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We developed an experimental model of a cyclic feeding regime (CFR) that increased a lifespan in rats. The manifestations of oxidative stress and their interrelation with parameters of cell immunity were assessed in rats at CFR. It is shown that changes of body mass, liver mass and indexes of pro/antioxidant system after periods of starving-ad libitum nutrition at CFR diet in old animals were less pronounced than in young animals. The body mass loss of 30% in 14 days was accompanied by oxidative stress. Indexes of phagocytosis did not change, but activity of oxidase system of neutrophil was increased in 2 times. The response of metabolic and physiological systems on repeat starving-ad libitum nutrition cycles differs from the response to the initial cycle of CFR. This is interpreted as a change of adaptation strategy and the effect of metabolic memory, which influences the choice of organism strategy of adaptation for subsequent starving. The dynamics of change of the studied indexes in response to CFR was age-dependent. It was supposed that different answer to CFR in young and old animals is determined by the different amount of carbon and fat depots in young and old animals.

Summary. The aim is to assess the presence of specific markers in patients with thymus-independent and thymus-dependent myasthenia gravis for choosing treatment tactics. Materials and methods. The presence of specific markers was assessed in 138 patients with thymus-independent (M – myasthenia gravis without thymus changes) and thymus-dependent (MH – myasthenia gravis with thymus hyperplasia, MT – myasthenia gravis with thymoma) for the choice of treatment tactics. We used methods of enzyme immunoassay, spectrophotometry, light and fluorescence microscopy. Results and discussion. The relationship between the clinical phenotypes of myasthenia gravis and the variants of HLA leukocyte antigen diplotypes was revealed: in young patients with thymus-independent myasthenia gravis (M), a high heterogeneity of the genotypic markers HLA-DR (DR1, DR2, DR3, DR5, DR7) was observed. Patients with thymus-dependent myasthenia (MT) had only the HLA DR2 and HLA DR7 diplo- and haplotypes. The presence of HLA DR2 and HLA DR7 haplotypes and certain changes in the complex of biomarkers (anti-nuclear antibodies, innate immunity and humoral sensitization) in some young patients with M with disease progression led to the development of myasthenia gravis with thymoma (MT) at an older age. Conclusions. The prognosis of the progression of myasthenia gravis and the development of remission can be made using genomic (the presence of certain HLA-DR haplotypes) and molecular (anti-nuclear antibodies ANA, different fractions of medium molecular weight peptides, circulating immune complexes) biomarkers, that can be used for the choice of treatment tactics.

Вивчено вміст TNF-α, IL-2, IL-8 в крові у 162 хворих з гнійними ранами. Встановлений позитивний зв'язок між концентрацією прозапальних цитокінів та об'ємом і площею ран, виявлено зниження рівня цитокінів при хронізації загоєння. Застосування озонобаротерапії у комплексному лікуванні хворих сприяло поліпшенню результатів лікування та нормалізації рівня цитокінів при хронізації ранового процесу Ключові слова: гнійні рани кінцівок, озонобаротерапія, бактеріофаг, хірургічнелікування Foundation. One of the mechanisms of ozone effect is its impact on immune state of organism. The work is devoted to study of peculiarities of the state of proinflammatory cytokines at the complex treatment of patients with festering diseases and wounds of limbs. Materials and methods. It was examined and treated 162 patients with festering diseases and wounds of limbs. In the main group 87 patients underwent treatment with ozonebaro-and ozonetherapy, and in the group of comparison 75 patients were treated according to accepted standards. It was studied the content of proinflammatory cytokines TNFα, Il-2, Il-8 in the blood of patients with festering wounds in both groups depending on the volume and area of wounds in the dynamics of treatment. Results. Studying the group of comparison it was established a positive connection between the concentration of TNFα, Il-2, Il-8 and the volume and area of the wound process. It was revealed that hyperactivity of organism that led to the "necrotic" script of development of an alternative phase of the wound process was one of the causes of large necrosis. At chronization of the wound process the level of cytokines decreased on the 15 day comparing with patients with a smooth clinical course that indicated the decrease of reactivity of organism. The offered medical and diagnostic algorithm of the treatment patients using ozone-and ozonebarotherapy favored an improvement of the results of treatment and fastened the healing of wounds. In analysis of the level of cytokines in patients of the main group it was revealed that at the high levels of proinflammatory cytokines the use of the offered methods of treatment favor the decrease of its level and at chronization (with the low level of cytokines) its concentration increases. So the use of ozonebaro-and ozonetherapy leads to normalization of immune response and diminishes the probability of chronization of the wound process. Conclusions. The study of the level of proinflammatory cytokines allows evaluate the clinical course of the wound process objectively, to reveal the tendency to its chronization. The use of ozonebaro and ozonetherapy leads to normalization of immune response at the too high or too low levels of IL-2, IL-8, TNF and diminishes the probability of chronization of the wound process. The data received during the research indicate an efficiency of the offered methods of treatment

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Ключевые слова: стопа диабетика, сахарный диабет, комплексное лечение Ключові слова: стопа діабетика, цукровий діабет, комплексне лікування

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