Considering a stage of the pathological process patients (boys at the age of 8-12 years) were divided into two (2) groups. Group I included 14 patients with the fragmentation stage (Perthes disease Stage II). Group 2 included 15 children with Perthes disease Stage III (the stage of re-ossification). Perthes disease regardless of the stage of the disease was characterized by the increase in oxygen-dependent and lysosomal phagocytic activity of neutrophils, the increase in the number of early extracellular traps, as well as by increased concentrations of pro-inflammatory cytokines (IL-1β and TNFa), IgE, decreased concentrations of IL-18. The fragmentation stage was characterized by moderate activation of cellular immunity with a prevailing increase in the number of T-lymphocytes with early activation markers (CD25). At the re-ossification stage the predominance of T-lymphocytes was observed with late activation markers (HLADR), being accompanied by moderate activation of humoral immunity (increased concentrations of class A and G serum immunoglobulins). The obtained data can be used as additional criteria for clarifying Perthes disease stage, predicting osteonecrosis development when making decision of the feasibility of performing reconstructive surgeries on the joint.
Целью нашей работы было изучить гематологические показатели крови кроликов в динамике после замещения костного дефекта ксеноматериалами на основе костного матрикса лошади. Исследование выполнено на 18 кроликах-самцах породы Шиншилла в возрасте от 6 до 10 месяцев. Животные были поделены на три группы (I -без заполнения костного дефекта, II -заполнение дефекта материалом на основе ксеноматрикса лошади, III -заполнение дефекта ксеноматриксом лошади совместно с комплексом антибактериальных препаратов). Забор крови производили венепункцией краевой вены уха. Гематологические показатели крови определяли на соответствующих сроках эксперимента (дооперационный уровень, 3-и, 7-е, 14-е, 30-е сутки после операции). Согласно результатам проведенного исследования у экспериментальных животных наблюдали умеренную эритроцитопению и лейкоцитоз, снижение концентрации гемоглобина и повышение концентрации тромбоцитов относительно дооперационных значений. Выявленные незначительные сдвиги в показателях периферической крови в раннем послеоперационном периоде связаны с ответной реакцией организма на оперативное вмешательство. Результаты исследования показали, что воспалительный процесс при заполнении костных дефектов ксеноматриксом лошади не выходил за рамки общего адаптационного синдрома, развивающегося после оперативного вмешательства.Ключевые слова: имплантационный материал, ксеноматериал, костный дефект, гематологические показатели крови The aim of our work was to study the blood hematological values of rabbits dynamically after bone defect filling with xenomaterials based on the horse bone matrix. 18 male Chinchilla rabbits at the age of 6-10 months were used in the study. The animals were divided into three groups (I -without bone defect filling, II -the defect filling with the material based on the horse xenomatrix, III -the defect filling with the horse xenomatrix together with a complex of antibacterial preparations). Blood sampling was performed by venipuncture of the regional ear vein. Hematological blood values were determined at the appropriate periods of the experiment (preoperatively, 3, 7, 14, 30 days after surgery). According to the results of the performed study, the experimental animals demonstrated moderate erythrocytopenia and leukocytosis, the decrease in hemoglobin concentration and the increase in blood platelet concentration. The identified insignificant shifts in peripheral blood values in the early postoperative period are associated with the organism's response to surgical intervention. As the study results demonstrated, when bone defect filling with the horse xenomatrix the inflammatory process did not go beyond the general adaptation syndrome developing after surgical intervention.
Purpose: To Study immune status in patients with coxarthrosis consequent to treatment of congenital hip dysplasia and Perthes' disease as well as to determine additional variables indicating arthrosis progression.Materials and methods: The authors analyzed results of preoperative immune examination of 13 male patients aged 11,4±0,7 years (10-13) with coxarthrosis of type I-II developed consequently to treatment of hip dysplasia and Perthes' disease. Based on obtained anatomical and functional outcomes the authors divided the patients into two groups. First group included 8 patients with postoperative improvement of joint function and absence of disease progression. Second group (5 patients) was featured by functional deterioration and arthrosis advancing.Results: Patients of the second group demonstrated statistically significant elevation in certain parameters of humoral (circulating immune complex) and cellular immunity (CD3+HLA-DR (%), CD3+HLA-DR (109/l)) as well as interleukin-6.Conclusion: Obtained results have proven that initial immune parameters (IL-6, circulating immune complex, lymphocytes with activation markers) can be used as additional variables for decision making in regard to option and advisability of reconstructive joint preserving procedures in patients with coxarthrosis consequent to treatment of hip dysplasia and Perthes' disease.
