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Background. Chronic endometritis (CE) is an inflammatory hysteropathy causing miscarriage and infertility. High invasiveness of the main method of CE diagnosis and vague clinical picture necessitate the need for the development of less invasive approaches to establish the presence of this disease.The aim of the study. To establish a significant association of the concentration of pro- and anti-inflammatory interleukins in the blood serum with the presence of chronic endometritis in premenopausal women without concomitant endocrine diseases.Materials and methods. This re-analysis of the data is based on the results of a cross-sectional study conducted between May 2017 and December 2019 which included 198 premenopausal women. In all participants, body weight and height were measured with the calculation of the body mass index, the concentration of Creactive protein, pro- and anti-inflammatory cytokines in the blood serum was determined, and a pipelle biopsy was performed to determine the CD138 expression in the endometrial stroma. Non-parametric methods, as well as ROC analysis, were used for statistical analysis.Results. 86 women were included in the re-analysis of the data, 37 of them had a confirmed diagnosis of chronic endometritis. Statistically significantly higher values of interleukin 1 (IL-1) concentration (p = 0.0028) and IL-1/tumor necrosis factor α ratio (p < 0.001) were determined in women with CE and normal body weight; threshold values of these parameters were ≥ 1.35 pg/ml (sensitivity 75 %, specificity 83 %; 95% confidence interval (95% CI): 0.88–2.15) and ≥ 1.03 (sensitivity 85 %, specificity 78 %; 95% CI: 0.81–1.27) respectively. Such a relationship was not revealed in women with overweight.Conclusions. The obtained results can be the basis for conducting a larger-scale study with determining the concentration of cytokines not only in the blood serum, but also in the endometrium of women with CE, which will allow the development of a minimally invasive method for determining the risk of the presence of chronic endometritis in premenopausal women.

Objective: to study the importance of cytokines, hepcidin, a soluble transferrin receptor, iron metabolism in the development of anemia of chronic diseases in patients with malignant neoplasms and rheumatic pathology, to identify the leading factors in the development of anemia for each of the studied groups and to develop a working classification of anemia of chronic diseases.Materials and methods. 63 patients with rheumatic pathology were examined. The study group included 41 (17 men/24 women, average age 53.4 ± 4 years) patients with anemia, the control group included 22 (9 men/13 women, age 49.3 ± 1.78 years) patients without anemia. The patients (n = 63) with stage II–IV malignant neoplasms were examined. The study group included 41 patients with anemia (34 men/7 women, age 67.1 ± 9.9 years), in the control group 22 patients without it (17 men/5 women, age 60.2 ± 14.9 years). The number of red blood cells, the hemoglobin level, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, concentrations of serum iron, total iron binding capacity (TIBC), ferritin, transferrin, C-reactive protein (CRP), transferrin saturation index (TSI), and soluble transferrin receptor (sTfR), hepcidin, interleukin (IL) – 6, – 10, tumor necrosis factor-α (TNF-α) were determined. Mann – Whitney U Test was applied to check for statistically significant differences in study samples.Results. Compared with the control group, elevated concentrations of ferritin, CRP, hepcidin, sTfR and IL-6 (p 0.05).Conclusion. The multicomponent anemia genesis in patients with cancer and rheumatic pathology is shown. The contribution of each mechanism to the development of anemia may vary depending on the specific nosological form. In patients with cancer, functional iron deficiency, activation of IL-6, IL-10, TNF-α synthesis and an increase in hepcidin synthesis lead to the development of anemia of chronic diseases. In patients with a rheumatic profile and anemia, a more pronounced synthesis of hepcidin and an increase IL-6 concentration are indicated. A working version of the classification of anemia of chronic diseases based on the leading pathogenetic factor is proposed (with a predominant iron deficiency, with impaired regulatory mechanisms of erythropoiesis, with insufficient production of erythropoietin).

