Changes in the Blood Serum Content of Bone Biomarkers and Cytokines in Children With Combined Trauma

Introduction. Currently, there is a limited number of works devoted to the comprehensive study of specific features of surgical treatment of patients with acute hematogenous osteomyelitis (AHO) which includes histological and immune histochemical (IHC) tests of the bone marrow at different periods of the disease. In this regard, the purpose of our work was to make the morphological analyses of bone tissue and bone marrow fragments in children with hematogenous osteomyelitis. Material and methods. In 2013- 2016, in the department of purulent surgery of the city hospital in Stavropol, there were 64 children with AHO of long tubular bones aged from 3 to 17. 47 boys (73.4%), 17 girls (26.6%). The lesion was located in : femur - 25 (39.1%) children; tibia - 24 (37.5%); fibula - 6 (9.4%); humerus - 5 (7.8%); ulna - 3 (4.7%); radius - 1 (1.5%). All children had urgent osteoperforation of the affected bone. Bone slices were taken for histological examination and bone marrow fragments for IHC examination. Tissue sections were stained with hematoxylin and eosin, pikrofuksin by Van Gieson, aniline blue by Mallory, trichrome by Masson. IHC examination was done using a standard protocol with anti-CD3, CD4, CD8 monoclonal antibodies. Results. In AHO, the histological examination has revealed fragments of spongy bone tissue, elements of yellow and red bone marrow with diffuse abundant leukocyte infiltration, hemorrhages in bone marrow spaces, microcore fractures and necrotic foci in the trabeculae, vast areas of pronounced autolytic resorption of the bone tissue. Accumulation of CD3+cells (2-4) is seen in the inflammation infiltrate areas located along the fistula passage. The expression of T-lymphocyte-helper markers, or CD4 +, is moderate in chronic osteomyelitis (2 points). The expression of T-lymphocyte suppressor marker, or CD8 +, is moderate in chronic osteomyelitis (2 points). Immunoreactive material - coarse granular, cytoplasmic, disseminated (3 points). CD8 + lymphocytes are seen in clusters of cells in the amount from 4-6 to 20-30. In addition, to our mind, the picture of structural location of lymphocytes, is not completed, since cells are moving to the zone of interaction of CD8 + lymphocytes. Conclusions. Thus, minor subpopulations of lymphocytes, in particular double-positive T cells, or CD3 + / CD4 + / CD8 + lymphocytes, or highly differentiated memory cells are registered in the red bone marrow of patients with AHO. It characterizes the immunoregulatory index of the organism and may indicate the presence of autoimmune component in the immune response. If even separate CD8 + lymphocytes are revealed in the bone marrow of children with hematogenous osteomyelitis at IHC, it may indicate a risk of complications.

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A Histological Picture of Bone Tissue in Children With Hematogenous Osteomyelitis

Minaev

Grigorova

Филипьева

et al. 2019

Russian Journal of Pediatric Surgery

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The Impact of Living Conditions on the Health of Primary School Children in the Zone of Military Conflict

Ершова

Glushko

2019

RPJ

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Introduction. Preserving and restoring the health of children in difficult situations is one of the priority tasks of modern Pediatrics. Therefore, taking into account the characteristics of the health status of children in a prolonged stressful situation associated with a military conflict is extremely important for the full and timely assistance to this contingent. Purpose of the study To conduct a comprehensive assessment of the health status of 7-9 years old children living in the military conflict zone in the Donbas region. Materials and methods. We examined 234 children (of 7-9 years), of which 123 people living in the war zone in the Donbas region. A year after the outbreak of military conflict there was carried out an assessment of the health status of children, including an assessment of psycho-emotional status (methods adapted to primary school age), an analysis of medical documentation (forms 025/U-04 and No. 112/U) with an assessment of the incidence rate, physical development, as well as the study of the autonomic nervous system (methods A.M. Wayne, cardiointervalography). Results All children in the territory of the military conflict were established to have violations of the psycho-emotional and cognitive spheres, expressed in signs of post-stress disorder and maladaptation. There were revealed alterations in the vegetative status, an increase in the frequency of registration of somatic pathology, as well as a change in anthropometric and physiometric indices of physical development were revealed. Conclusion Identified violations in the state of health of children living in the zone of military conflict dictate the need for dynamic monitoring and rehabilitation measures with the integrated participation of medical, psychological, pedagogical and social specialists

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Matrix metalloproteinases in children with uncomplicated compression fractures of the spine

Смирнов

Карасева

Фисенко

et al. 2021

RPJ

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The aim of the study was to determine changes in the content of matrix metalloproteinases (MMP) and their tissue inhibitor in children with uncomplicated compression fractures of the spine (UCFS). Materials and methods. Eighty-five children, including 69 patients with UCFS (average age 12.3 ± 2.6 years), were comprehensively examined. The reference group consisted of 16 children (average age 11.8 ± 2.7 years) without spinal pathology. During the diagnostic period for 1-3 days, changes in the MMP content and their tissue inhibitor (TIMP-1) in blood serum were determined by the enzyme immunoassay method in all children after trauma. Results. It was found that in the acute period after spinal injury, the blood levels of gelatinases (MMP-2 and MMP-9), stromelysin (MMP-3), and collagenases (MMP-8) significantly increased compared to their levels in children of the reference group. At the same time, the levels of TIMP-1 and the ratio of MMP/TIMP-1 concentrations in the blood of patients with UCFS significantly decreased compared to the control, which indicates the predominance of the proteolytic effect of MMP. Analysis of changes in the content of MMP in the blood in UCFS boys and girls did not reveal significant differences in the levels of the studied MMP and TIMP-1, except for a significant increase in the concentrations of stromelysin (MMP-3) in the blood serum of boys compared with its level in girls and the control. With different severity of the course of UCFS in children, a significant increase in MMP concentrations associated with an increase in the severity of the injury was revealed, and a substantial decrease in the content of TIMP-1 in the blood of patients compared to its levels in children with 1-2 degrees of severity and control. Conclusion. The established patterns indicate that the determination of the content of MMR and TIMP-1 in the blood in UCFS children allows monitoring the course of the reparative process after injury to the vertebral bodies in children.

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Changes in the Blood Serum Content of Bone Biomarkers and Cytokines in Children With Combined Trauma

Cited by 4 publications

References 25 publications

A Histological Picture of Bone Tissue in Children With Hematogenous Osteomyelitis

A Histological Picture of Bone Tissue in Children With Hematogenous Osteomyelitis

The Impact of Living Conditions on the Health of Primary School Children in the Zone of Military Conflict

Matrix metalloproteinases in children with uncomplicated compression fractures of the spine

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