General Surgery

doi: 10.25005/2074-0581-2020-22-3-455-460
ROLE OF MONOCYTES IN PATHOGENESIS OF GENERALIZED PERITONITIS

A.R. Saraev, Sh.K. Nazarov, S.G. Ali-Zade

Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To study the sepsis markers informativeness to assess the role of monocytes in the pathogenesis of generalized peritonitis (GP).

Methods: The study included 160 patients with GP, who were divided into 3 groups, according to the stages of the disease. To establish the activity of monocytes was made a determination of the level of cytokine TNF-α and presepsin in the blood.

Results: Studies showed that the level of TNF-α in patient with septic shock was reliably lower (24.5±13.3 pg/ml) than in patients with endogenous intoxication and abdominal sepsis. The value of TNF-α in deceased patients also was low – 4.8±0.9 pg/ml. This indicates a decrease in the ability of monocytes in GP at the stage of septic shock to exude a sufficient amount of pro-inflammatory cytokines in response to endotoxin aggression. The level of presepsin increased by stages and amounted to 355.6±8.6, 783.4±24.0 and 1587.7±70.5 pg/ml, respectively. This indicates the circulation in the blood of the CD14 receptor, which is able to express on monocytes, converting them into endothelial progenitor cells.

Conclusion: Monocytes as endothelial progenitor cells contribute to the regeneration and restoration of endothelial function in its dysfunction that develops in GP and abdominal sepsis. In consequence of developing immunosuppression and suppression of monocyte function in the stage of septic shock, the process of renewal of endothelial cells is weakened, the secretion of pro-inflammatory cytokines, in particular TNF-α, decreases, which can contribute to an increase in mortality in septic shock.

Keywords: Monocytes, abdominal sepsis, septic shock, endothelial dysfunction, progenitor cells.

Download file:


