Vol 70, No 1 (2015)

РATHOPHYSIOLOGY: CURRENT ISSUES
THE COMPARATIVE ANALYSIS OF AMYLOIDOSIS VARIOUS MODELS
Kozlov V.A., Sapozhnikov S.P., Sheptukhina A.I., Golenkov A.V.

Abstract

Considered natural and experimental amyloidosis models in the existing theories context and known amyloidogenesis mechanisms. Available clinical and experimental observations indicate that the opinion of a fatal incurable amyloidosis wrong. It is shown that there is a significant amount of experimental easily replicable amyloidosis models, which may be used for practicing the treatment methods of this pathology. We offer an amyloidosis models classification: natural (animal models with generic amyloidosis), cell clones, artificial (infectious, protein, etc.). Based on the analysis of amyloidosis existing models concluded — none of the accepted in the scientific the theories community for amyloid building does not combine or explains all known facts about the amyloidogenesismechanisms. It is assumed that there is a proteins group, the beta-sheet structure, which are potentially capable of amyloid conformation building. It is assumed that beta-sheets of these proteins have similar amino acid composition. The condition for the amyloid building conformation is getting too much protein in sufficient quantities in an uncharacteristic place where the ionic strength of the tissue fluid is such that it promotes the amyloid building conformation. It is assumed that an unfortunate amount of ionic strength environment amyloid protein is provided by polysaccharides, tubulins proteins and ionized silicon.

 

Annals of the Russian academy of medical sciences. 2015;70(1):5-11
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GLUTATHIONE-DEPENDENT ENZYMES AND GLUTATHIONE IN INFERTILITY OF MEN WITH DIFFERENT BODY MASS
Kolesnikova L.I., Vanteeva O.A., Kurashova N.A., Dashiev B.G.

Abstract

Objective: Our aim was to investigate the glutathione-disulfide system of antioxidant defense in men with different body mass index and infertility. Methods: 60 men with infertility were examined — 30 with normal weight and 30 with overweight. 30 fertile men were included in the control group. Hemolysate made from red blood cells was used as a material for study. The level of reduced (GSH) and oxidized glutathione (GSSG), and glutathione activity was determined by enzyme spectrofluorophotometer SHIMADZU-1501 (Japan). Results: In infertile men with normal body weight decrease of GSH to 15.35% was combined with a decrease in the activity of enzymes — glutathione reductase (GR) to 53.41%, glutathione peroxidase (GPO) to 51.44%, and increased activity of glutathione-S-transferaze (GST) to 31.52% as compared with the control group. In the group of infertile men with overweight a decrease in the activity of GR, 56.77% and 56.22% at the GPO on the background of a stable level of GST was detected in comparison with fertile men. The concentration of GSH in infertile group decreased by 20.08%, and the concentration of GSSG increased by 20.38%. Conclusion: It has been established that imbalance in the glutathione system is the most prominent feature in men with infertility and overweight as compared to infertile men with normal body weight.

Annals of the Russian academy of medical sciences. 2015;70(1):12-16
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INFLAMMATION AND BRAIN AGING
Salmina A.B., Komleva Y.K., Kuvacheva N.V., Lopatina O.L., Pozhilenkova E.A., Gorina Y.V., Gasymly E.D., Panina Y.A., Morgun A.V., Malinovskaya N.A.

Abstract

The review covers current concepts on cell and molecular mechanisms of neuroinflammation and aging with the special focus on the regulation of cytokine-producing activity of astroglial cells and intercellular communication. The review reflects that a key component of the aging phenomenon as a result of ineffective implementation of anti-inflammatory response are processes of the dysregulated cytokine production, in particular, an increase in the secretion of proinflammatory cytokines and an imbalance in the expression of the receptors and receptor associated proteins. Interpretation of the molecular mechanisms of cell conjugating neuroinflammation and aging cells can give rise to new therapeutic strategies that are relevant to the treatment of a wide range of central nervous system diseases and the development of new experimental models of diseases of the central nervous system.

