IMMUNOLOGICAL CRITERIA FOR EFFECTIVE SYSTEMIC USE OF MURAMYL PEPTIDE IMMUNOMODULATOR IN THE TREATMENT OF PATIENTS WITH BURN INJURIES

  • V. I. Nagaichuk
  • R. М. Chornopyshchuk
  • S. D. Khimich
  • О. А. Nazarchuk
  • М. І. Burkovskyi
  • А. S. Bobelo
Keywords: burn injuries, immunological parameters, neutrophilic granulocytes form factor, immunocorrection, Liastenum®.

Abstract

Abstract. Introduction. The problem of providing effective care to patients with burn injuries remains far from being finally solved. Due to significant immune disorders that occur against the background of thermal damage, the use of immunomodulatory drugs remains promising. Therefore, the aim of this study was to analyze the effectiveness of systemic use of the immunomodulatory drug Liastenum® in the complex treatment of patients with burn injuries.

Materials and methods: The study involved 35 patients with burn injuries with the index of damage severity ranging from 30 to 60 units. Patients in the main group (n = 15) in addition to the usual treatment received an immunomodulator Liastenum®, which was administered intramuscularly at a dose of 2 mg once every 3 days (course dose — 10 mg). Treatment of patients in the comparison group (n = 20) did not involve the use of drugs with targeted immunocorrective action. Examination of patients included laboratory immunological examination of venous blood with assessment of various parts of the immune system and determination of the “Neutrophilic granulocytes form factor” indicator, which was performed on the 3rd, 14th, 21st day after the injury.

The results of the study and their discussion. The obtained results allowed to confirm the ability of Liastenum® to stimulate the functional activity of neutrophilic granulocytes, restoring the phagocytic reserves of these cells, to normalize the level of lymphocytes and their individual subpopulation forms. In general, the action of the immunomodulatory drug was characterized by a balanced effect on the cellular, humoral parts of the immune system, phagocytosis.

Conclusions. The effectiveness of systemic use of immunomodulatory drug Liastenum® in a comprehensive program of care for patients with burn injuries by balanced correction of immune disorders was laboratory established.

References

1. Cheng W, Shen C, Zhao D, Zhang H, Tu J, Yuan Z, Song G, Liu M, Li D, Shang Y, Qin B; with the Epidemiological Study Group of Burns. The epidemiology and prognosis of patients with massive burns: A multicenter study of 2483 cases. Burns. 2019 May;45(3):705-16. doi: 10.1016/j. burns.2018.08.008.
2. Hall C, Hardin C, Corkins CJ, Jiwani AZ, Fletcher J, Carlsson A, Chan R. Pathophysiologic Mechanisms and Current Treatments for Cutaneous Sequelae of Burn Wounds. Compr Physiol. 2017 Dec 12;8(1):371-405. doi: 10.1002/cphy.c170016.
3. Medzhitov R, Schneider DS, Soares MP. Disease tolerance as a defense strategy. Science. 2012;335:936–41. doi: 10.1126/science.1214935.
4. Hotchkiss RS, Monneret G, Payen D. Immunosuppression in sepsis: A novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis. 2013;13(3):260- 68. doi: 10.1016/S1473-3099(13)70001-X.
5. Grigoryev EV, Matveeva VG, Shukevich DL, Radivilko AS, Velikanova EA, Khanova MYu. Induced immunosuppression in critical care: diagnostic opportunities in clinical practice. Bulletin of Siberian Medicine. 2019;18(1):18- 29. [In Rus.]. doi: 10.20538/1682-0363-2019-1-18–29.
6. Ravat F, Payre J, Peslages P, Fontaine M, Sens N. La brûlure : une pathologie inflammatoire [Burn: An inflammatory process]. Pathol Biol (Paris). 2011 Jun;59(3):63-72. French. doi: 10.1016/j.patbio.2009.12.001.
7. Rowan MP, Cancio LC, Elster EA, Burmeister DM, Rose LF, Natesan S, Chan RK, Christy RJ, Chung KK. Burn wound healing and treatment: review and advancements. Crit Care. 2015 Jun 12;19:243. doi: 10.1186/s13054-015- 0961-2.
8. Calum H, Moser C, Jensen PØ, Christophersen L, Maling DS, van Gennip M, Bjarnsholt T, Hougen HP, Givskov M, Jacobsen GK, Høiby N. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection. Clin Exp Immunol. 2009 Apr;156(1):102-10. doi: 10.1111/j.1365- 2249.2008.03861.x..
9. Nahaichuk V, Nazarchuk O. Correlation of Susceptibility to Antiseptics With Biofilm-forming Properties in Acinetobacter baumannii as a Pathogen of Surgical Infection. Malaysian Journal of Medicine and Health Sciences. 2020;16(1):1-5.
10. Ashkenazi S. Beginning and possibly the end of the antibiotic era. J Paediatr Child Health. 2013;49(3):E179–82.
11. Shepeleva V.M., Tugbaeva O.G., Emelyanova A.M., Styazhkina S.N. The use of immunomodulators in the systemic therapy of burn wounds: a clinical case. Modern science. 2020;4(1):294-297. [In Rus.].
12. Kuznetsova LV, Babadjan VD, Frolov VM, Kravchun PG, Kuznetsov GV, Prilutsky OS et al. Immunological research methods. L.V. Kuznetsova, В.М. Frolov (eds). Clinical and laboratory immunology. Kyiv: Polygraph Plus LLC; 2012. p. 82-143. [in Ukr.].
13. Chornopyshchuk RM, Sydorenko SA, Burkovskyi MI. Automated Morphometry of Neutrophilic Granulocytes – A Simple and Reliable Method of Assessment of the Wound Process Activity. In: Sontea V., Tiginyanu I. (eds) 3rd International Conference on Nanotechnologies and Biomedical Engineering. IFMBE Proceedings. Springer, Singapore. 2016;55:391-393. https://doi.org/10.1007/978- 981-287-736-9_93
14. Ipaktchi K, Vogt PM. Immunologie und Sepsissyndrom beim Brandverletzten [Immunology and sepsis syndrome in burn trauma]. Unfallchirurg. 2009 May;112(5):472- 8. German. doi: 10.1007/s00113-009-1652-8. Erratum in: Unfallchirurg. 2009 Sep;112(9):826. PMID: 19440644
Gromov MI. The use of immunomodulators in surgical practice. Terra medica nova. 2006;1:10-15. [In Rus.].
Published
2021-06-20
How to Cite
Nagaichuk, V. I., ChornopyshchukR. М., Khimich, S. D., NazarchukО. А., BurkovskyiМ. І., & BobeloА. S. (2021). IMMUNOLOGICAL CRITERIA FOR EFFECTIVE SYSTEMIC USE OF MURAMYL PEPTIDE IMMUNOMODULATOR IN THE TREATMENT OF PATIENTS WITH BURN INJURIES. Kharkiv Surgical School, (2), 72-79. https://doi.org/10.37699/2308-7005.2.2021.14
Section
QUESTIONS OF BURN DISEASE