References
  1. Lazanovich VA, Markelova EV, Smirnov GA, Smolina TP. Klinicheskaya znachimost’ ekspressii Toll2, Toll4, CD14, HLA-DR na monotsitakh u patsientov s sepsisom [Clinical significance of the expression of Toll2, Toll4, CD14, HLADR on monocytes in patients with sepsis]. Meditsinskaya immunologiya. 2015;3(17):221-8. Available from: https://doi.org/10.15789/1563-0625- 2015-3-221-228
  2. Semelyov VN, Tyrenko VV, Nikitin VYu, Yurkin AK, Sukhina IA, Tarakanova LA. Issledovanie pokazateley kletochnogo i gumoral’nogo immuniteta u bol’nykh ostrym mieloidnym leykozom i sepsisom [The study of indicators of cellular and humoral immunity in patients with acute myeloid leukemia and sepsis]. Vestnik Rossiyskoy voenno-meditsinskoy akademii. 2016;3:43-6.
  3. Perez A, Bellon JM, Gurbindo MD, Munoz-Fernandez MA. Impairment of stimulation ability of very-preterm neonatal monocytes in response to lipopolysaccharide. Hum Immunol. 2009;71(2):151-7. Available from: https:// doi.org/10.1016/j.humimm.2009.11.011
  4. Samsygina GA. O predraspolagayushchikh faktorakh i faktorakh riska razvitiya neonatal’nogo sepsisa i o sovremennykh podkhodakh ego lecheniya [On predisposing and risk factors for the development of neonatal sepsis and on modern approaches to its treatment]. Pediatriya. 2012; 91(3):32-7.
  5. Patrakeeva VP. Tsitokinovaya regulyatsiya proliferativnoy aktivnosti kletok perifericheskoy krovi [Cytokine regulation of proliferative activity of peripheral blood cells]. Ekologiya cheloveka. 2015;12:28-33.
  6. Chaudhry H, Zhou J, Zhong Y, Ali MM, McGuire F, Nagarkatti PS, et al. Role of cytokines as a double-edged sword in sepsis. In Vivo. 2013;27:669-84.
  7. Kalashnikova AA, Voroshilova TM, Chinenova LV, Davydova NI, Kalinina NM. Subpopulyatsii monotsitov u zdorovykh lits i u patsientov s sepsisom [Subpopulations of monocytes in healthy individuals and in patients with sepsis]. Meditsinskaya immunologiya. 2018;6:815-24. Available from: https://doi. org/10.15789/1563-0625-2018-6-815-824
  8. Horio E, Kadomatsu T, Miyata K, Arai Y, Hosokawa K, Doi Y, et al. Role of endothelial cell-derived angptl2 in vascular inflammation leading to endothelial dysfunction and atherosclerosis progression. Arterioscler Thromb Vasc Biol. 2014;34(4):790-800. Available from: https://doi.org/10.1161/ATVBAHA. 113.303116
  9. Poroyskiy SV, Voronkov AV, Poroyskaya AV. Otsenka posleoperatsionnogo sostoyaniya rezorbtsionnoy funktsii bryushiny i vazodilatiruyushchey aktivnosti endoteliotsitov eyo sosudov [Assessment of the postoperative state of the resorption function of the peritoneum and the vasodilating activity of its endothelial cells]. Volgogradskiy nauchno-meditsinskiy zhurnal. 2012:3;44-9.
  10. Rabelink TJ, de Boer HC, van Zonneveld AJ. Endothelial activation and circulating markers of endothelial activation in kidney disease. Nat Rev Nephrol. 2010;6:404-4.
  11. Gureev SA, Zinovkin DA, Shebushev NG. Endotelial’nye progenitornye kletki: uchastie v angiogeneze i perspektivy ispol’zovaniya v autologicheskoy kletochnoy terapii ateroskleroticheskikh porazheniy sosudov [Endothelial progenitor cells: participation in angiogenesis and prospects for using atherosclerotic vascular lesions in autologous cell therapy]. Problemy zdorov’ya i ekologii. 2013;2:7-11.
  12. Velkov VV. Presepsin – novyy vysokoeffektivnyy biomarkyor sepsisa [Presepsin – a new highly effective biomarker of sepsis]. Kliniko-laboratornyy konsilium. 2012;2:56-62.
  13. Zou Q, Wen W, Zhang X. Presepsin as a novel sepsis biomarker. World J Emerg Med. 2014;5:16-9.
  14. Pizzolato E, Ulla M, Galluzzo C, Lucchiari M, Manetta T, Lupia E, et al. Role of presepsin for the evaluation of sepsis in the emergency department. Clin Chem Lab Med. 2014;52(10):1395-400
  15. Faix JD. Presepsin – the new kid on the sepsis block. Clin Biochem. 2014;47(7- 8):503-4.
  16. Rudnov VA, Kulabukhov VV. Sepsis-3: obnovlyonnye klyuchevye polozheniya, potentsial’nye problemy i dal’neyshie prakticheskie shagi [Sepsis 3: updated key points, potential problems and further practical steps]. Vestnik anesteziologii i reanimatologii. 2016;4:4-11. Available from: https://doi. org/10.21292/2078-5658-2016-13-4-4-11
  17. Saraev AR. Usovershenstvovanie klassifikatsii peritonitov [Improvement of peritonitis classification]. Avicenna Bulletin (Vestnik Avitsenny). 2018;20(4):442-7. Available from: https://doi.org/10.25005/2074-0581- 2018-20-4-442-447
  18. Surbatovic M, Raffay V, Jevdjic J, Radakovic S, Jevtic M, Filipovic N, et al. Tumor necrosis factor-α in emergency department patients with systemic inflammation as a predictor of severity and outcome of sepsis. Obshchaya reanimatologiya. 2008;4(5):14-9. Available from: https://doi.org/10.15360/1813- 9779-2008-5-14
  19. Bhardwaj N, Mathur P, Kumar S, Gupta A, Gupta D, John NV, et al. Depressed monocytic activity may be a predictor for sepsis. J Lab Physicians. 2015;1(7):26-31. Available from: https://doi.org/10.4103/0974-2727.154785

Authors' information:


Saraev Alisher Rakhmatulloevich
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Researcher ID: F-5504-2019
ORCID ID: 0000-0001-9695-1924
SPIN: 6911-9887
Author ID: 849178
E-mail: dr.saraev@mail.ru

Nazarov Shokhin Kuvvatovich
Doctor of Medical Sciences, Full Professor, Head of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Researcher ID: C-4033-2019
ORCID ID: 0000-0003-2099-2353
SPIN: 1817-7089
Author ID: 845034
E-mail: shohin67@mail.ru

Ali-Zade Sukhrob Gaffarovich
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University
Researcher ID: B-6807-2019
ORCID ID: 0000-0002-2456-7509
SPIN: 6854-5343
Author ID: 258253
E-mail: suhrob_a@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Saraev Alisher Rakhmatulloevich
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (918) 650540

E-mail: dr.saraev@mail.ru

Materials on the topic: