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Biomarkers of Systemic Inflammation in Local and Diffuse Peritonitis
Biochemistry (Moscow), Supplement Series B: Biomedical Chemistry Pub Date : 2021-05-14 , DOI: 10.1134/s1990750821020074
E. V. Mikhalchik , I. V. Borodina , I. V. Vlasova , T. V. Vakhrusheva , N. P. Gorbunov , O. M. Panasenko , S. M. Titkova , M. V. Anurov , G. B. Ivakhov , I. V. Ermakov , A. V. Teplyshev , D. V. Klinov

Abstract

The progression of purulent inflammation in any acute surgical abdominal pathology can lead to local or diffuse peritonitis. The parameters characterizing the degree and specificity of the inflammatory response in blood such as cytokine concentration, neutrophil activity, plasma antioxidant capacity (thiols concentration) could be considered as potential predictors of complications. The luminol-dependent chemiluminescence (CL) response of blood activated by the phorbol ester (PMA), levels of cytokines IL-6, IL-8, IL-10, myeloperoxidase (MPO) and thiols were measured in plasma of patients with uncomplicated conditions (group 1, n = 8), local peritonitis (group 2, n = 9) or diffuse peritonitis (group 3, n = 9) at admission (before surgery, b/s), immediately after surgery (a/s) and a day after surgery (1 day) as well as in healthy volunteers (norm, n = 12). At all time-points the concentrations of cytokines and MPO measured by the ELISA method, in group 3 were higher than in healthy volunteers and in patients in groups 1 and 2. Blood CL demonstrated a more than 5-fold increase above the normal values in all patients, and it was also higher in group 2 as compared to group 1. In group 3 there were patients with both maximal and minimal CL values, which could be a consequence of neutrophil priming or exhaustion (“immune paralysis”), respectively. In these patients the plasma thiol content demonstrated a more than 3-fold decrease below normal values. In patients with fatal outcomes (group 3, n = 2) within a day after surgery, either a decrease of the CL to zero values concurrently with elevated IL-8 and IL-6 concentrations and low thiol levels was observed, or CL exceeded normal values more than 20 times with concurrent complete exhaustion of the plasma thiol pool. No clear dependency between the plasma parameters and neutrophil activity was found. This suggests that a panel of parameters for prognosis and/or early diagnostics of infectious complications in acute abdominal pathology should include different biomarkers of the inflammatory response: cytokine profile (IL-6, IL-8, IL-10), MPO and neutrophil activity, antioxidant plasma capacity (e.g., total thiols concentration).



中文翻译:

局部和弥漫性腹膜炎中全身性炎症的生物标志物

摘要

在任何急性外科腹部疾病中化脓性炎症的进展都可能导致局部或弥漫性腹膜炎。表征血液中炎症反应的程度和特异性的参数,例如细胞因子浓度,中性粒细胞活性,血浆抗氧化能力(硫醇浓度),可以被认为是并发症的潜在预测指标。在病情复杂的患者血浆中,测定了由佛波酯(PMA)激活的血液的鲁米诺依赖性化学发光(CL)反应,细胞因子IL-6,IL-8,IL-10,髓过氧化物酶(MPO)和硫醇的水平(第1组,n = 8),局部腹膜炎(第2组,n = 9)或弥漫性腹膜炎(第3组,n= 9)入院时(手术前,b / s),手术后立即(a / s)和手术后一天(1天)以及健康志愿者(正常,n = 12)。在所有时间点上,第3组中通过ELISA方法测得的细胞因子和MPO浓度均高于健康志愿者以及第1和第2组患者。血液CL值显示比正常值高5倍以上。所有患者,并且与第1组相比,第2组也更高。在第3组中,CL值既有最大值又有最小值,这可能分别是中性粒细胞引发或疲惫(“免疫麻痹”)的结果。在这些患者中,血浆硫醇含量显示低于正常值三倍以上。在具有致命结果的患者中(第3组,n= 2)在手术后一天之内,观察到CL降至零值,同时IL-8和IL-6浓度升高,硫醇水平低,或者CL超过正常值20倍以上,同时完全耗尽血浆硫醇池。血浆参数和中性粒细胞活性之间没有明确的依赖性。这表明急性腹腔病理中感染并发症的预后和/或早期诊断的一组参数应包括炎症反应的不同生物标志物:细胞因子谱(IL-6,IL-8,IL-10),MPO和嗜中性白细胞活性抗氧化剂血浆容量(例如总硫醇浓度)。

更新日期:2021-05-14
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