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Summary. A range of specific biomarkers to evaluate the severity of the condition, the choice of tactics, effectiveness and prognosis of treatment are used. Goal. Evaluation of biomarkers characterizing the etiopathogenetic disorders in hepatosplenomegaly syndrome complicated by recurrent bleeding from esophageal phlebectasis to select individual treatment tactics. Materials and methods. The digestive function of phagocytes is investigated, the concentration of opsonizing, membranotropic cytotoxic factors and the degree of endogenous intoxication in 3 groups of patients with different etiological factors of hepatosplenomegaly, complicated by bleeding are evaluated. Results. The presence of specific trigger factors (viral hepatitis, herpes viruses, hereditary-related disorders of lysosomal enzymes) made it possible to classify patients into three groups. In the first group of patients with viral hepatitis B and C the induction of phagocytic activity of neutrophils, a significant increase in lymphocytotoxicity on the background of disorders of protein and lipid metabolism showed. In the second group of patients with the presence of herpes group viruses and autoimmune component an imbalance of opsonizing factors revealed, in particular proteins of the complement system, which caused impaired clearance of low molecular weight immune complexes and products of their degradation. In the third group of patients with hepatitis a significant decrease in the activity of lysosomal enzymes of phagocytic cells are found. The identified pathogenetic biomarkers indicate the presence in this group of patients with congenital enzymopathy characteristic of accumulation diseases. For patients with a pronounced manifestation of intercellular interactions disorders, as an effective alternative to liver transplantation the use of transfusions of mesenchymal stem cells, which are capable of trans differentiation under the influence of mediator microenvironment factors may be. |
