Vitovskaya O. P., Taha S. A., Bychkova N. G.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The purpose of the study was to investgate the features of the immune status and new possibilites for its correcton in patents with nonproliferatve diabetc retnopathy and type 2 diabetes mellitus. Object and methods of investgaton. We observed 87 patents with nonproliferatve DR (NRDR) and diabetes mellitus; the average age of which was 68.3 ± 2.1 years. All patents were examined during primary treatment and 1 month afer the start of therapy. Patents were divided into 2 groups: 42 patents received traditonal therapy (comparison group), and 45 patents (the main group) – in additon to traditonal therapy received ethylmethylhydroxypyridine in the form of «Мexicor» one ampoule (50 mg/ml) 2.0 ml intramuscularly once a day for ten days, then orally one capsule (100 mg) 3 tmes a day for one month. The control group consisted of 36 healthy individuals, randomized by age and sex. Immunological examinaton of patents included the determinaton of the main populatons and subpopulatons of peripheral blood lymphocytes, the level of expression of the actvaton antgens (CD25 +, CD95 +, CD54 +, CD11b +, CD62L +, HLA-DR +) on them, the functonal actvity of T- and B-lymphocytes, the phagocytc actvity of neutrophils, circulatng immune complexes of different molecular weight and the level of pro- and ant-inflammatory cytokines. Results and discussion. The use of ethylmethylhydroxypyridine succinate signifcantly reduced the relatve amount of CD95 + lymphocytes, which indicates the ant-inflammatory effect of this scheme, which was clinically manifested by a decrease in the progression of DR. In the patents of the main group, the increase in the stmulated proliferaton of T lymphocyte actvity by 10.74% (p> 0.1) was revealed in the treatment group, which indicates a restoraton of the sensitvity of the T cell receptor apparatus, as well as the normalizaton of spontaneous RBTL, whose level decreased by 15,77% (p <0,05), which, in turn, indicates a decrease in autoimmune manifestatons with constant antgen stmulaton with autoantgens of the eye tssue and a decrease in the degree of endothelial damage of the vessels as a manifestaton of type 2 diabetes. The treatment helped to eliminate the imbalance of the CEC – the patents of the main group had a signifcant decrease in the level of pathogenic CEC of medium size (11-19S) – by 16.22 (p <0.05), and small (<11S) – by 18.95% p <0.05), with a simultaneous increase in the concentraton of physiological CECs of large size (> 19S) by 26.47% (p <0.05). As a result of the treatment, a signifcant decrease in the level of proinflammatory cytokines was revealed in the main group of patents: TNF-α by 43.4% (p <0.05), IL-1β – by 40.68% (p <0.05), IL-6 – by 28.78% (p <0.05), TGF-β – by 47.26% (p <0.05), and an increase in the serum concentraton of ant-inflammatory IL-4 by 30.11% (p <0.05) to values that did not differ from the norm. Such a pronounced ant-inflammatory effect with a signifcant decrease in the level of pro-inflammatory cytokines is due to the effects of ethylmethylhydroxypyridine succinate – oppression of free radical oxidaton and improvement of endothelial functon parameters. Conclusions. Thus, we showed the clinical and immunological efcacy of including ethylmethylhydroxypyridine succinate in complex therapy of patents with nonproliferatve DR. A signifcant decrease in the level of actvated subpopulatons of lymphocytes ready to enter apoptosis was revealed, as well as the normalizaton of CEC concentraton of different sizes. Normalizaton of the level of proinflammatory cytokines and TGF-β has also been established, since it is their constant uncontrolled hyperproducton that is the key moment of subsequent damage to the visual organs in diabetes with the development of heavier forms of DR.

type 2 diabetes, nonproliferatve diabetc retnopathy, treatment, antoxidants

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«Bulletin of problems biology and medicine» Issue 1 Part 2 (143), 2018 year, 103-108 pages, index UDK 616.735-002-06:616.379-008.64]-097-085

10.29254/2077-4214-2018-1-2-143-103-108