Disorders of the immune status in patients with chronic cerebral ischemia; differentiated pharmacological correction

Аннотация

Introduction: Chronic cerebral ischemia (CCI) accounts for 60-75% of all cerebrovascular diseases in Russia and around the world. The problem: the issues concerning the role of immunity in the pathogenesis of CCI depending on the main etiologic factor and stage of the disease are hardly elaborated, which makes the main pharmacological correction impossible. The objective of the study is to establish the immune disorder patterns in patients with CCI I-II associated with arterial hypertension and to develop differentiated pharmacological methods for their correction.

Material and methods: The results of treatment of 104 patients of Kursk Regional Clinical Hospital with CCI associated with II-stage arterial hypertension were analyzed: 52 patients were with CCI I stage (2^th-4^th groups of 12-14 patients) and 52 patients were with CCI II stage (5^th -7^th groups of 12-14 patients), aged 50±5, who received the basic pharmacological therapy (enalapril and vinpocetine). The patients of the 2^nd and 5^th groups additionally received ceraxon and mexicor, those of the 3^rd and the 6^th groups additionally received immunomodulator glutoxim, and those from the 4^th and 7^th groups received polyoxidonium. Twenty-two healthy donors were in the control group. Immune disorders were assessed by the parameters of the functional activity of neutrophils, levels of cytokines in plasma, components of the complement and inhibitors.

Results and discussion: In the case of CCI I and II stages similar proinflamatory immune disorders were detected, which is indicative of immune inflammation. The inclusion of glutoxime and polyoxidonium in a complex pharmacotherapy helps reduce the severity of immune and neuropsychic status indicators, which are more evident in case of stage II.

Conclusions: In case of CCI I stage, the medications used can be arranged according to their clinico-immunological efficacy in ascending order: ceraxon+mexicore ^® ceraxon+mexicor+glutoxim ^® ceraxon+mexicor+polyoxidonium, and in case of CCI II stage: ceraxon+mexicor ^® ceraxon+mexicor+polyoxidonium = ceraxon+mexicor+glutoxim.