Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-34-41
E. Peda, B. Nanaeva, O. Knyazev, T. Alexandrov, T. Baranova
Introduction: Currently, the possibilities in the treatment of Crohn’s disease (CD) are expanding. Various classes of genetically engineered biological therapy are available for the treatment of inflammatory bowel diseases (IBD). Vedolizumab, having a selective nature of action, has a higher safety profile of the drug, which suggests lower immunogenicity and, as a consequence, long-term efficacy. Materials and methods: A retrospective study was conducted on the basis of the National Medical Research Centre of Coloproctology named after A. N. Ryzhikh, which included 54 patients treated with vedolizumab. In the course of the work, the survival of therapy was evaluated, as well as the influence of demographic characteristics, localization, phenotype of the disease and other factors on the effectiveness of therapy. Results: The study showed 86.0% (95% CI 72.8-93.1) survival of therapy for 15 months and 75.9% (95% CI 58.8-86.7) for two years. No statistically significant differences were obtained when assessing the effect of gender, comorbidity, lesion localization, disease phenotype, smoker status and the use of glucocorticosteroids during vedolizumab induction. During the analysis, it was revealed that significant factors affecting the effectiveness of therapy are the age of CD debut less than 21 years and the SES-CD index index more than 7, as well as previous therapy with the use of two or more anti-TNF drugs. Discussion: Despite the small sample size, the findings allow us to predict the effectiveness of therapy, which may affect survival.
简介目前，治疗克罗恩病（CD）的可能性正在不断扩大。各种基因工程生物疗法可用于治疗炎症性肠病（IBD）。维多珠单抗具有选择性作用，药物安全性较高，免疫原性较低，因此具有长期疗效。材料与方法在以 A. N. Ryzhikh 命名的国家结肠直肠医学研究中心的基础上进行了一项回顾性研究，其中包括 54 名接受过维妥珠单抗治疗的患者。在研究过程中，评估了治疗的存活率，以及人口学特征、疾病的定位、表型和其他因素对治疗效果的影响。结果显示研究显示，15 个月的治疗存活率为 86.0%（95% CI 72.8-93.1），两年的治疗存活率为 75.9%（95% CI 58.8-86.7）。在评估性别、合并症、病灶定位、疾病表型、吸烟状况以及在维多珠单抗诱导期间使用糖皮质激素的影响时，未发现有统计学意义的差异。分析结果显示，影响疗效的重要因素包括 CD 首次发病年龄小于 21 岁、SES-CD 指数大于 7 以及既往曾使用两种或两种以上抗肿瘤坏死因子药物治疗。讨论：尽管样本量较小，但研究结果使我们能够预测可能影响生存的治疗效果。
{"title":"Long-term efficacy of vedolizumab therapy in patients with Crohn’s disease","authors":"E. Peda, B. Nanaeva, O. Knyazev, T. Alexandrov, T. Baranova","doi":"10.31146/1682-8658-ecg-217-9-34-41","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-34-41","url":null,"abstract":"Introduction: Currently, the possibilities in the treatment of Crohn’s disease (CD) are expanding. Various classes of genetically engineered biological therapy are available for the treatment of inflammatory bowel diseases (IBD). Vedolizumab, having a selective nature of action, has a higher safety profile of the drug, which suggests lower immunogenicity and, as a consequence, long-term efficacy. Materials and methods: A retrospective study was conducted on the basis of the National Medical Research Centre of Coloproctology named after A. N. Ryzhikh, which included 54 patients treated with vedolizumab. In the course of the work, the survival of therapy was evaluated, as well as the influence of demographic characteristics, localization, phenotype of the disease and other factors on the effectiveness of therapy. Results: The study showed 86.0% (95% CI 72.8-93.1) survival of therapy for 15 months and 75.9% (95% CI 58.8-86.7) for two years. No statistically significant differences were obtained when assessing the effect of gender, comorbidity, lesion localization, disease phenotype, smoker status and the use of glucocorticosteroids during vedolizumab induction. During the analysis, it was revealed that significant factors affecting the effectiveness of therapy are the age of CD debut less than 21 years and the SES-CD index index more than 7, as well as previous therapy with the use of two or more anti-TNF drugs. Discussion: Despite the small sample size, the findings allow us to predict the effectiveness of therapy, which may affect survival.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"178 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-13-19
A. Pershko, V. Grinevich, E. S. Ivanyuk
The study of inflammatory bowel disease is characterized by dynamism and new discoveries. Subtle and new mechanisms of participation of genetic and environmental factors in the pathogenesis of inflammatory bowel diseases have been deciphered, as well as new classes of drugs have appeared that allow influencing many parts of the inflammatory process. However, the paradox of the situation lies in the fact that the more recent advances and discoveries in the field of biology and medicine, the more “gray spots” become in our understanding of the pathogenesis and approaches to the treatment of this category of patients. At the same time, the fundamental problems of IBD, related to reducing the risk of surgical interventions and restoring the quality of life of patients to the population level, are far from being resolved. The article discusses new methodological approaches to the treatment of patients with inflammatory bowel diseases using new classes of cytostatics and granulocyte-macrophage colony-stimulating factors.
