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

Abstract

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.

Citicolina: revisión farmacológica y clínica, actualización 2022

“…Alizadeh et al [ 596 ] showed that citicoline is more useful drug for improving speech and language skills than piracetam in post-stroke aphasia. Shulginova et al [ 597 ] described a role of citicoline alone or in combination with other drugs in patients with chronic cerebral ischemia with disorders of the immune status.…”

“…Alizadeh et al [ 596 ] demostraron que la citicolina es un fármaco más útil para mejorar las habilidades del habla y el lenguaje que el piracetam en la afasia posterior al accidente cerebrovascular. Shulginova et al [ 597 ] describieron el papel de la citicolina sola o en combinación con otros fármacos en pacientes con isquemia cerebral crónica con trastornos del estado inmunitario.…”

Derivatives of 3-Hydroxypyridine in The Correction of Disorders in The Structural and Functional Properties of Erythrocytes in Experimental Acute Destructive Pancreatitis Due to Chronic Ethanol Intoxication

“…Destructive pancreatitis of alcoholic etiology is known to be characterized by more severe damages to the nervous, cardiovascular and digestive systems, and primarily the hepatic parenchyma 1-3 . In presence of chronic alcohol intoxication (CAI) there develop cytolytic, cholestatic, liver cell failure biochemical syndromes of hepatocytes damage, the lipid peroxidation activation (LPO) and blood coagulation processes is observed, a drop in the whole number of circulating erythrocytes and their membrane sorption parameters, the emergence of secondary alcohol-associated immunodeficiency is noted 4,5 . Pathogenic mechanisms of tissue damage, due to the growth of oxidative stress, in particular, are also characteristic of acute pancreatitis when LPO processes cause damages not only to pancreatic cells, but also to the hepatocytes membranes, peripheral blood cells, erythrocytes, in particular 6 .…”

Endogenous Intoxication and the Role of Antioxidants in Motion Activity Correction with Traumatic Brain Injury in Rat Model

“…Mexicor and cytoflavin are two such remedies. (6)(7)(8)(9) These medicines are largely used to manage ischemic conditions. (10)(11)(12) The aim of this study was to assess the effectiveness of cytoflavin and mexicor in the posttraumatic period of TBI.…”