Objective Assess the immune status of children with ischemic deformity of the proximal femur taking into account the treatment outcome. Material and methods Preoperative assessment of the immune status was performed for 16 adolescents with ischemic deformity of the proximal femur. Patients' age was 14.4 ± 0.45 years. Immunological parameters of 12 adolescents with satisfactory (group I) and 4 patients with poor (group II) anatomical and functional outcome of surgical treatment were compared. Peripheral blood lymphocyte typing was produced with laser cytometry assay, and IgA, IgM, IgG, IgE, IL-18, IFNγ and circulating immune complexes were quantified with enzyme-linked immunoassay. Results Сomparative analysis of preoperative immunological parameters showed statistically significant decline of Т-helper cells (СD3+СD4+), high levels of activated СD3+CD25 and СD3+HLADR T lymphocytes, low levels of activated NК cells (СD8dimCD38+) and IFNγ in group II. Humoral immune parameters indicated to low levels of IgA, IgM, IgG and higher levels of circulating immune complexes in group II relative to group I. Conclusion Preliminary data obtained suggest that cellular and humoral immune deficiency can be associated with unfavorable outcome of joint preservation procedure. Such immunological parameters as T lymphocytes subpopulation, immunoglobulins, circulating immune complexes and IFNγ can be used as significant prognostic factors for preoperative planning and postoperative rehabilitation of adolescents with ischemic deformity of the proximal femur.
Degenerative-dystrophic processes in the articular tissues are accompanied by the changes in the values of congenital immunity, being a result of immune responses to aseptic inflammation. The purpose of this study - to investigate the oxygen-dependent mechanisms of neutrophil phagocytic activity (NBT-test, myeloperoxidase activity), the biochemical values of lipid peroxidation, the oxidative modification of proteins and the activity of enzyme antioxidant protection in children (at the age of 12-16 years) with osteochondropathy of the femoral head.The increase in spontaneous NBT-test and myeloperoxidase content in neutrophils, the decrease in NBT stimulation index, as well as the statistically significant increase in the activity of superoxide dismutase, the main producer of hydroperoxide, was revealed in the group examined. At the same time, no increase in catalase activity and in the content of lipoperoxidation products was observed, however, redistribution of the products of oxidative modification of proteins with ketone predominance was found. In case of osteochondropathy development in children the activation of the oxygen-dependent mechanisms of neutrophil phagocytic activity is observed, as well as the increase in the number of the secondary products of protein peroxidation - ketones. An increase in SOD activity, with a simultaneous and significant decrease in catalase activity evidence of accumulation of hydroperoxide causing neutrophil activation and chemotaxis. The study data can be used for predicting osteonecrosis development as additional criteria when decision-making of the advisability of performing reconstructive surgeries of the joint.
A comparative study of cellular immunity parameters was performed in patients with long bone chronic posttraumatic osteomyelitis in regard to osteomyelitis stages. Thirty patients with the fistulous form of long bone chronic posttraumatic osteomyelitis and 13 patients with long bone chronic posttraumatic osteomyelitis in the remission stage were examined using laser flow citometry. It was revealed that a moderate leukocytosis, increased monocyte and neutrophile absolute number as well as increased CD25 and HLA-DR-positive T-lymphocyte number are typical for chronic osteomyelitis regardless of the pathological process stages. The remission stage in patients with chronic posttraumatic osteomyelitis is accompanied by moderate activation of humoral immunity (increased B-lymphocyte (CD19+) number and increased production of IgG). The decrease in the peripheral blood lymphocyte number and well as reduction of HLA-DR expression on monocytes creates prerequisites for the development of fistulous osteomyelitis form and can be an indication for administering the preparations of immunomodulating action.
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