Chronic glomerulonephritis (CGN) is a disease with a steadily progressing course, which is based on inflammation with the activation of immune cells. The severity of the inflammatory reaction in the kidney tissue is determined by the balance of locally pro-inflammatory factors and protective mechanisms, which include anti-inflammatory cytokines and T-regulatory lymphocytes (Treg). The study of processes that can modulate the severity of inflammation in the kidney is of particular interest for understanding the basic patterns of CGN progression. Aim. To determine the clinical significance of the Th17, Th1, and Treg cytokines in urine to assess the activity and progression of chronic glomerulonephritis with nephrotic syndrome (NS). Materials and methods. The study included 98 patients with CGN 37 women and 61 men. Patients were divided into two groups according to the degree of CGN activity. Group I consisted of 51 patients with NS. In 21 subjects, a decrease in GFR60 ml/min was revealed. Group II included 47 patients with proteinuria from 1 to 3 g/day without NS. GFR60 ml/min/1.73 m2 was observed in 26 patients. A kidney biopsy was performed in 65 patients and the hystological diagnosis was verified: 20 had mesangioproliferative GN, 16 had membranous nephropathy, 18 had focal segmental glomerulosclerosis, and 11 had membranoproliferative GN. The control group consisted of 15 healthy people. The levels of IL-6, IL-10, IL-17, tumor necrosis factor a (TNF-a) in the urine were determined using enzyme-linked immunosorbent assay. The number of FoxP3-positive cells in the inflammatory interstitial infiltrate of the cortical layer was determined in 39 patients (in a biopsy sample in a 1.5 mm2 area). Results. In group of patients with CGN, there was an increase in the levels of Th17, Th1, and Treg cytokines in urine TNF-a and IL-10 compared with healthy individuals. An increase in the levels of IL-6 in the urine of patients with high clinical activity of CGN (with NS and renal dysfunction) was more pronounced than in patients with NS and normal renal function. There was a decrease in the number of Treg cells in the interstitium of the kidney and a decrease in the production of anti-inflammatory IL-10 in CGN patients with NS, compared with patients without NS. The most pronounced changes in the cytokine profile were observed in patients with FSGS with an increase in pro-inflammatory cytokines and a decrease in Treg in the kidney tissue/anti-inflammatory IL-10 in the urine. Conclusion. An imbalance of cytokines characterized by an increased levels of pro-inflammatory IL-17, IL-6, TNF-a, and a reduced levels of anti-inflammatory IL-10 and T-regulatory cells in the kidney tissue is noted in patients with NS, especially with FSGS. Imbalance of cytokines reflects the high activity of CGN and the risk of the progression of the disease.

Ischemic stroke is the most common form of brain stroke. It is associated with functional changes of various blood and bone marrow cell populations, altered release of various cytokines, chemokines, etc. There are conflicting data about serum and plasma TNFα levels in acute ischemic stroke.We have examined 21 patients with a diagnosis of ischemic stroke treated at the hospital. The severity of ischemic stroke was evaluated by neurologists, in accordance with NIHSS criteria at admission and at discharge. In the patients with ischemic stroke, we have found a significantly increased serum concentration of tumor necrosis factor-α (p < 0.001), as compared with healthy individuals. The highest concentrations of this marker were recorded on days 1 and 3 of the disease, being significant at p < 0.001 and p= 0.003, respectively, then decreasing by day 14, however, not reaching, the levels of control group. It should be noted that, among patients with ischemic stroke, there is a significantly (p < 0.001) increased proportion of individuals with high serum concentrations (>10 pg/ml) of this cytokine, i.e., 76.2±9.3% on day 1 of the disease.To statistically evaluate the individual differences of the patients’ dynamics, they were divided into subgroups, depending on the level of TNFα on the 1st day of hospitalization, using a discriminant analysis with estimation of a classification matrix. The correlation analysis showed numerous strongly positive correlations between TNFα levels on the 1st and 3rd days, as well as between similar indexes on the 1st and 14th days. A correlation between TNFα concentrations on the 3rd and 14th day was also found (r = 0.711; p < 0.01). Also, positive correlation in various periods of observation was established between the absolute levels of cytokine and differences in their concentration changes. The level of tumor necrosis factor-alpha on the first and third day of hospitalization did positively correlate (respectively, r = 0.503, p < 0.01; r = 0.411, p < 0.01) with the volume of the ischemic lesion according neuroimaging methods research. The volume of the ischemic focus was positively correlated with the difference in the concentration of TNFα on days 1-3 and 1-14 (respectively, r = 0.425, p < 0.01; r = 0.507, p < 0.01).The results of our study show a necessity for measuring TNFα levels at admission, in order to plan treatment in these groups of patients, especially in cases of increase or insufficient decrease in TNFα recorded on the 3rd day of therapy.

The purpose is to assess the structural state of the cornea and pre-corneal lacrimal film in patients with myopia before refractive surgery, to identify the relationship with changes in cytokine concentration in the tear. Material and methods. 62 patients (124 eyes) with myopia were examined. The first group included 26 patients, only glasses were used for the correction of myopia, and in the 2nd group, 36 patients who used soft contact lenses during 5 to 15 years. Methods of examination: determination of the thickness of the corneal epithelium, height and width of the lacrimal meniscus, assessment of the biomechanical properties of the cornea, the Norn and Schirmer tests. Content of cytokines in the tear – interleukin 10 and tumor necrosis factor α – was measured using the test set «BEST» by enzyme immunoassay. Results. The decrease in the thickness of the epithelium of the cornea, the height and width of the lacrimal meniscus, the stability of the tear film, and the ratio of interleukin-10 to the tumor-α necrosis factor in patients who use contact lenses for a long time are revealed. The conclusion. Prolonged wearing of contact lenses for correction of myopia is accompanied by signs of symptomatic dry eye syndrome against a background of moderate oppression of the anti-inflammatory activity of tears.

