PECULIARITIES OF CHANGES ОF IMMUNOREGULATORY SYSTEM OF WOMEN WITH BACKGROUNG PATHOLOGY OF UTERINE CERVIX (NA)

A comparative research of cytokines IL-1b, IL-4, IL-6, IL-8, INF-/, TNF-a and its concentration in cellular material suspension on surface of pseudo erosion of uterine cervix was carried out. It was clarified that inefficient activation of local protective factors of immune system plays the main role in clinical behavior of pseudo erosion of uterine cervix. Imbalance of cytokines output to pro-inflammatory factors was observed

Assessment of range of uric and serum biomarkers in determination of bladder cancer severity

Purpose: to establish efficiency of a range of uric and serum biomarkers of bladder cancer for diagnostics and the prognosis of risk of development of disease recurrence. Material and methods: TPA and TPS, VEGF level research in blood serum, UBC in urine in 176 people, among which 135 patients with bladder cancer (RMP) have been conducted. Group of comparison has included16 patients (patients with cystitis). The control group has been made of 25 almost healthy men. 75 patients had non-muscle invasive RMP (Ta-1N0M0). Results. It has been statistically determined that reliable growth of of TPA, TPS in blood serum and UBC in urine in patients with non-muscle invasive RMP in comparison with patients in groups of control and comparison has been established. The increase of UBC in urine of patients of this group with recurrence of tumoral growth within a year has been noted. In comparison with cytological research of urine sedimentation, molecular markers of RMP (the uric UBC and serum TPA, TPS) possess diagnostic sensitivity, allow to confirm the presence of disease, to carry out diagnostics of stages of organ and extra invasion. RMP is possible to consider as an additional prognostic serum marker increase in the VEGF level in blood serum. Conclusion. Inclusion in diagnostic process in the clinical research of biomarkers showed that identification of NMIRMP increased from 18,1% in 2006 to 55,6% in 2011. The chosen volume of complex treatment allowed to reduce recurrence and lethality in the first two years from 32 to 15,5%

The diagnostic value of biomarkers of inflammation, angiogenesis and fibrogenesis to assess the severity of urodynamic obstruction in children with congenital megaureter

The aim of the study is to determine the diagnostic value of urine biomarkers of inflammation (interleukin-1p, tumor necrosis factor-a), angiogenesis (vascular endothelial growth factor) and fibrogenesis (monocyte chemoattractant protein-1, matrix metalloproteinase-9) to assess the severity of urodynamic obstruction of the ureter. Materials and Methods — Complex investigation of 47 children with congenital nonrefluxing megaureter at the age from 1 month till 11 years is carried. Results. The correlation between the urine level of IL-1p and main laboratory criteria of inflammation occurred, so IL-1p as an integrative indicator of pyelonephritis activity was appeared. The relation between levels of VEGF and MCP-1 and indicators of renal hemodynamics allowed to consider increased levels of these factors as markers of irreversible nephrosclerosis. The urine level of MMP-9 was strongly correlated with parameters of peristalyic activity of the ureter. The group of children with lower peristalyic activity of the megaureter was significantly different from group with normal ureteral peristalsis by the high urine level of MMP-9. We do not have reliable data about the diagnostic value of determination of the urine level of TNF-a in children with congenital megaureter. Conclusion: The urine level of biological markers investigations are very important for clinical practice for determination of pyelonephritis activity (IL-1p), severity of ischemic deterioration of renal parenchyma (VEGF, MCP-1). Further studies are needed to clarify the pathogenic role of MMP-9 in the regulation of peristalyic activity of the ureter during embryonic and postnatal development in patients with congenital nonrefluxing megaureter

