Improvement of Treatment and Prevention of Liver Echinococcosis

Abstract

The purpose of the study was to determine optimal pathogenetically justified methods and means to improve the results of diagnosis and treatment of liver echinococcosis. Materials and methods. During treatment, on the 1st, 3rd, 5th, and 10th day of the postoperative period, patients were examined for the functional state of the liver by blood analysis for the amount of proinflammatory cytokines TNF-α, IL-6, IL-4 and IL-10, IL-1. The activity of humoral immunity was assessed based on the level of immunoglobulins IgA, IgG and IgM. Results and discussion. On the 1st day after the operation, the level of IgA increased and amounted to 5.56 ± 0.1 q/L. The improvement in the dynamics of indicators was observed on the 5th day of observations, and this trend persisted up to 10 days after surgical treatment. On day 5, a significant decrease in the concentration of the main proinflammatory cytokines TNF-α, IL-6 and IL-4 was revealed, compared with the indicators before treatment and on the first day after treatment – 12.5 ± 0.6 pg/ml; 11.7 ± 0.3 pg/ml and 4.0 ± 0.2 pg/ml, respectively. This treatment regimen resulted in a marked decrease in TNF-α, IL-6 and IL-10 levels on day 10. The initial level of cytokines and immunoglobulins indicates a pronounced immunosuppressive effect on the body of a parasitic disease. A significant decrease in cytokines IL-1, IL-6 and IL-10 in patients after surgery and a decrease in indicators after maintenance therapy can serve as a potential immunological marker for evaluating its effectiveness. When studying the cytokine profile in the patients we examined, there was a significant increase in the level of TNF-α and IL-6 in blood serum relative to the control values, which is directly dependent on the severity of the pathological process and the functional state of the liver and suppresses the secretion of anti-inflammatory cytokines, which was confirmed by data from foreign authors. As well as the works published earlier, the data of our studies show that Echinococcus granulosus cysts induce a strong antibody response in most patients, causing, at the same time, a reaction of antigen-specific antibodies of various classes with different intensity and specificity against the background of their synthesis and increased secretion. It is necessary to note an increase in quantitative and qualitative indicators of IgG, IgM and IgA levels in the blood serum of patients with liver echinococcosis, with IgG predominance. Conclusion. A comprehensive study of inflammatory mediators and the dynamics of cytokine levels makes it possible to diagnose complications in time and prevent possible relapses of the disease. The data obtained made it possible to justify the further use of imunofan and to develop recommendations for the management of patients with liver echinococcosis in the postoperative period