 

Annals of the Russian academy of medical sciences. 2015;70(1):17-25
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ROLES OF DIFFERENT MACROPHAGE PHENOTYPES IN THE PATHOGENESIS OF SOME HUMAN DISEASES
Sakharov V.N., Litvitskii P.F.

Abstract

Macrophages have recently been shown to play a key role in promoting of recovery after some diseases as well as in aggravation of inflammatory responses, all the functions being resulted from microenvironmental conditions and therefore phenotypes acquired by macrophages in these conditions. In this article some protective functions of macrophages during infectious and oncologic diseases as well as pathogenic roles in a number of inflammatory diseases are reviewed. Much attention is devoted to opportunities of macrophage reprogramming.

Annals of the Russian academy of medical sciences. 2015;70(1):26-31
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PEDIATRICS: CURRENT ISSUES
OBSTRUCTIVE SLEEP APNEA SYNDROME IN CHILDREN AS A RISK OF CARDIOVASCULAR PATHOLOGY DEVELOPMENT
Kozhevnikova O.V., Namazova-Baranova L.S., Abashidze E.A., Altunin V.V., Balabanov A.S., Shirokova I.V., Kondrakhina I.I., Polunina T.A., Margieva T.V.

Abstract

Objective: Our aim was to examine the predictors of cardiovascular disorders in children affected by obstructive sleep apnea syndrome (OSAS) based on the results of polysomnography and continuous monitoring of blood glycose. Мethods: Before the examination, parents filled in questionnaires concerning their children sleep quality. The procedure was followed by the study of the sleep by means of polysomnography (Embla s 7000, USA). A system of continuous monitoring of blood glucose was applied (Guardianreal-time, Medtronicminimed, USA) by means of which a glycemic profile tissue fluid was studied. Results: A night sleep research of 120 children aged 3–16 y.o. is presented. There were 4 groups depending on the pathology: diseases of the nervous system (n =31), ENT-pathology (n =18), bronchial asthma (n =24) and overweight and obesity (n =34). The comparison group consisted of 13 apparently healthy children. The study has shown that the parents of every second child with sleep disorders did not know about the fact. The 60 % of the patients with high body mass index (BMI) had a snore, which was significantly higher the in children with normal body mass index — 35% (р =0.012). The index of apnea-hypopnea (AHI) was higher in the patients with ENT-pathology 17 times (p <0.001) and the patients with obesity 7 times (p <0.001) in comparison to the comparison group. In the analysis of the overall sample (n =120) was obtained significant negative correlation with heart rate variability and heart rate (r = 0.405; p <0.001). It is also shown that among 14 investigated children with OSAS only 8 had episodes of hypoglycemia (less than 3.3 mmol/l) during night sleep. All of them were with a high body mass index and with above average stature (>1sd). Conclusion: Children with ENT-pathology and with high high body mass index have high risk of cardio-vascular diseases. Children with above average stature and with increased body mass index affected by OSAS have additional backgrounds for cardiovascular diseases development as a result of the latent periods of hypoglycemia at night.

 

Annals of the Russian academy of medical sciences. 2015;70(1):32-40
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TOPICAL ISSUES OF FOOD ALLERGY DIAGNOSIS IN PEDIATRIC PRACTICE
Makarova S.G., Namazova-Baranova L.S., Vishneva E.A., Gevorkyan A.K., Alekseeva A.A., Petrovskaya M.I.

Abstract

Food allergy (FA) in children, especially in infancy, is still a significant public health problem. The severity and prognosis of disease progression associated with FA considerably depends on the correct and early diagnostics of this pathology, as well as on the following management of a child. At the same time delayed elimination diet administration, unreasonable or overlong dietary intervention might have become abuse management of a patient and have a negative impact on the development of a child and reduce the quality of life. The article summarizes the current practical approaches to the diagnosis of FA based on evidence-based medicine and adopted European and Russian national consensus documents, as well as on our own experience of management of patients with this pathology. FA diagnosis in a child usually includes clinical laboratory tests and clarification of clinical and anamnestic data. Unfortunately, it is a fact that preference is given to laboratory methods for diagnosis based on specific IgE determination or skin samples. However, the basis for cause-significant allergen identifying is detecting detailed medical history and clinical picture of a disease which still appears to be the most reliable tool for FA diagnosis.

