Цитокіновий статус і матриксна металопротеїназа-9 у хворих з кардіоренальним синдромом 2 типу на тлі хронічної серцевої недостатності і цукрового діабету 2 типу

Abstract

Цель исследования - оценить наличие и характер связей между цитокиновым статусом на основании определения провоспалительного ИЛ-1бета, противовоспалительного ИЛ-10, функциональным состоянием почек и индикатором фибролиза матриксной металопротеиназы-9 (ММР-9) у пациентов c кардиоренальнім синдромом (КРС) на фоне хронической сердечной недостаточности (ХСН) и сахарного диабета (СД) 2 типа. Дисбаланс в работе системы цитокинов ассоциируется с гиперактивностью антифибротичного фактора ММР-9 у больных из КРС на фоне ХСН и СД 2 типа. Высокие уровни ММР-9 привлечены к нарушениям функционального состояния почек, который в большей степени проявляется в изменениях тубулоинтерстициального компонента, меньшей – канальцевого. Перспективами исследования является определение предикторной ценности ММР-9 в прогрессе КРС на фоне ХСН и СД 2 типа. Abstract. The co-morbidities are the negative impacts in the prognosis according to the results of research. Comorbid condition that is the most common in patients with chronic heart failure (CHF) is diabetes mellitus (DM). According to the survey, which included more than 1 million American adults, heart failure and diabetes independently increase the risk of death of 50-100%. Silverberg et al determine that the relationship between the heart and kidney is one-directional. Such relationships have been described as part of cardiorenal syndrome. The patients with chronic heart failure and diabetic renal disease have high activity markers of immune inflammation by pro-inflammatory cytokine level, what we described in previous papers. Interest of scientists attracts the attention of fibrosis - fibrolysis in patological processes in the kidney at the present stage. MCP-1 - as fibrotic marker - is actively involved in the mechanisms of atherosclerosis, type 2 diabetes, cardiovascular disease. Tesch G.H. et al. showed dominant expression of MCP-1 by tubular and not glomerular cells, which accordingly contributes tubular damage, as well as its influence on the increase in the number of activated macrophages near epithelial tubular cells with subsequent destruction at nephritis . Urinary excretion of MCP-1 is closely related with the severity of inflammatory cell infiltration of the interstitium in patients with highly active against a urinary forms of chronic glomerulonephritis. Patients with type 2 diabetes have enough strong correlation between increased levels of MCP-1 in the peripheral blood and urine, the expressiveness of albuminuria, interstitial infiltration, the degree of renal damage and duration of the disease. MCP-1 is considered as an indicator of tubulointerstitial renal disease in patients with cattle on a background of chronic heart failure and type 2 diabetes. Antifibrosis system is less well studied. The question of interactions between cytokines and MMP-9 as antifibrotic marker remains debatable. The aim is to assess the existence and nature of the relationship between cytokine status on the basis of the definition of pro-inflammatory IL-1β, anti-IL-10, the functional state of the kidneys and the indicator fibrolysis MMP-9 in patients with CRS on a background of chronic heart failure and type 2 diabetes type. The imbalance in the system cytokines associated with hyperactivity antifibrotic factor MMP-9 in patients with CRS with a chronic heart failure and type 2 diabetes in a background.High levels of MMP-9 are involved in violations of the functional state of kidneys, more pronounced changes in the tubulointerstitial component less - tubular. Study is to determine the prospects predictor’s values of MMP-9 in progress of CRS with the background of CHF and type 2 diabetes.