{"title":"New opportunities in the diagnosis and treatment of inflammatory bowel diseases","authors":"A. Pershko, V. Grinevich, E. S. Ivanyuk","doi":"10.31146/1682-8658-ecg-217-9-13-19","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-13-19","url":null,"abstract":"The study of inflammatory bowel disease is characterized by dynamism and new discoveries. Subtle and new mechanisms of participation of genetic and environmental factors in the pathogenesis of inflammatory bowel diseases have been deciphered, as well as new classes of drugs have appeared that allow influencing many parts of the inflammatory process. However, the paradox of the situation lies in the fact that the more recent advances and discoveries in the field of biology and medicine, the more “gray spots” become in our understanding of the pathogenesis and approaches to the treatment of this category of patients. At the same time, the fundamental problems of IBD, related to reducing the risk of surgical interventions and restoring the quality of life of patients to the population level, are far from being resolved. The article discusses new methodological approaches to the treatment of patients with inflammatory bowel diseases using new classes of cytostatics and granulocyte-macrophage colony-stimulating factors.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"67 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-231-237
L. P. Petrosyan, M. Sargsyan, V. O. Petrosyan, V. N. Mukuchyan
There are certain difficulties with diagnosing of poliarteritis nodoza, that is explained by the folllowung factors: non-specificity of the initial symptoms, polymorphism of clinical manifestations, the abcence of specific laboratory markers. Тhe diagnosis is made primarily on the basis of the clinical picture, that becomes apparent during the first three months of illness. The abcence of a detailed clinical picture does not exclude the presense of poliarteritis nodoza. It may be explained by the concomitant pathology, in this case periodic illness (familian mediterranean fever). Due to medical literature data, poliarteritis nodoza is surely associated with periodic illness. The prevalence of poliarteritis nodoza in general population is about 6 on 100 000 people.The prevalence of poliarteritis nodoza among the patients suffering from periodic illness is 1%. The patients when they are diagnosed polyarteritis nodosa in association with periodic illness are younger than the patients when they are diagnosed only polyarteritis nodosa. It turned out to be interesting that the treatment of patients with polyarteritis nodosa in association with periodic illness through glucocorticoid drugs in the combination with colchicines proved to be successful and resulted in remission.
{"title":"Clinical features of the course of polyarteritis nodosa in combination with familial Mediterranean fever","authors":"L. P. Petrosyan, M. Sargsyan, V. O. Petrosyan, V. N. Mukuchyan","doi":"10.31146/1682-8658-ecg-217-9-231-237","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-231-237","url":null,"abstract":"There are certain difficulties with diagnosing of poliarteritis nodoza, that is explained by the folllowung factors: non-specificity of the initial symptoms, polymorphism of clinical manifestations, the abcence of specific laboratory markers. Тhe diagnosis is made primarily on the basis of the clinical picture, that becomes apparent during the first three months of illness. The abcence of a detailed clinical picture does not exclude the presense of poliarteritis nodoza. It may be explained by the concomitant pathology, in this case periodic illness (familian mediterranean fever). Due to medical literature data, poliarteritis nodoza is surely associated with periodic illness. The prevalence of poliarteritis nodoza in general population is about 6 on 100 000 people.The prevalence of poliarteritis nodoza among the patients suffering from periodic illness is 1%. The patients when they are diagnosed polyarteritis nodosa in association with periodic illness are younger than the patients when they are diagnosed only polyarteritis nodosa. It turned out to be interesting that the treatment of patients with polyarteritis nodosa in association with periodic illness through glucocorticoid drugs in the combination with colchicines proved to be successful and resulted in remission.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"40 7-8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-75-84
A. Shuleshova, A. A. Lisitsa, D. V. Danilov, A. E. Komlev
