Interconditionality of the effects of types I and II of inflammation on the processes of lipid peroxidation and antioxidant protection in patients with obstructive jaundice of gallstone origin in the postoperative period
Introduction. The pathogenesis of obstructive jaundice is complex, characterized by the development of local and systemic inflammatory reactions, endotoxemia and associated organ and histodestructive changes. Inflammatory activation of immune cells stimulates the transcription of genes responsible for oxidative stress, reactive oxygen species destroy the membranes of immunocompetent cells, prolonging local inflammation. Aim of the study was to assess the contribution of immuno-inflammatory changes to lipid peroxidation processes and the functioning of antioxidant defense in the formation of postoperative complications in patients with obstructive jaundice of gallstone origin. Material and methods. 70 patients with a clinical picture of obstructive jaundice were examined. The concentration of 6 cytokines was studied: type I inflammation (IL-2, IL-8, TNFα, IFN-γ); type II (IL-4, IL-10) by enzyme immunoassay. The content of malondialdehyde and the activity of antioxidant enzymes were studied in red blood cells by spectrophotometric methods. Analysis of statistical data was carried out using the Statistica 10 application programs. Results. The predominant role in the pathogenesis of obstructive jaundice with a complicated postoperative period of type I inflammatory process has been demonstrated, and in the pathogenesis of obstructive jaundice with an uncomplicated postoperative period of type I and type II inflammation. A significant increase in the content of malondialdehyde in red blood cells was found in patients of both compared groups, which confirms the strengthening of lipid peroxidation in the early postoperative period. At the same time, the results revealed in our work, indicating an increase in the activity of antioxidant defense, an increase in the activity of superoxide dismutase and catalase enzymes, which contribute to a decrease in the manifestations of oxidative stress and are more likely indicative of the protective role of type II inflammation in OJ patients with uncomplicated postoperative period. Conclusion. In patients with OJ with a complicated postoperative period, an increase in the processes of lipid peroxidation, a decrease in the activity of antioxidant enzymes and a predominant type I inflammation are revealed. In patients with OJ with an uncomplicated postoperative period, the manifestations of oxidative stress are compensated by an increase in the activity of antioxidant enzymes, types I and II of inflammation are detected.