 

Annals of the Russian academy of medical sciences. 2015;70(1):41-46
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ROTAVIRUS INFECTION: EPIDEMIOLOGY, PATHOLOGY, VACCINATION
Mayanskii N.A., Mayanskii A.N., Kulichenko T.V.

Abstract

Diarrheal infections remain the major cause of morbidity and mortality among children under 5 years of age. The rotavirus holds the leading position among principal diarrheal pathogens that include also norovirus, enteropathogenic and enterotoxigenic Escherichia coli. Rotaviruses are transmitted by the fecal-oral route and are extremely contagious and stable in the environment. This facilitates viral transmission, particularly in children daycare centers and hospitals. Rotavirus infection causes acute gastroenteritis with diarrhea and dehydration of various degrees resulting primarily from destruction of intestinal villus enterocytes with subsequent impairment of the ion transport and absorption. The incidence of rotavirus infection peaks during the winter and spring in countries with temperate climate. Many children have asymptomatic infection that supports rotavirus circulation in the population. Several vaccines have been developed for specific prophylaxis of rotavirus infections and demonstrated protection from severe acute rotavirus gastroenteritis and all-cause diarrheal mortality.

 

Annals of the Russian academy of medical sciences. 2015;70(1):47-55
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SURGICAL TREATMENT OF RARE COMBINATION OF INTESTINAL MALROTATION WITH SECONDARY LYMPHANGIECTASIA
Morozov D.A., Pimenova E.S., Tatochenko V.K., Bakradze M.D., Gadliya D.D., Morozova O.L., Talalaev A.G.

Abstract

The rare combination of intestinal lymphangiectasia with malrotation of the duodenum in a child of three months of life is described. Basing on the literature review only 3 similar cases were described in the world practice. The boy with protein-losing enteropathy was examined at Moscow Scientific Centre of Children’s Health. The child had vomiting, diarrhea, loss in body weight, hypoproteinemia, lymphopenia. The infectious nature of the disease was excluded. It had been suggested the Waldman desease (primary intestinal lymphangiectasia). The prognosis for such disease is unfavorable. An examination of the child was continued against the backdrop of ongoing symptomatic therapy. Complete physical examination included monitoring laboratory blood tests, X-ray examination with contrast, CT-scan, gastroduodenoscopy with biopsy of the mucosa of the small intestine. Malrotation duodenum with the recurrent mid-gut volvulus with the development of secondary intestinal lymphangiectasia was diagnosed. Modern methods of examination and multidisciplinary approach made it possible to diagnose the case. Operation to eliminate fixation duodenum resulted in the recovery of the patient. At the present time the child grows and develops according to age and does not require treatment. The prognosis for this disease is regarded as favorable.

 

Annals of the Russian academy of medical sciences. 2015;70(1):56-62
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MICROBIOLOGY: CURRENT ISSUES
PAST AND PRESENT OF STREPTOCOCCUS PYOGENES: SOME PATHOGENIC FACTORS AND THEIR GENETIC DETERMINATION
Totolyan A.A.

Abstract

In this review two aspects dealt with Streptococcus pyogenes — one of the leading agent responsible for infectious diseases and another related to their complications in humans worldwide — are given. In the first part of the review the comparative evaluation of laboratory diagnostic approaches and methods used in the second half of the twentieth century and molecular technologies developed during last twenty years are described. In the second part the role of the main microbial pathogenic factors as well as the data on intra- and interspecies genetic exchange with extrachromosomal genetic elements and their influence on biological properties of the pathogen are discussed. Essential for today possibilities for molecular epidemiology of streptococcal pathology approaches must be introduces in diagnostic laboratories within the country.

