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The Dynamics and Interaction of Endothelium State and Immune Status Variations in Program Hemodialysis Patients against the Background of Atorvastatin Therapy

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Author(s): А.L. Barsuk | А.M. Vozova | Е.V. Malinok | L.V. Lovtsova | I.Е. Okrut | V.B. Kuzin

Journal: Sovremennye Tehnologii v Medicine
ISSN 2076-4243

Volume: 5;
Issue: 2;
Start page: 78;
Date: 2013;
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Keywords: Program hemodialysis (PHD) | Endothelium state in PHD | Immune status in PHD | Atorvastatin

ABSTRACT
The aim of the investigation was to study the interaction of endothelium state and immune status variations in program hemodialysis (PHD) patients against the background of atorvastatin therapy.Materials and Methods. 54 patients included in the study were divided into two groups in a random manner. The main group patients (n=28) received atorvastatin, 20 mg a day, for 30 days against the background of PHD, the main patients (n=26) had PHD alone. Endothelin level (1–21) and Willebrand factor activity were determined by enzyme immunoassay, the content of active nitric oxide metabolites was estimated spectrophotometrically. The immune status indices (CD3, CD4, CD8, CD16, CD19, CD56) were studied by monoparametric analysis using monoclonal antibody technique. The content of interleukins (IL-6, IL-10, IL-1&beta) and tumor necrosis factor &alpha (TNF-&alpha) were investigated using enzyme immunoassay.Results. PHD patients within the observation period (30 days) were found to have the following changes: high concentration of nitric oxide and endothelin (1-21), reduced Willebrand factor activity; the decrease of relative number of T helpers and the increased number of cytotoxic Т lymphocytes, as well as the increased IL-10 level and reduced TNF-&alpha level in relation to the initial values. Atorvastatin administration for 30 days does not have any significant effect on endothelium condition, but reduces total lymphocyte count and immunoregulatory index, as well as proinflammatory cytokine IL-6 level in PHD patients.The main patients in the observation period were found to have the interaction of the changed values of endothelium state (nitric oxide level) with the levels of IL-6 and IL-10, TNF-&alpha, as well as Willebrand factor activity — with relative number of T helpers and immunoregulatory index.The patients with atorvastatin therapy were recorded to have nothing but the interaction of the Willebrand factor activity changes with IL-6 content.Conclusion. Due to the necessity of long-term administration of statin preparations in program hemodialysis patients, it is recommended to control the changes of endothelium state and immune status values in the course of the treatment.

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