Urinary biomarkers in acute pyelonephritis

The aim of the study is a comparative evaluation of the diagnostic value of determining of concentration of cyto-kines in the serum and urine of patients with acute pyelonephritis. Materials and Methods: The study of cytokine profile in blood serum and urine has been performed in 21 patients with acute pyelonephritis aged from 23 to 63 years. The concentration of interleukin (IL-1 p, IL-6, IL-8, IL-10) receptor antagonist, IL-1 (IL-1RA), tumor necrosis factor — alpha (TNF-a), C-reactive protein (CRP), in serum and urine of patients under the survey have been determined by the enzyme-linked immunosorbent assay (ELISA) using the appropriate reagent sets «Vector-Best» (Novosibirsk). The study of all these biomarkers in patients with acute pyelonephritis has been performed three times: at admission before antibiotic therapy (1 point); in a 5-7 days-period from the beginning of treatment (2 points); 1.5 months after completion of treatment (3 points,). Results: Before the treatment there has been an increase in levels of IL-6, IL-8, IL-1RA, TNF-a, CRP in serum. Simultaneously, the concentration of these substances in the urine has been higher. In 2 and 3-point changes the level of cytokines has been different; however, the content of them in the urine has been determined to be higher than in the serum. Conclusion: Analysis of changes in levels of cytokines and C-reactive protein in serum and urine showed that these biomarkers in acute pyelonephritis may be used as indicators of inflammatory activity. The data received suggest that the study of cytokine levels in the urine may be used to assess the severity of inflammatory changes in the renal parenchyma and in monitoring of therapy effectiveness

State of renal hemodynamics and nephrofibrosis parameters in patients with nephrolithiasis applying angiotensin converting enzyme inhibitors

The aim of the study is to evaluate the influence of angiotensin converting enzyme (ACE) inhibitors of quinapril on the condition of renal hemodynamics, changes of profibrotic cytokines level and transforming growth factor at patients with nephrolithiasis undergone various kinds of surgery. Patients were divided into 2 groups initially and in 1 month after surgery. Concentrations of IL-6, TGFp and МСР-1 were determined in blood serum. Assessment of renal blood flow state by Doppler ultrasonography was performed in the same terms. As a result of quinapril treatment the decrease of МСР-1, TGFp and IL-6 was marked in comparison with the group which did not receive nephroprotective therapy. The analysis of Doppler ultrasonography data showed authentic improvement of renal blood flow in 1 month after surgery. The most informative parameter proved to be the resistance index that indicated the decrease of vascular resistance after surgical treatment in condition of quinapril therap

Biomolecular assessment of renal function in various types of surgical treatment of renal cell carcinoma

Objective: to assess the possibility of using the markers of acute kidney injury to predict the preoperative risk for the subsequent decline in glomerular filtration rate in different types of surgical treatment of renal cell carcinoma (RCC). Material and methods. 60 patients with histologically confirmed RCC T1-3M0N0 operated in the clinic of urology of Saratov State Medical University n.a. V. I. Razumovsky in the volume of nephrectomy or partial nephrectomy. Before surgery all patients underwent standard examination intended for patients with kidney tumors: ultrasound, MRI, excretory urography and dynamic renoscintigraphy, the perioperative values of serum creatinine and glomerular filtration rate were determined. Using the method of immuno-enzymatic analysis the concentrations of excreted with the urine NGAL and IL-18 in serum samples at the preoperative stage, after 5 days and after 1 month of postoperative follow-up were investigated. Differences in clinical data and clinical variables were compared by using Spearman rank correlations and t-test. Results. The determined parameters of acute kidney injury markers IL-18 and NGAL in the early postoperative period were increased in patients after open nephrectomy. Moreover, the correlation analysis according to the Spearman method revealed a strong significant correlation between the preoperative levels of IL-18 and GFR after surgery (r=1; p&lt;0.05). Conclusion. Laparoscopic resection of RCC is the method of choice for surgical treatment of RCC. As a predictor of adverse prognosis, the level of IL-18 in serum may be used. Its increase correlates with a decline in renal function in the postoperative period, and according to some reports, IL-18 also is an independent predictor of adverse prognosis in patients with a localized RCC.</p

Biomarkers of renal damage and immunohistochemical detection of oncogenesis in the surgical treatment of renal cell carcinoma