 

Annals of the Russian academy of medical sciences. 2015;70(1):63-69
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MOLECULAR-GENETIC CHARACTERIZATION OF SHIGA-TOXIN PRODUCING ESCHERICHIA COLI ISOLATED DURING A FOOD-BORNE OUTBREAK IN ST. PETERSBURG IN 2013
Onishchenko G.G., Dyatlov I.A., Svetoch E.A., Volozhantsev N.V., Bannov V.A., Kartsev N.N., Borzenkov V.N., Fursova N.K., Shemyakin I.G., Bogun A.G., Kislichkina A.A., Popova A.V., Myakinina V.P., Teimurazov M.G., Polosenko O.V., Kaftyreva L.A., Makarova M.A., Matveeva Z.N., Grechaninova T.A., Grogor'eva N.S., Kicha E.V., Zabalueva G.V., Kutasova T.B., Korzhaev Y.N., Bashketova N.S., Bushmanova O.N., Stalevskaya A.V., Chkhindzheriya I.G., Zhebrun A.B.

Abstract

Shiga toxin-producing Escherichia coli (STEC) food-borne infections are reported worldwide and represent a serious problem for public healthcare. In the Russian Federation there is little information on epidemiology and etiology of STEC-infections as well as on molecular-genetic peculiarities of STEC pathogens. Objective: Our aim was to describe a food-borne outbreak as hemorrhagic colitis (HC) along with hemolytic uremic syndrome (HUS), enterocolitis, and acute gastroenteritis in children in St.-Petersburg in 2013. Methods: Epidemiological, microbiological, molecular-genetic and bioinformatiс methods were applied. Results: Objects to study were clinical specimens, milk and food samples, as well as STEC strains isolated during the outbreak. The outbreak of food-borne infection was found to be caused by STEC-contaminated raw milk as confirmed by epidemiological analysis, detection of STEC DNA and isolation of relevant pathogens in milk and sick children fecal specimens. The whole-genome sequencing revealed two groups of pathogens, E. coli O157:H7 and E. coli О101:H33 among collected strains. Group I strains were attributed to the previously known sequence type ST24, while group II strains belonged to the previously non-described sequence type ST145. In strain genomes of both groups there were identified nucleotide sequences of VT2-like prophage carrying stx2с gene, plasmid enterohemolysin gene, and gene of the STEC main adhesion factor intimin. Gene of intimin gamma was identified in E. coli O157:H7 strains and intimin iota 2 in E. coli O101:H33 strains. The latter previously was identified only in enteropathogenic E. coli (EPEC) strains.Conclusion: The additional knowledge of epidemiology and biology of STEC pathogens would assist clinicians and epidemiologists in diagnosing, treating and preventing hemorrhagic colitis.

 

Annals of the Russian academy of medical sciences. 2015;70(1):70-81
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SHORT MESSAGES
RISK MANAGEMENT OF A PATIENT ON THE BASIS OF REMOTE HEALTH MONITORING: CURRENT SITUATION AND PROSPECTS
Namazova-Baranova L.S., Suvorov R.E., Smirnov I.V., Molodchenkov A.I., Antonova E.V., Vishneva E.A., Smirnov V.I.

Abstract

Review is dedicated to the problem of remote monitoring of health status. Existing approaches to the organization of an outdoor monitoring of a patient using telemedicine technologies are reviewed and analyzed. A new approach to risk management of a patient which meets the requirements of pediatric hospital is provided.

 

Annals of the Russian academy of medical sciences. 2015;70(1):82-89
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DIAGNOSTIC VALUE OF INTEGRAL SCORING SYSTEMS IN ASSESSING THE SEVERITY OF ACUTE PANCREATITIS AND PATIENT’S CONDITION
Vinnik Y.S., Dunaevskaya S.S., Antyufrieva D.A.

