированного КТ, причем наибольшие цифры отмечались в группах, где выявлялось значительное повреждение мозговой ткани. Ключевые слова: тяжелая черепно-мозговая травма, прогноз, белок S-100В

Risk factors for cardiovascular disease in ethnic Europeans and Koreans living in the Primorsky Krai

Aim. To study the prevalence of the main risk factors for cardiovascular diseases in young ethnic Europeans and Koreans permanently residing in the Primorsky Krai.Material and methods. The data of the ethnic Europeans (group 1) were taken from the ESSE-RF multicenter epidemiological study conducted in the Primorsky Krai (n=911); group 2 included ethnic Koreans (n=106), who underwent all clinical and laboratory tests used in ESSE-RF study. Subjects of both groups did not have cardiovascular disease. Biochemical assessment included total cholesterol (TC), low- and high-density lipoproteins (LDL and HDL), triglycerides (TG), apolipoprotein B (apoB) and A (apoA), lipoprotein (a), glucose, uric acid (UA) and creatinine. Both groups were divided into subgroups depending on the status of smoking and compared among themselves. Statistical processing included the Mann-Whitney test, the Kruskal-Wallis test and chi-squared test.Results. Both groups were in the same age range (p=0,44). The prevalence of smoking was 24,3% and 28,3% for the ethnic Europeans and Koreans, respectively (p=0,22). Among the European population, a higher body mass index (p>0,05) was noted. Systolic and diastolic blood pressure did not statistically differ (p>0,05), resting heart rate was significantly higher in group 1 (p<0,05). Second- and third-generation Korean immigrants compared with group 1 had significantly higher levels of TC, TG, apoB, non-HDL-C, LDL-C (p<0,001), while HDL-C, apoA and lipoprotein (a) rates did not have significant differences (p>0,05) between groups. In group 2, glucose, creatinine and UA values also had higher values (p<0,0001). In the Korean population in the group of former smokers, the values of systolic and diastolic blood pressure are significantly higher than those of active smokers and never smokers (p<0,05). Smokers of group 1 had a lower level of HDL-C, apoA (p<0,01) and higher levels of TG (p<0,05) and UA (p<0,01); in former smokers, UA and apoA values remained at the level of active smokers (p>0,05).Conclusion. It was shown that young ethnic Koreans had a higher values of laboratory parameters associated with cardiovascular risk (CVR) compared with ethnic Europeans, which should be taken into account when assessing CVR and requires the correction of preventive measures for cardiovascular disease. It was found that the body mass index is higher among active and former smoking in both cohorts compared with never smokers. Active and former smokers of the European ethnic group had a significantly lower apoA and HDL-C levels and higher TG and UA values. Thus, the study demonstrates the need to individualize the CVR assessment in people of different ethnic groups living in the same territory and to take into account the smoking status of both active and former smokers