Synthetic Analogue of Leu-Enkephalin in COVID-19 (a Prospective Clinical Study)

Magomedov, M.A.; Burda, N. G.; Misikov, Z. F.; Ryzhkov, A. Yu.; Antonova, V. V.; Черпаков, Р. А.

doi:10.15360/1813-9779-2022-4-11-19

Obŝaâ reanimatologiâ

2022

DOI: 10.15360/1813-9779-2022-4-11-19

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Synthetic Analogue of Leu-Enkephalin in COVID-19 (a Prospective Clinical Study)

M.A. Magomedov

N. G. Burda²,

Z. F. Misikov

et al.

Abstract: One of the main problems facing intensivists when treating patients with COVID-19 is severe and critical acute respiratory distress syndrome (ARDS) with the underlying viral pneumonia. The current guidelines of the Russian Ministry of Health (Version 15 of 22.02.22) do not include drugs with a lung protective effect. This issue could be solved by administration of a synthetic analogue of leu-enkephalin.Aim. Study the eﬃcacy of a synthetic analogue of leu-enkephalin in ARDS in patients with COVID-19.Materials a… Show more

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2024

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Cited by 2 publications

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The Role of Leu-Enkephalin Synthetic Analogue in Regulation of Systemic Inﬂammatory Response and Prevention of ARDS in Severe Combined Injury

Ryzhkov,

Antonova,

Cherpakov

et al. 2024

Obŝaâ reanimatologiâ

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The aim of the study. To study the eﬀect of ley-enkephalin synthetic analogue on the dynamics of inﬂammatory response markers and organ dysfunction in patients with severe combined trauma.Materials and methods. A prospective clinical study with historical control from two clinical centers — N. I. Pirogov State Clinical Hospital No. 1 and N.V. Sklifosovsky Clinical and Research Institute for Emergency Medicine — included men and women with severe combined trauma and the ISS scores values of 18–44, aged 18 to 70 years. Diagnostic and therapeutic approaches in all patients followed current international, national& local protocols and 2022 clinical recommendations of the Russian Society of Surgeons «Combined and multiple trauma in combination with shock (Polytrauma)». In the study group, treatment was supplemented with extended (72 hours from the admission) infusion of the test drug through a syringe dispenser following the study protocol. Eﬀects of the test drug prolonged infusion were evaluated for the following laboratory parameters: levels of cortisol, procalcitonin, interleukin 6, NTproBNP and leukocyte count. Laboratory tests were performed at 4 time points: prior to test drug infusion, 24 hours and 72 hours after initiation of infusion, and on Day 7. The study evaluated patient’s dynamics using APACHE II, SOFA and SAPS II scales and percentage of patients developing organ dysfunction (renal, respiratory, cardiovascular), rates of sepsis complications and mortality.Results. Patients who received the test drug had signiﬁcantly lower concentrations of systemic inﬂammatory response markers, i. e. PCT (P=0.001) and IL-6 (P=0.010) after 24 hours of follow-up vs the control group patients. The incidence of ARDS has also decreased in the study group (P=0.011 vs control). Acute kidney injury (AKI) rate was insigniﬁcantly higher in the control group (P=0.349). The duration of hospital stay in the control group was 35 (17; 51) days vs 18 (14; 30) days in the study group (P=0.140)Conclusion. The use of ley-enkephalin synthetic analogue inhibits production of such key systemic inﬂammatory response markers as PCT and IL-6, and reduces PCT concentrations within 24 hours in patients with severe combined trauma. ARDS developed less frequently in the study group, but there was no signiﬁcant diﬀerence in the incidence of AKI, AHF and infectious complications between the groups.

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The Role of Leu-Enkephalin Synthetic Analogue in Regulation of Systemic Inﬂammatory Response and Prevention of ARDS in Severe Combined Injury

Ryzhkov,

Antonova,

Cherpakov

et al. 2024

Obŝaâ reanimatologiâ

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The effect of a tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on oxidative stress in patients with severe combined trauma: a prospective clinical study

Antonova,

Evseev,

Goroncharovskaya

et al. 2023

Annals of Critical Care

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INTRODUCTION: Severe combined trauma remains the leading cause of mortality and disability of the workable population. Under damaging factor influence, a whole cascade of pathological processes is triggered, leading to development of multiple organ failure. OBJECTIVE: Exploration of the effects synthetic analogue of tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on the dynamics of oxidative stress markers in patients with severe polytrauma and the development of organ dysfunction. MATERIALS AND METHODS: 104 patients with severe combined trauma were included in study. There were 38 patients in the Dalargin group and 66 patients in the control group. Patients from main group received Dalargin in the form of a constant infusion through a syringe dispenser at the dose of 10 mcg/kg/hour at first 12 hours of hospitalization and 5 mcg/kg/hour up to 72 hours from the moment of admission. The control group received standard treatment. Indicators of oxidative stress were evaluated at the time of admission (0 days), 1, 3, 5, 7, 10 and 14 days from the therapy onset. RESULTS: In the main group, there was a significant decrease in oxidative stress markers such as malondialdehyde from the first day of treatment (p < 0.05), normalization of stable nitric oxide metabolites at day 10, and a decrease in total antioxidant activity below normal throughout the observation period. Mortality was comparable in both groups (p > 0.05), but the length of hospital stay was lower in surviving patients in the Dalargin group (p < 0.05). The development of organ dysfunction (acute respiratory distress syndrome, acute kidney injury) was less frequent in the Dalargine group (p < 0.05), but infectious complications (pneumonia, meningitis, wound suppuration) were comparable. CONCLUSIONS: Dalargin leads to a decrease of oxidative stress markers and normalization of endothelial function indicators, which contributes to a decrease of organ dysfunction frequency.

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Synthetic Analogue of Leu-Enkephalin in COVID-19 (a Prospective Clinical Study)

Cited by 2 publications

References 19 publications

The Role of Leu-Enkephalin Synthetic Analogue in Regulation of Systemic Inﬂammatory Response and Prevention of ARDS in Severe Combined Injury

The Role of Leu-Enkephalin Synthetic Analogue in Regulation of Systemic Inﬂammatory Response and Prevention of ARDS in Severe Combined Injury

The effect of a tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on oxidative stress in patients with severe combined trauma: a prospective clinical study

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