Abstract

Objective: The aim of the study was to evaluate the diagnostic value of specific and nonspecific scoring systems Tolstoy–Krasnogorov score, Ranson, BISAP, Glasgow, MODS 2, APACHE II and CTSI, which used at urgent pancreatology for estimation the severity of acute pancreatitis and status of patient. Methods: 1550 case reports of patients which had inpatient surgical treatment at Road clinical hospital at the station Krasnoyarsk from 2009 till 2013 were analyzed. Diagnosis of severe acute pancreatitis and its complications were determined based on anamnestic data, physical examination, clinical indexes, ultrasonic examination and computed tomography angiography. Specific and nonspecific scores (scoring system of estimation by Tolstoy–Krasnogorov, Ranson, Glasgow, BISAP, MODS 2, APACHE II, CTSI) were used for estimation the severity of acute pancreatitis and patient’s general condition. Effectiveness of these scoring systems was determined based on some parameters: accuracy (Ас), sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). Results: Most valuables score for estimation of acute pancreatitis’s severity is BISAP (Se — 98,10%), for estimation of organ failure — MODS 2, (Sp — 100%, PPV — 100%) and APACHE II (Sp — 100% PPV — 100%), for detection of pancreatonecrosis sings — CTSI (Sp — 100%, NPV — 100%), for estimation of need for intensive care — MODS 2, (Sp — 100%, PPV — 100%, NPV — 96,29%) and APACHE II (Sp — 100%, PPV — 100%, NPV — 97,21%), for prediction of lethality — MODS 2, (Se — 100% Sp — 98,14%, NPV — 100%) and APACHE II (Se — 95,00%, NPV — 99,86%). Conclusion: Most effective scores for estimation of acute pancreatitis’s severity are Score of estimation by Tolstoy–Krasnogorov, Ranson, Glasgow and BISAP. Scoring systems MODS 2, APACHE II high specificity and positive predictive value allow using it at clinical practice.

 

Annals of the Russian academy of medical sciences. 2015;70(1):90-94
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PROSTATE CANCER: PAPILLOMAVIRUSES AS A POSSIBLE CAUSE
Volgareva G.M.

Abstract

Prostate cancer (PC) incidence and mortality are steadily increasing. Causation of PC is not clearly understood; in particular, role of human papillomaviruses (HPV) is still disputable. The review contains analysis of literature data on possible participation of HPV, powerful biological carcinogens, in PC genesis. PC incidence increase in persons with immunodeficiency indicates involvement of some infectious agent in the disease etiology. Several research groups communicated HPV DNA finding including that of oncogenic types in PC specimens (transrectal biopsies). There are limited data on the occurrence of oncogenic HPV 16 oncoprotein E7 in such specimens and on its unfavorable effect on disease prognosis. The successful attempt is known to transfect normal human prostate cells with oncogenic HPV DNA in vitro. Epidemiological data on associations of PC with HPV are controversial. It may result from the considered in the present review certain technical peculiarities of these studies. Сontrol for serum antibodies to HPV E6 and E7 oncoproteins recognized to indicate HPV-positive tumor growth in an organism has not been performed yet in PC patients. DNA of oncogenic HPV is rather commonly found in organs adjacent to prostate — urethra, rectum, urinary bladder. In the study held in Russia on a group of healthy men examined for sexually transmitted diseases genitourinary HPV infection was found in every second person; 42% of them harbored oncogenic HPV. Possible participation of oncogenic HPV in PC genesis deserves close attention and further study.

Annals of the Russian academy of medical sciences. 2015;70(1):95-100
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HYPOPHYSIS-ADRENAL AND THYROID SECRETION AT LAW ORDER STAFF IN DEPENDENCE FROM PROFESSIONAL LOADING
Kubasov R.V., Barachevskii Y.E., Ivanov A.M.

