Novosti
Khirurgii
This journal is
indexed in Scopus









Year 2012 Vol. 20 No 3

GENERAL AND SPECIAL SURGERY

V.A. KOSINETS

CHANGES IN THE IMMUNE SYSTEM AT GENERALIZED PURULENT PERITONITIS AND POSSIBILITIES OF THEIR CORRECTION

SEE HPE I.M.Sechenov First Moscow Medical University,
The Russian Federation

Objectives. To study the state of immune globulin and interleukin profiles of the blood serum in patients with generalized purulent peritonitis and a possibilities of correction of their changes by intracutaneous injections of the preparation Ronkoleukin.
Methods. The treatment analysis of 26 patients with generalized purulent peritonitis has been conducted. The influence of the intracutaneous injections of the preparation of recombinant interleukin-2 Ronkoleukin on the level of immune globulins and interleukins in the blood serum has been studied.
Results. In patients with generalized purulent peritonitis in the postoperative period the expressed changes in the immune system are observed, characterizing by the disimmunoglobulinemia phenomenon the decrease in the level of IgM, IgG and the general IgA on the background of the content increase of the secretory IgA in blood serum. From the 1 day of the postoperative period the unidirectional content increase of both the pro-inflammatory (Il-1β, Il-6, Il-8), and anti-inflammatory interleukins (Il-10) has been established on the background of the decrease in the level of regulatory mediators (Il-2, Il-4).
On the background of the conventional treatment the expressed pathological changes from the immune system remained on the 5 day of the postoperative period testifying to the continuing inflammatory process. At the same time in the main group of patients in whom the preparation Ronkoleukin was injected intracutaneously as the immune-correcting therapy during the indicated terms the studied parameters were approaching to normal levels or didnt differ from them.
Conclusions. The obtained data indicate the positive impact of the suggested scheme of immune-corrective therapy on immune globulin and interleukin profiles of the blood in a complex treatment of patients with generalized purulent peritonitis that is possible to regard as a productive immunotropic effect.
Thus, the intracutaneous injections of the preparation Ronkoleukin has been firstly proposed while treating generalized purulent peritonitis, which being rather simple in usage permits to reduce significantly the daily volume and duration of the preparation administration.

Keywords: generalized purulent peritonitis, Ronkoleukin, interleukins, immune globulins.
p. 36 42 of the original issue
References

1.Gostishchev VK, Sazhin VP, Avdovenko AL. Peritonit. [Peritonitis]. Moscow, RF: GEOTAR-Media; 2002. 238 p.
2. Savel'ev BC, Gel'fand BR, Filimonov MI. Peritonit: prakt ruk [Peritonitis: a practical guideline]. Moscow, RF: Litterra; 2006. 208 p.
3. Briskin BS, Khachatrian NN, Savchenko ZI. Immunnye narusheniia i immunokorrektsiia pri intraabdominal'noi infektsii [Immune disorders and immunotherapy with intraabdominal infections]. Khirurgiia. 2004;(2):2427.
4. Gel'fand EB, Gologorskii BR, Gel'fand BR. Abdominal'nyi sepsis: integral'naia otsenka tiazhesti sostoianiia bol'nykh i poliorgannoi disfunktsii [Abdominal sepsis: an integral assessment of the severity of patient state and multiple organ failure]. Anesteziologiia i Reanimatologiia. Saint-Petersburg, SSSR; 1998. 21 p.
5. Efimenko NA, Rozanov VE, Bolotnikov AI. Immunopatogenez i kontseptsiia sovremennoi immunoterapii peritonita u postradavshikh s tiazheloi sochetannoi travmoi zhivota [Immunopathogenesis and the concept of modern immunotherapy of peritonitis in patients with severe concomitant abdominal trauma]. Moscow, RF: AVTOGRAF, 2008. 302 p.
6. Gain IuM. Leonovich SI, Zavada NV, Alekseev SA, Rudenok VV, Shakhrai SV, Lunevskii AV. Immunnyi status pri peritonite i puti ego patogeneticheskoi korrektsii: ruk dlia vrachei [The immune status in peritonitis and the ways of its pathogenetic correction: a guideline for physicians]. Minsk, RB: Iunipress; 2001. 256 p.
7. Egorova VN, Smirnov MN. Novye vozmozhnosti immunoterapii s ispol'zovaniem Ronkoleikina rekombinantnogo interleikina-2 cheloveka [New possibilities of immunotherapy by using Roncoleukin - human recombinant IL-2]. TerraMedica. 1999;(2):1517.
8. Kozlov VK. Sepsis: etiologiia, patogenez, kontseptsiia sovremennoi immunoterapii [Sepsis: etiology, pathogenesis, the concept of modern immunotherapy]. Saint-Petersburg, RF: Dialekt, 2008. 296 p.
9.Atkinns MB, Mier JW. Therapeutic applications of Interleukin-2. New York, USA: Marcel Dekker; 1993. p. 389408.
10. Iarilin AA. Kozha i immunnaia sistema [The skin and the immune system]. Kosmetika i Meditsina. 2001;(2):513.
11. Streilein JW. Skin-associated lymphoid tissue. Immunol Ser. 1989;46:7396.
12. Jiang X., Clark RA, Liu L, Wagers AJ, Fuhlbrigge RC, Kupper TS. Skin infection generates non-migratory memory CD8+ TRM cells providing global skin immunity. Nature. 2012 Feb 29;483(7388):22731. doi: 10.1038/nature10851.
13. Anisimov AIu. Immunoterapiia Ronkoleikinom v kompleksnom lechenii bol'nykh abdominal'nym sepsisom : posobie dlia vrachei [Roncoleukin immunotherapy in complex treatment of patients with abdominal sepsis: A guideline for physicians]. Kazan', RF; 2004. 28 p.
14. Zhenilo VM, Kostriukov VK, Dudarev IV. Ekstrakorporal'naia immunofarmakoterapiia ronkoleikinom pri lechenii bol'nykh peritonitom [Extracorporeal immunopharmakotherapy by Roncoleukin in the treatment of patients with peritonitis]. Vestn Intensiv Terapii. 2010;(5):1920.
15. Kozlov VK, Lebedev MF, Egorova VN. Korrektsiia disfunktsii immunnoi sistemy ronkoleikinom [Correction of the immune system dysfunction by Roncoleukin]. TerraMedica. 2001;(2):1214.

Address for correspondence:
119991, Rossiiskaia Federatsiia, g. Moskva, ul. Iauzskaia, d. 11, GOU VPO Pervyi Moskovskii gosudarstvennyi meditsinskii universitet im. I.M. Sechenova, kafedra obshchei khirurgii,
e-mail: vkosinets@yandex.ru,
Kosinets Vladimir Aleksandrovich
Information about the authors:
Kosinets V.A., Candidate of Medical Sciences, Applicant for Doctors Degree of the Chair of General Surgery of I.M. Sechenov First Moscow State Medical University.
Contacts | ©Vitebsk State Medical University, 2007