Cytokine status in patients with sepsis

Abstract

Cytokines are specific proteins that are produced by lymphocytes. Cytokine production and release occurs rapidly and is rigorously controlled. Their activity is characterized by ensuring the interaction between cells and systems, regulation of inflammatory reactions and responsible for the development of autoimmune processes. Patients with sepsis develop immunosuppression, when immune deficiency can progress to immunoparalysis. Cytokines cause effects similar to manifestations of acute and chronic infectious diseases having an ability to cause inflammation (pro-inflammatory) or inhibit the inflammatory process development (anti-inflammatory). The aim of the work is to find out the dynamics of changes in the most important cytokines in patients with sepsis caused by diabetic foot syndrome. Materials and methods. A total of 146 patients with sepsis who received treatment in the Zaporizhzhia Purulent-Septic Center with diabetic foot beds between 2006 and 2019 were examined and followed up. Patients were distributed according to the forms of the disease: group 1-104 (71.2 %) patients with sepsis, group 2-42 (28.8 %) patients with septic shock. The average age of the patients was 62.8 ± 3.4 years, and the duration of type 2 diabetes mellitus was 12.3 ± 3.4 years. The groups were representative in terms of sex, age and concomitant pathology. The studies were conducted in dynamics: upon admission, on the 7-8th and 12-16th days of the postoperative period. Results. The disease in sepsis patients was caused by wet gangrene of the lower extremities which occurred in 84.6 % of cases (88 patients). In 16 patients (15.4 %), the complications were caused by foot phlegmon and extended osteomyelitis. The cause of sepsis in patients with septic shock was wet gangrene of the extremities in 100 % of cases. Postoperative mortality in sepsis patients was 18.3%, and in patients with septic shock-70.8 %. The dynamics of changes in serum cytokines has been found to be indicative of these indicators imbalance which depends on the inflammatory process severity. The balance between cytokines is an important point in the regulation of inflammatory process onset and development. The course of the disease and its outcomes depend on this balance.

Інтерлейкін-6 – Диференційний Маркер Бактерійної Пневмонії Та Вперше Діагностованого Туберкульозу Легень У Віл-Позитивних Хворих

“…Цей цитокін впливає на формування та функціонування запальної реакції, відповідь імунітету, регулює кровотворення. Є дані, що ІЛ-6 може сприяти переходу гострих запальних процесів у хронічні та призводити до загострення хронічних форм запалення [5].…”