Abstract

Background: A current etiological and pathogenic opinion about human health disturbance thereupon extreme factor effects is shown that this cause is principal mechanism of regulatory system (neuroimmunoendocrine complex) distress. In endocrine link occurs hormonal disbalance in hypothalamus-hypophysis axis, physiological interrelation disturbances in central – peripheral gland system (hypophysis-adrenal, hypophysis-thyroid) and metabolism abnormalities subsequently. Objective: Our aim was to determine the particular content of adrenocorticotropic and thyrothrophin hormone, cortisol, thyroxin and triiodthyronine features at law order staff in dependence from professional loading. Methods: It’s provided two investigation series among law order staff groups — combatants, ordinary policemen and military school students. The investigation period for all people corresponds to combat mission beginning and its finish. In blood serum an adrenocorticotropic (ACTH) and thyrothrophin (TSH) hormone, cortisol, thyroxin (Т4) and triiodthyronine (Т3) levels were determined. Results: A higher ACTH and TSH levels detected at combatants in both investigation series. A cortisol, Т4 and Т3 at combatants before military mission were least in comparative with other groups, but after mission it indexes were largest. Conclusion: Prolonged changes of endocrine secretory function that lead to hormonal disbalance can result to adaptation derangement. In connection with it in medical providing system for person that undergo extreme negative professional factors it’s necessary create a special endocrine link  with the view of organism resistance and life viability to extreme emergency factors and for prevention of pathological conditions.

 

Annals of the Russian academy of medical sciences. 2015;70(1):101-105
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MECHANISMS OF HYPOXIA DEVELOPMENT DURING PREGNANCY AND THE DISORDER OF FETUS BLOOD SUPPLY AT CYTOMEGALOVIRUS INFECTION
Lutsenko M.T., Andrievskaya I.A., Ishutina N.A., Mironenko A.G.

Abstract

Objective: Our aim was to study the mechanisms of hypoxia development at pregnancy associated with cytomegalovirus infection (CMVI). Methods: 30 parturient women with CMVI relapse at the 25–28 weeks of pregnancy and their newborns were examined. Cytochrome C, Hsp-70, p53, Bcl-2 and caspase-3 in placenta homogenate were found out with serologic methods, the morphology of erythrocytes with cytophotometry, erythrocytes membrane proteins with disc-electrophoresis method, TBA-active products with V.B. Gavrilov’s method, superoxide dismutase activity with
spectrophotometry, 2.3-diphosphoglyceric acid (2.3 DPG) with I.S. Luganov’s method, erythrocytes membrane microviscosity with fluorimethric method, oxyhemoglobin and methemoglobin with Evelyn and Malloy’ method, and erythrocytes deformability with M.T. Lutsenko’s method. Results: In blood erythrocytes of CMV-seropositive parturient women there was the decrease of cytoskeleton proteins: α- and β-spectrine was
1.14 times less, ankyrin was 1.62 times less, band 4.1 protein was 1.29 times less; there was 1.87 times increase of antigen-binding glycophorin, 1.37 times growth of TBA-active products and 1.35 times drop of superoxide dismutase activity; the deformability index was 9.5 times less, 2.3 DPG was 1.22 times less and oxyhemoglobin was 1.06 times less. In placenta homogenate Bcl-2 was 1.5 times less, Hsp-70 was 2.5 times more, p53 was 6.1 times more, cytochrome C was 1.76 times more, caspase-3 was 3.86 times more. In umbilical cord blood erythrocytes 2.3 DPG was 1.3 times more and oxyhemoglobin was 1.06 times less. Conclusion: The obtained data  proves that CMVI relapse at 25–28 weeks of pregnancy causes the disorder of morphofunctional state of mother’s blood erythrocytes and their ability to oxygenation, the development of fetoplacental barrier, the decrease of fetus oxygen blood supply and the development of intrauterine hypoxia.