Aim. To establish the prevalence of atherosclerotic lesions in the unpaired visceral artery branches of the abdominal aorta. To explore the features of clinical presentation, the state of the mucosa of the upper GI tract. Materials and methods. A total of 118 patients with atherosclerosis of the unpaired visceral artery branches of the abdominal aorta aged 45 to 89 years were examined. The comparison group included 120 patients without atherosclerosis in the unpaired visceral artery branches of the abdominal aorta. Patients in both groups had coronary atherosclerosis. Ultrasound dopplerography (USDG) as a screening technique, CT angiography, and MSCT aortography were used to verify occlusion-stenotic lesions in the unpaired visceral artery branches of the abdominal aorta. The diagnosis of erosion changes in the gastric mucosa was confirmed by clinical symptoms and endoscopic examination findings. Results. In our study, hemodynamically relevant stenosis (>70%) was identified in 28.8% of patients. The clinical presentation of atherothrombosis in mesenteric vessels was shown to be nonspecific. Abdominal pain was the most common symptom in the examined patients with abdominal angina (76.3%). The upper GI endoscopy in patients with a verified diagnosis of chronic abdominal ishemia (CAI) showed gastric mucosa atrophy (focal or diffuse) in 100% of cases. Gastric erosions are identified in 55.1% of patients. Gastric ulcers are observed in 27.1% of patients. Erosive and ulcerative lesions of the gastric mucosa are combined with atrophic changes in the mucosa. Erosive esophagitis was detected in 28.8% of patients. The frequency of detected focal abnormalities in the esophageal mucosa accounts for 27.3%, and those in the gastric mucosa is 54.2%, mainly due to intestinal metaplasia. Conclusion. Due to the increasing prevalence of obliterative vascular diseases, early detection of changes in the upper gastrointestinal tract remains an urgent challenge. The comprehensive endoscopic examination using additional endoscopic NBI and ZOOM techniques allows to identify all changes in the mucosa, including small focal abnormalities. Timely detection of the disease makes it possible to choose the right treatment method.
{"title":"Atherosclerosis of unpaired visceral branches of the abdominal aorta (clinical and instrumental diagnostics)","authors":"A. Shuleshova, A. A. Lisitsa, D. V. Danilov, A. E. Komlev","doi":"10.31146/1682-8658-ecg-217-9-75-84","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-75-84","url":null,"abstract":"Aim. To establish the prevalence of atherosclerotic lesions in the unpaired visceral artery branches of the abdominal aorta. To explore the features of clinical presentation, the state of the mucosa of the upper GI tract. Materials and methods. A total of 118 patients with atherosclerosis of the unpaired visceral artery branches of the abdominal aorta aged 45 to 89 years were examined. The comparison group included 120 patients without atherosclerosis in the unpaired visceral artery branches of the abdominal aorta. Patients in both groups had coronary atherosclerosis. Ultrasound dopplerography (USDG) as a screening technique, CT angiography, and MSCT aortography were used to verify occlusion-stenotic lesions in the unpaired visceral artery branches of the abdominal aorta. The diagnosis of erosion changes in the gastric mucosa was confirmed by clinical symptoms and endoscopic examination findings. Results. In our study, hemodynamically relevant stenosis (>70%) was identified in 28.8% of patients. The clinical presentation of atherothrombosis in mesenteric vessels was shown to be nonspecific. Abdominal pain was the most common symptom in the examined patients with abdominal angina (76.3%). The upper GI endoscopy in patients with a verified diagnosis of chronic abdominal ishemia (CAI) showed gastric mucosa atrophy (focal or diffuse) in 100% of cases. Gastric erosions are identified in 55.1% of patients. Gastric ulcers are observed in 27.1% of patients. Erosive and ulcerative lesions of the gastric mucosa are combined with atrophic changes in the mucosa. Erosive esophagitis was detected in 28.8% of patients. The frequency of detected focal abnormalities in the esophageal mucosa accounts for 27.3%, and those in the gastric mucosa is 54.2%, mainly due to intestinal metaplasia. Conclusion. Due to the increasing prevalence of obliterative vascular diseases, early detection of changes in the upper gastrointestinal tract remains an urgent challenge. The comprehensive endoscopic examination using additional endoscopic NBI and ZOOM techniques allows to identify all changes in the mucosa, including small focal abnormalities. Timely detection of the disease makes it possible to choose the right treatment method.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"131 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-68-74
