It is well known, that the injury of organs and systems and also immunological rates considerably determine clinical course and the result of brucellosis. In the article are presented the results of examination of 120 patients with acute brucellosis. The control group included 30 practically healthy persons. Groups were representative by the age and sex. The diagnosis of brucellosis was set on the base of complaints, anamnesis, epidemiological and clinical data and the results of serological examination of the blood. All patients also underwent the fixation of interleukin -6, іinterleukin-4 and TLR-2 in the blood serum. The detailed epidemiological, clinical and immunological characteristic of patients with brucellosis was presented. Among examined persons prevailed men, persons of young able-bodied persons and rural dwellers. It was revealed, that the dominating way of transmission was the contact one. The highest level of infection was fixed among the workers of farm enterprises and veterinarians. The season features were also revealed, the highest level of morbidity was in summer-autumn period. The main clinical features were: fever, arthralgia, risen disposition to perspire, hepatosplenomegaly. It was revealed, that the level of pro-inflammatory interleukins considerably prevailed over the level of anti-inflammatory ones. Despite the high sensitivity of PCR diagnostics, the positive results in our research were received only in one third of patients.
Бруцельоз залишається глобальною проблемою для багатьох країн. Метою дослідження було визначення динаміки показників IL-4 та Il-6 у хворих на гострий бруцельоз під впливом лікування. Пацієнти і методи. Обстежено 178 хворих з клінікою гострого бруцельозу, які зверталися за медичною допомогою. Специфічні методи дослідження проводили методом ІФА з виявленням IgM та IgG. Згідно з критеріями включення в дослідження, зі 178 обстежених хворих повністю відповідало всім критеріям лише 120 осіб, які і склали основну групу. До контрольної групи увійшло 30 практично здорових осіб. Серед обстежених переважали особи чоловічої статі – 75,0 %. Середній вік пацієнтів з бруцельозом становив (35,9±2,8) року. Результати досліджень та їх обговорення. У хворих на гострий бруцельоз найчастіше виявляли наступні клінічні симптоми: гарячку – у 86,7 % осіб, загальну слабкість – у 87,5 %, пітливість – у 70,0 %, а також артралгії у 64,2 % пацієнтів. Тоді як найрідше хворі вказували на наявність міалгій – у 35,0 % та втрату маси тіла – у 25,8 % хворих. При об’єктивному обстежені було виявлено, що 77,5 % осіб мали ті чи інші проблеми з боку серцево-судинної системи, тоді як ураження статевої системи у вигляді орхіту мало місце лише в 1 хворого (0,8 %). Була встановлена достовірна різниця між показниками загального аналізу крові та біохімічних показників серед основної групи до та після лікування і здоровими особами. Так, виявлено, що рівень IL-4 в сироватці крові хворих на гострий бруцельоз до лікування становив (11,3±0,7), а рівень IL-6 – (15,3±1,4) пг/мл проти (15,3±1,4) та (8,5±0,9) пг/мл після терапії відповідно. Висновки. Рівні АЛТ та АСТ до лікування були в 1,7 та 1,9 разу вищими порівняно з показниками після терапії та в 1,9 і в 2,5 разу – порівняно з показниками контрольної групи. Рівні IL-4 та IL-6 були в 1,6 та в 1,8 разу вищими у хворих на гострий бруцельоз до лікування, та в 1,8 та в 2,0 рази вищими порівняно зі здоровими особами.
Currently, there are single data on the relationship between TLR-2 polymorphisms (Arg753Gln) and TLR-4 (Asp299Gly) polymorphisms and susceptibility to brucellosis. Therefore, the aim of the study was to determine the frequency of TLR-2 (Arg753Gln) and TLR-4 (Asp299Gly) polymorphisms in patients with acute brucellosis with cardiovascular lesions in the Republic of Azerbaijan. Materials and methods: 178 patients with a brucellosis clinic were examined. According to the criteria for inclusion in the study, only 120 people fully met all the criteria, which made up the main group. The control group consisted of 30 healthy individuals. TLR-2 (Arg753Gln) and TLR-4 (Asp299Gly) polymorphisms were also determined for all patients in both groups. In order to assess the state of the cardiovascular system, an electrocardiogram was recorded, blood pressure was measured, and an ultrasound scan of the heart was performed for all patients. Results: it was found that 93 patients (77.50±3.13 %) with acute brucellosis had some or other signs of impairment in the work of the cardiovascular system, identified clinically or as a result of functional examination. Among carriers of the Asp / Gly genotype of the TLR-4 gene, an increased risk of brucellosis with CVS diseases was determined (χ2=30.19; p <0.0001; OR=24.29; 95 % CI [5.45 – 108.37]), while the carriage of the homozygous genotype Asp / Asp, by contrast, had a protective effect on the development of brucellosis (OR=0.06, 95 % CI [0.02 – 0.20]). Among the carriers of the Arg / Gln genotype and the Gln / Gln genotype of the TLR-2 gene, a significantly increased risk of brucellosis with CVS diseases was determined (χ2=5.68; p=0.02; OR=3.10; 95 % CI [0.99 – 9.67]) and (OR=2.48; 95 % CI [0.53 – 11.61]), respectively. While the carriage of the homozygous Arg / Arg genotype, by contrast, was rarely seen in patients with brucellosis (OR=0.28, 95 % CI [0.10 – 0.74]). Conclusions: The Asp / Gly genotype of the TLR-4 gene was 12.7 times more frequently detected in patients with acute brucellosis with CVS diseases than in healthy individuals and 9.5 times more often than in patients without CVS diseases (p<0.05). The Arg / Gln genotype of the TLR-2 gene was 2.4 times more frequently detected in patients with acute brucellosis with CVS diseases than in healthy individuals (p<0.05).
Currently, there are isolated data on the relationship between IL-4 polymorphism (C-589T) and susceptibility to brucellosis. Therefore, the purpose of the study was to determine the frequency of polymorphism of IL-4 (C-589T) in patients with acute brucellosis. Materials and methods: the article presents the results of surveys of 120 patients with acute brucellosis. The control group consisted of 30 practically healthy persons. The diagnosis of brucellosis was based on complaints, anamnesis, epidemiological and clinical data, and the results of a specific study. The definition of the polymorphism of IL-4 (C-589T) was performed for all patients in the main and control group. A detailed description of patients with brucellosis is presented. Among the observed prevailed men and young people of working age. Results: A mild degree was established in 74 (61.66 %) patients, while severe - only in 11 (9.17 %) patients. It was determined that the genotype CT (65.83 %) was significantly more common among patients with brucellosis than in the control group, where the frequency of this genotype was only 16.66 %. While the CC genotype was 3.2 times more common among healthy individuals than among patients in the main group (76.67 % versus 24.17 %), it was found that the CC genotype of the IL-4 gene was 13 times more common in patients for acute brucellosis with mild progress than with severe. Conclusions: The genotype IL-4 (C-589T) SS is significantly associated with the mild course of brucellosis.
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