Cardiovascular events caused by early development and rapid progression of atherosclerotic vascular disease are the main reason behind early lethality among patients with systemic lupus erythematosus (SLE). The rapid development of atherosclerosis in patients with this disease is related to the inflammatory nature of SLE and associated with different inflammatory mediators.Objective. To specify the role of markers and inflammatory mediators (soluble CD40L (sCD40L), soluble tumor necrosis factor α receptors (sTNFα), and neopterin) in the development of atherosclerosis in SLE patients. Materials and Methods. 227 patients (156 females and 71 males) with SLE were examined; median age was 35.6±0.7 years; mean duration of disease was 132.9±7.7 months. The presence of the conventional risk factors (RF) of cardiovascular diseases was determined in SLE patients and control group individuals. Thickening of the intima-media complex and presence of atherosclerotic plaques are signs of atherosclerotic lesion of vessels. The control group consisted of 116 individuals having no rheumatic diseases. Serum concentrations of sCD40L, sTNFα, and neopterin were determined in 187, 193, and 155 SLE patients, respectively, and in 20 control group individuals.Results. sCD40L, sTNFα, and neopterin levels in SLE patients were higher than those in the control group (p0.05 in all cases)). A relationship was found between sTNFα concentration and arterial hypertension, systolic and diastolic arterial blood pressure levels, concentrations of triglycerides (TG), high-density lipoprotein CS (HDL CS), apolipoprotein A1, factors associated with SLE (duration of disease, chronic kidney disease, SLEDAI-2K score, and lesion index (p

Objective. To study clinical significance of proinflammatory cytokines (tumor necrosis factor α – TNFα, interleukine 6 – IL6, IL18), soluble receptors of TNFα (sTNF-R), anti- inflammatory cytokines (IL10) and integral marker of cytokine-dependent cell immune response activation neopterin in antiphospholipid syndrome (APS).Material and methods. Serum concentration of cytokines and neopterin was evaluated by immunoenzyme assay with commercial kits “BioSource International, Inc.” (USA), “Bender MedSystems” (Austria) and “IBL” (Germany) in 39 pts with primary APS (PAPS), 53 pts with secondary APS (SAPS) associated with systemic lupus erythematosus (SLE), 164 pts with SLE and 54 healthy donors.Results. Level of Th1 cytokines (TNFα, IL18), sTNF-R and neopterin in PAPS, SAPS and SLE as well as Th2 cytokines (IL6, IL10) in SAPS and SLE were significantly higher than in donors (p

Chronic glomerulonephritis (CGN) is a disease with a steadily progressing course, which is based on inflammation with the activation of immune cells. The severity of the inflammatory reaction in the kidney tissue is determined by the balance of locally pro-inflammatory factors and protective mechanisms, which include anti-inflammatory cytokines and T-regulatory lymphocytes (Treg). The study of processes that can modulate the severity of inflammation in the kidney is of particular interest for understanding the basic patterns of CGN progression., Aim: To determine the clinical significance of the Th17, Th1, and Treg cytokines in urine to assess the activity and progression of chronic glomerulonephritis with nephrotic syndrome (NS)., Materials and Methods: The study included 98 patients with CGN 37 women and 61 men. Patients were divided into two groups according to the degree of CGN activity. Group I consisted of 51 patients with NS. In 21 subjects, a decrease in GFR60 ml/min was revealed. Group II included 47 patients with proteinuria from 1 to 3 g/day without NS. GFR60 ml/min/1.73 m2 was observed in 26 patients. A kidney biopsy was performed in 65 patients and the hystological diagnosis was verified: 20 had mesangioproliferative GN, 16 had membranous nephropathy, 18 had focal segmental glomerulosclerosis, and 11 had membranoproliferative GN. The control group consisted of 15 healthy people. The levels of IL-6, IL-10, IL-17, tumor necrosis factor a (TNF-a) in the urine were determined using enzyme-linked immunosorbent assay. The number of FoxP3-positive cells in the inflammatory interstitial infiltrate of the cortical layer was determined in 39 patients (in a biopsy sample in a 1.5 mm2 area)., Results: In group of patients with CGN, there was an increase in the levels of Th17, Th1, and Treg cytokines in urine TNF-a and IL-10 compared with healthy individuals. An increase in the levels of IL-6 in the urine of patients with high clinical activity of CGN (with NS and renal dysfunction) was more pronounced than in patients with NS and normal renal function. There was a decrease in the number of Treg cells in the interstitium of the kidney and a decrease in the production of anti-inflammatory IL-10 in CGN patients with NS, compared with patients without NS. The most pronounced changes in the cytokine profile were observed in patients with FSGS with an increase in pro-inflammatory cytokines and a decrease in Treg in the kidney tissue/anti-inflammatory IL-10 in the urine., Conclusion: An imbalance of cytokines characterized by an increased levels of pro-inflammatory IL-17, IL-6, TNF-a, and a reduced levels of anti-inflammatory IL-10 and T-regulatory cells in the kidney tissue is noted in patients with NS, especially with FSGS. Imbalance of cytokines reflects the high activity of CGN and the risk of the progression of the disease.