M. A. Osadchuk, E. Mironova, N. V. Kireeva
{"title":"Expression of motilin and vasoactive intestinal peptide in the mucosa of the sigmoid colon in patients with diverticular disease of the large intestine and irritable bowel syndrome","authors":"M. A. Osadchuk, E. Mironova, N. V. Kireeva","doi":"10.31146/1682-8658-ecg-217-9-68-74","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-68-74","url":null,"abstract":"","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"16 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-253-260
I. N. Kupriyanova, R. B. Berdnikov, R. M. Bozrov, M. A. Stafilova
The article presents a clinical observation of Whipple’s disease in a 42-year-old patient with a history of stage IIB Hodgkin’s lymphoma, in whom the disease debuted with articular syndrome, lymphadenopathy of the retroperitoneal and mesenteric lymph nodes, deep vein thrombosis of the leg. The diagnosis was confirmed by a morphological study of biopsy specimens of the duodenal mucosa, mesenteric lymph nodes 12 p. of the intestine, electron microscopic detection of accumulations of rod-shaped bacteria in the intestinal mucosa 6 years after the onset of clinical manifestations. Dynamic observation for 5 years was carried out using video gastroduodenoscopy, morphological assessment of changes in xanthoma macrophages proposed by A. Herbay, the percentage of damage by PAS-positive macrophages to the area of the lamina propria of the duodenal mucosa of the intestine. Conducted therapy with ceftriaxone for 14 days followed by taking co-trimaxosole for 4 years 7 months led to a stable remission.
{"title":"Whipple’s disease: 5-year clinical follow-up","authors":"I. N. Kupriyanova, R. B. Berdnikov, R. M. Bozrov, M. A. Stafilova","doi":"10.31146/1682-8658-ecg-217-9-253-260","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-253-260","url":null,"abstract":"The article presents a clinical observation of Whipple’s disease in a 42-year-old patient with a history of stage IIB Hodgkin’s lymphoma, in whom the disease debuted with articular syndrome, lymphadenopathy of the retroperitoneal and mesenteric lymph nodes, deep vein thrombosis of the leg. The diagnosis was confirmed by a morphological study of biopsy specimens of the duodenal mucosa, mesenteric lymph nodes 12 p. of the intestine, electron microscopic detection of accumulations of rod-shaped bacteria in the intestinal mucosa 6 years after the onset of clinical manifestations. Dynamic observation for 5 years was carried out using video gastroduodenoscopy, morphological assessment of changes in xanthoma macrophages proposed by A. Herbay, the percentage of damage by PAS-positive macrophages to the area of the lamina propria of the duodenal mucosa of the intestine. Conducted therapy with ceftriaxone for 14 days followed by taking co-trimaxosole for 4 years 7 months led to a stable remission.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"157 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-99-106
N. A. Konyshko, G. S. Konyshko
The frequency of achieving control as a result of taking antihypertensive drugs in women in the age group 55-64 years reaches 78.9%, the frequency of gastrointestinal symptoms occurring during treatment of hypertension is up to 62%. The aim: to analyze the probable causes of the development of symptoms of diseases of the gastrointestinal tract in postmenopausal patients receiving antihypertensive therapy. Material and methods. A comprehensive clinical examination of out-patient and in-patient patients of health care institutions of the Smolensk region with hypertension aged 50 to 84 years, (group AG, n=160) mean age 67.4 ± 17.4 years. Results. Complex examination and observation on the basis of standard methods with high probability shows the formation of gastroesophageal reflux disease, gastritis, simple erosions of the gastric mucosa, biliary dysfunction, chronic pancreatitis steatohepatosis in the observed patients. Conclusions: In postmenopausal women receiving antihypertensive therapy, there are major gastrointestinal symptoms of varying severity, arising in conditions of irrational nutrition, psycho-emotional and physical stress on the background of irregular medication. Based on the analysis of modern scientific sources, it can be argued that complex rational antihypertensive, antiplatelet, hypolipidemic, antisecretory and eradication therapy and the correction of modifiable risk factors ensures the achievement of remission of gastrointestinal and cardiovascular disease in the optimal time, improves the quality, life expectancy of patients and improves disease prognosis.