 

Annals of the Russian academy of medical sciences. 2015;70(1):106-112
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THE INFLUENCE OF THE THYMUS PEPTIDES ON ANALGESIA CAUSED BY ACUTE AND CHRONIC IMMOBILIZATION
Novoseletskaya A.V., Kiseleva N.M., Belova O.V., Zimina I.V., Inozemtsev A.N., Arion V.Y., Sergienko V.I.

Abstract

Objective: Our aim was to investigate the influence of thymic polypeptides on pain sensitivity and to analyze a possible role of the opioid system in the implementation of the analgesia caused by immobilization stress. Methods: The study was performed on male Wistar rats at the Moscow state University named after M. V. Lomonosov. We studied effects of thymus peptides: thymuline (0.15 mg/kg), fraction 5 thymosin (0.25 microgram/kg) and tactivin (0.5 mg/kg) on pain sensitivity in rats using test «tail flick» without stress, with acute (3 h) and sub acute (12 h) immobilization stress. The comparison groups were animals treated with saline and spleen polypeptides. Results: It is shown that preparations of thymus increase the threshold of pain sensitivity in the intact animals. Immobilization stress duration 3 and 12 h in thymus peptides treated rats caused a less pronounced increase in pain threshold than in the control groups (immobilization stress 3 h: tactivin — р=0.025, thymuline — р=0.022, fraction 5 thymosin — р=0.033; immobilization stress 12 h: tactivin — р=0.034, thymuline — р=0.027, fraction 5 thymosin — р=0.036.). The opioid receptor blocker naloxone (1 mg/kg) did not completely block the stress-induced analgesia, indicating the presence of both opioid and non-opioid components in this state. In thymus peptides treated rats, opioid component was less pronounced than in the control groups (tactivin — р=0.031, thymuline — р=0.026, fraction 5 thymosin — р=0.029). Conclusion: Pre-activation of the opioid system by the thymus polypeptides leads to an increase in the share of non-opioid component of the stress-induced analgesia and prevents the depletion of the opioid system in immobilization stress.

 

Annals of the Russian academy of medical sciences. 2015;70(1):113-117
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DYNAMICS OF PAIN TOLERANCE THRESHOLDS AND HUMORAL IMMUNITY FACTORS AT DORSALGY
Polyvyanaya O.Y., Levashova A.I., Morozova V.S., Petrochenko S.N., Myagkova M.A., Moseikin I.A.

Abstract

Objective: Our aim was to study the possible markers of pain syndrome — indicators of pain sensitivity — pain pressure tolerance thresholds (PPTT), and immuno-indicators — natural antibodies against pain processing mediators (eAb) for evaluation the possibility of its using for a objective pain assessment at chronic low back pain. Methods: Pain sensitivity was assessed daily and nightly, by measuring the PPTT. The natural antibody levels (eAb), were determined in serum by ELISA. Measurement of all parameters were performed at 1st, 10th and 21th days. Results: 173 patients (93 women and 80 men) with chronic low back pain were included in the study. At 1st day most patients had lowered PPTT: 55% of men and 74% during the day, 72% of men and 89% of women at night. Dynamic study has shown a tendency of PPTT normalization in men. The study of diurnal PPTT variations have shown that night PPTT lower than day PPTT on 15–17%. We found gender PPTT differences: PPTT values in women 1726% lower than in men. Analysis of individual eAb profiles has showed that elevated and high levels of eAb to β-endorphin, orphanin and histamine have 84%, 78%, 84% women and 82% 85 and 95% men, respectively. These indicators higher than those for serotonin, dopamine and angiotensin (55%, 65%, 70% in women and 65%, 66%, 66% in men, respectively; p <0.05). Dynamic study of eAb levels have shown a significant anti-histamine eAbs decrease (23%; p =0.015) only. Conclusion: The pathological changes in pain sensitivity and levels of eAbs to pain-processing mediatos are evidenced. Further investigations are necessary to clarify to role of these variations in pain processing and for use these indicators for objective pain assessment.

 

Annals of the Russian academy of medical sciences. 2015;70(1):118-124
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