NON-SPECIFIC PROTECTION FACTORS AND THE CYTOKINE SYSTEM IN POSTOPERATIVE VENTAL HERNIAS

Аннотация

Incisional ventral hernias (POVH) account for up to 20-22% of all external abdominal hernias and are second in frequency after inguinal ones. Over 5% of all laparotomies are complicated by the formation of postoperative ventral hernias [4,5]. A fundamentally important condition for the successful treatment of patients with postoperative ventral hernias is the need to assess immunological reactivity both before surgery and in the postoperative period. [1,2,3] Keywords: postoperative ventral hernias, superoxide dismutase. The aim of the study was to study acute phase proteins and levels of pro- and anti- inflammatory cytokines in patients with incisional ventral hernias. Materials and methods of research: In the period 2021-2022, a prospective study was performed in 80 patients with postoperative ventral hernias. The study included 15 men (18.8%) with an average age of 56±2.46 years and 65 women (81.2%) with an average age of 60±1.32 years. The control group consisted of 30 healthy volunteers. The inclusion criteria for this group was the presence of a postoperative ventral hernia in a patient who agreed to an immunological examination and planned surgical treatment in TashPMI clinics using a polypropylene mesh implant from Lintex, Esfil standard and Esfil easy (Russia, St. Petersburg). Immunological studies were carried out by determining the level of serum cytokines (IL-1β, TNF-α, and IL-4), C-reactive protein and lactoferrin by ELISA (Cytokin, St. Petersburg). Results and conclusions of the study: The conducted studies showed how the initial immune status changes: the content of all studied pro-inflammatory cytokines and the level of IL-4 increase. Thus, the concentration of IL-1β increases by 4.6, TNF-α by 7, and IL-4 by 3.6 times. Perhaps a more significant increase in the level of TNF-α is associated with its more pronounced systemic effect. It is known that CRP, interacting with T-lymphocytes, phagocytes and platelets, regulates their functions during inflammation. The level of C-reactive protein in patients with postoperative ventral hernias is 1.6 times higher than the control values (p<0.01), and the level of lactoferrin, one of the indicators of innate immunity and which is also an acute phase protein, is reduced (420.2±27 .3 ng/ml) compared with the values of the control group (536.2±32.4 ng/ml) i.e. 1.27 times. Thus, the development of POVH is accompanied by an increase in the level of both pro- inflammatory and anti-inflammatory cytokines, as well as a multidirectional value of acute phase proteins, i.e. indicate an imbalance between Th1 and Th2 types of immune response.