Objective: to assess the possibility of using markers of renal injury and carcinogenesis as additional criteria for the choice of the method of surgical treatment of RCC and to minimize the risk of development and progression of kidney injury. Material and Methods. 60 patients with morphologically confirmed RCC T1-3M0N0 operated on in the volume of open nephrectomy or laparoscopic nephrectomy or laparoscopic resection and the kidney were examined. Patients were divided into 3 groups: group 1: patients after nephrectomy performed for kidney cancer using traditional surgical technique, group 2: patients after laparoscopic nephrectomy and group 3: after laparoscopic resection of kidney tumor. Before surgical operation, on the 5-7 day and after 1 month, all patients were examined by concentrations of urinary excreted lipocalin 2 (NGAL), and serum concentrations of IL-18, MMP-9 and IGF-1. Renal function was estimated using the calculated GFR equation (CKD-EPI 2009) based on serum creatinine level. Immunohistochemical study of histological preparations of distant tumors on proliferation antibodies (Ki-67, PCNA), apoptosis (BAX, Bcl-2) was performed. Differences in clinical data and clinical variables were compared using Spearman rank correlations and t-test. Results. The studied indices of renal damage of IL-18, NGAL, MMP-9 and IGF-1 both in the early (5-7 days) and later (1 month) postoperative period showed a correlation between the surgical intervention method and the degree of tumor cell differentiation. Conclusion. The levels of biomolecular markers of renal damage (IL-18, NGAL, MMP-9 and IGF-1) correlate with the degree of differentiation in thetumoral cells and functional activity of the remaining renal parenchyma in the postoperative period, but also depend on the individual characteristics of the patient's body. A certain level of expression of MMP-9 and IL-18 with a small tumor size can be a guide to determine the indications for the choice of organ-preserving surgery in patients.</p

The differential approach to estimation of renal damage in the patients with nephrolithiasis by means of noninva-sive markers

The aim of this study was the estimation of clinical importance markers of renal damage at surgical treatment of nephrolithiasis. We studied results of operations in 110 patients with nephrolithiasis. The study presents new candidates for biochemical markers of acute kidney injury and renal interstitial fibrosis, with potentially high sensitivity and specificity. In this study were measured the concentrations of these biomarkers in urine. We suggested, that increased concentrations molecular mediators of renal damage (L2, IL-18) and interstitial fibrosis (MCP-1, TGFp, IGF1) in the patients with nephrophibrosis and strongetubulointerstitial injury, saved long-time period after operation, has been shown of progression chronic kidney diseas

The diagnostic importance of biomarkers of angio-genesis and inflammation at patients with prostate diseases

Purpose: to establish the nature of change of the maintenance of PSA and markers of angiogenesis and inflammation in blood serum at patients with prostate diseases. Material and Methods. 72 patients with the level of the general PSA more than 4 ju/ml were examined. The first group of patients with benign prostatic hyperplasia with histology conclusion and with benign prostatic hyperplasia and prostatic intraepithelial neoplasia of low degree included 29 patients, the second group consisted of 9 patients with prostatic intraepithelial neoplasia of high degree, the third group included 5 patients with the localized prostate cancer, the fourth group consisted of 25 patients with locally advanced prostate cancer, and the fifth group with 6 metastatic prostate cancer patients. Results. At patients with prostate diseases the rise of VEGF level in blood serum occurs with increase of the maintenance of PSA and develops at the precancer stage (the prostatic intraepithelial neoplasia of high degree) and against high concentration of biomarkers of inflammation. Determination of VEGF concentration in blood serum at patients with "a gray zone" of PSA may have clinical value at the personified maintaining of patients with prostate cancer at the stage of pre-biopsy diagnostics. Conclusion. The simultaneous increase of the VEGF content in blood serum and the general PSA at prostate cancer patients is one of characteristics of a progression of tumoral growth.</p

Modern methods of early diagnostics of juvenile arthritis

The problem of inflammatory diseases of joints is one of the most important issues in the pediatrics. Nowadays the significant attention in this sphere is paid to the search of new accurate criteria of diagnostics. It will help estimate the severity of disease, determine the prognosis, choose the method of treatment and monitoring and evaluate the efficacy of the therapy