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Journal 'Cytokines & inflammation', 2009, No. 3

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Practitioner Advisor

Number 3'2009

Influence of perftoran, high doses of ascorbic acid and their combination on cytokine profile and level of serum immunoglobulins in acute pancreatitis

D.B. Demin, A.I. Smoliagin, E.V. Popova, V.S. Tarasenko, N.A. Shchetinin

Serum levels of cytokines (TNFα, IL-4, IL-10, IFNγ) and immunoglobulins (IgA, IgM, IgG) were investigated in 60 patients with severe acute pancreatitis (AP). Patients were divided into 4 groups according to treatment regimens. Group I (n=14) received standard therapy (ST; infusion of pancreatic secretion blockers, spasmolytics, antibiotics); group II (n=14) - ST + 5% ascorbic acid (AA, 2000 mg i.v. on admission and for the next 7 days); group III (n=16) - CT plus Perftoran (PF; i.v. on admission in a single dose of 6 ml per kg bodyweight); group IV (n=16) - ST plus PF and AA at doses identical to the previous groups). It was found that acute pancreatitis is characterized by a significant decrease in the content of IgG and manifold increase in the levels of both pro- and anti-inflammatory cytokines, that indicates cytokine storm, which is one of the criteria for immune deficiency and purulent-septic complications. PF and its combination with AA significantly increased the content of IgA and IgG, and significantly reduced the level of both Th1, and Th2 cytokines suggesting that the suppression of cytokine overproduction occurred. In groups III and IV, the IFNγ/IL-10 ratio was 3-6 times higher than in groups I and II and demonstrated a tendency to grow, confirming the beneficial immunomodulatory properties of PF and AA in the treatment of AP. (Cytokines and Inflammation. 2009. Vol. 8, 3. P. 59-63.)

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