RESUMEN
Interstitial cystitis/bladder pain syndrome (IC/BPS) is an enigmatic chronic disorder characterized by vague bladder pain of variable severity accompanied by urinary symptoms. The pathogenesis and etiology of IC/BPS remain incompletely defined. However, there is an emerging consensus about the central role of epithelial dysfunction, bladder sensory nerve up-regulation, and mast cell activation in the genesis of IC/BPS. Accumulating evidences have suggested that tissue damage is recognized at the cell level via receptor-mediated detection of intracellular proteins (so-called alarmins) released by the necrotic cells. Among these proteins IL-33, galectin-3 (Gal-3) and advanced glycation end products (AGE), may have an important role because they can be participated as cellular components that stimulate the immune system. We determined IL-33, Gal-3, and AGE in 24-hour urine specimens from patients with IC/BPS and healthy subjects. Study participants included 43 woman with IC/BPS and 29 female volunteers. Urinary IL-33, EGF and Gal-3 levels were measured using an enzyme-linked immunosorbent assay, whereas the content of AGE was quantified by natural AGE-specific fluorescence (Ex. 370 nm, Em. 440 nm). Urinary IL-33, and Gal-3 levels were normalized by urinary creatinine (Cr) levels and compared among subgroups. We have found that the levels of IL-33 and Gal-3 were significantly increased in IC/BPS. The level of the IL-33 in the urine of healthy women was equal to 0.32, while the level of IL-33 in IC/BPS patients increases up to 0.58 (p<0.05). Further, the amounts of urine Gal-3 were also elevated in IC/BPS compared to healthy subjects (0.16 versus 0.07; p>0.01) and AGE-specific fluorescence in urine was increased up to 140% in IC/BPS patients. These data suggest on the participation of IL-33, Gal-3 and AGE in the pathogenesis of IC/BPS.
Asunto(s)
Cistitis Intersticial/fisiopatología , Galectina 3/orina , Interleucinas/orina , Dolor/etiología , Vejiga Urinaria/fisiopatología , Proteínas Sanguíneas , Estudios de Casos y Controles , Cistitis Intersticial/orina , Femenino , Galectinas , Productos Finales de Glicación Avanzada/orina , Humanos , Interleucina-33 , Persona de Mediana EdadRESUMEN
Urinary Tract Infections (UTI) represent a serious medical problem with considerably high rate of morbidity. Recurrent episodes of urinary tract infection (rUTI) may commonly develop in the way of relapse or reinfection. For patients, rUTI is always associated with costs, discomfort and decreased quality of life. Standard treatment of rUTI is through antibiotics and usually such treatment is required repeatedly. Repeat course of antibiotics leads to increase of resistance of uropathogenic strains. According to the European Association of Urology, "the present state of microbial resistance development is alarming". Our post-marketing trial was designed to demonstrate the substantial effect of the bacterial vaccine Solco-Urovac® both with independent administration and in conjunction with standard antibacterial medication within therapy and prevention of rUTI. Total of 115 patients (men and non-pregnant women) were enrolled in our open-label post-marketing trial. Each patient had more than one year history of rUTI and in the past had already taken appropriate course of standard therapy. The trial group included 50 patients: 32 men, 18 women (average age ± 32.5). 32 patients (men) of the trial group received vaccination with Solco-Urovac® together with the standard antibacterial medication. According to bacteriologic tests, in 62% cases infection was caused by Escherichia coli, and in 38% cases by Morganella morganii, Proteus mirabilis, Klebsiella pneumoniae, Enterococcus faecalis. 18 patients within the trial group were women with no recurrence episode at the start and during the trial period. Each woman was involved as the intercourse partner of the respective man within the trial group. The women received only vaccination with Solco-Urovac®. 65 patients of the control group had more than one year history of rUTI and had been treated earlier, too. Patients of the control group received appropriate antibacterial medication without Solco-Urovac®. After therapy and follow-up examination, results in the both groups were classified, also in consideration of the pathogen-specified subgroups, and then summarized and compared respectively. During the follow-up period no case of rUTI was noticed in women. In total, analysis of the medical records of 50 patients of the trial group demonstrated no case of rUTI in 46 patients during the follow-up period. Altogether, the rate of improvement of symptoms was as follows: the trial group - 92%, the control group - 74%. Through comparison with the past medical histories of patients, the higher rate of improvement and longer absence of rUTI episodes after treatment were certainly associated with the effect of Solco-Urovac®. The results of our post-marketing trial allow recommending Solco-Urovac® for appropriate reference within the Georgian National Guideline on Urologic Infections.
Asunto(s)
Vacunas Bacterianas/administración & dosificación , Infecciones Urinarias/microbiología , Infecciones Urinarias/terapia , Adolescente , Adulto , Anciano , Bacterias/clasificación , Bacterias/aislamiento & purificación , Bacterias/patogenicidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Embarazo , Calidad de Vida , Recurrencia , Factores de Riesgo , Infecciones Urinarias/prevención & controlRESUMEN
Calcium and Phosphorus are the basic elements in making the inorganic matrix of bone tissue. With the purpose of our research was to study the local effect of hydoxypatite and Platelet Rich Plasma (P.R.P.) on the course of reparative osteogenesis. We used hydroxyapatite granules made by the firm "Polystom" with the chemical formula Ca(10)(PO(4))(6)(OH)(2). Platelet Rich Plasma we have got from blood of rabbits by centrifuging. Experiment was made on 30 rabbits. by operation the standard defects were created with the diameter of 66mm and the depth of 4-5mm on the mandibular bone of the rabbits. In the laboratory group defects were filled with hydroxyapatite and P.R.P., in control group with their own blood. After 7,14,21,35 and 50 days after operation three rabbits were taken from each group. Mandibular bone fractions with defects were relieved from soft tissue, were fixed in 10% neutral formalin and were stained with hematoxyn-eozine. The study showed that in the study group at the initial stage of differentiation from the moment of traumatization the pre-osteoblast and osteoblast contour permanently appears. And in the control group the resorbtion processes were clearly expressed. At the end of the experiment of 50 days in the experimental group the compaction of osteogenic structure was observed in all defect areas. Newly generated tissue underwent compaction. The results of the experiment prove that the hydroxypatite and Platelet Rich Plasma has a stimulative role in the process of osteogenesis. Activation of the reparative processes is far more intensive at the final stage of osteogenesis.