{"title":"Probable gastrointestinal disease factors in postmenopausal age women receiving antihypertensive therapy","authors":"N. A. Konyshko, G. S. Konyshko","doi":"10.31146/1682-8658-ecg-217-9-99-106","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-99-106","url":null,"abstract":"The frequency of achieving control as a result of taking antihypertensive drugs in women in the age group 55-64 years reaches 78.9%, the frequency of gastrointestinal symptoms occurring during treatment of hypertension is up to 62%. The aim: to analyze the probable causes of the development of symptoms of diseases of the gastrointestinal tract in postmenopausal patients receiving antihypertensive therapy. Material and methods. A comprehensive clinical examination of out-patient and in-patient patients of health care institutions of the Smolensk region with hypertension aged 50 to 84 years, (group AG, n=160) mean age 67.4 ± 17.4 years. Results. Complex examination and observation on the basis of standard methods with high probability shows the formation of gastroesophageal reflux disease, gastritis, simple erosions of the gastric mucosa, biliary dysfunction, chronic pancreatitis steatohepatosis in the observed patients. Conclusions: In postmenopausal women receiving antihypertensive therapy, there are major gastrointestinal symptoms of varying severity, arising in conditions of irrational nutrition, psycho-emotional and physical stress on the background of irregular medication. Based on the analysis of modern scientific sources, it can be argued that complex rational antihypertensive, antiplatelet, hypolipidemic, antisecretory and eradication therapy and the correction of modifiable risk factors ensures the achievement of remission of gastrointestinal and cardiovascular disease in the optimal time, improves the quality, life expectancy of patients and improves disease prognosis.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"31 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140505297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-17DOI: 10.31146/1682-8658-ecg-217-9-89-98
V. A. Osadchij, N. I. Bikova, I. S. Dolgopolov
Purpose of the study. To find out the effectiveness of the use of angiotensin-converting enzyme (ACE) inhibitors in the complex therapy of erosive and ulcer lesions of the stomach and duodenum in unstable angina pectoris (UA). Materials and methods. A survey of 109 patients with UA with gastroduodenal erosions and ulcers was carried out, taking into account their clinical signs, endoscopic features and the parameters of gastric secretion. The patients were divided into two groups depending on the nature of the treatment of erosions and ulcers. The first group included 40 patients treated with standard therapy, and the second one included 69 patients who additionally received ACE inhibitor lisinopril at an average dose of 7.27±0.16 mg a day. Results. The therapy by lisinopril resulted in decreasing of pain and dyspeptic syndrome, especially in patients with acute erosions, compared with conventional treatment group. According to endoscopic examination, in patients treated with lisinopril, an acceleration of repair processes in the tissues of the gastroduodenal zone was observed. The depth and size of damages, a reduction in the period of persistence of microbleeding signs and inflammatory changes in the periulcerous zone were also less pronounced in lisinopril patient’s group. In patients with acute erosions a decrease in the number and size of erosive defects of the mucous membrane was observed. The study of the parameters of gastric secretion showed that gastroduodenal erosions and ulcers in UA revealed the activation of the acid-peptic factor and a decreasing in the production of gastromucoproteins. Increased production of pepsinogen and a sharply reduced formation of protective mucus was observed in patients after conventional treatment, despite some positive dynamics. Normalization in pepsinogen secretion with some inhibition of the production of mucopolysaccharides was observed in Lisinopril treated patients at the end of therapy. Acid production in both groups was reduced, which was associated with could be provoked by an uptake of antisecretory agents. Conclusion. The use of ACE inhibitor lisinopril in the complex therapy in patients with UA with gastroduodenal erosions and ulcers is pathogenetically justified and clinically effective. This combination helps to reduce the duration of clinical signs, accelerate the healing of defects and normalize the parameters of gastric secretion.
{"title":"Efficacy of the use of angiotensin converting enzyme inhibitors in the complex therapy of gastroduodenal erosions and ulcers in patients with unstable angina","authors":"V. A. Osadchij, N. I. Bikova, I. S. Dolgopolov","doi":"10.31146/1682-8658-ecg-217-9-89-98","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-217-9-89-98","url":null,"abstract":"Purpose of the study. To find out the effectiveness of the use of angiotensin-converting enzyme (ACE) inhibitors in the complex therapy of erosive and ulcer lesions of the stomach and duodenum in unstable angina pectoris (UA). Materials and methods. A survey of 109 patients with UA with gastroduodenal erosions and ulcers was carried out, taking into account their clinical signs, endoscopic features and the parameters of gastric secretion. The patients were divided into two groups depending on the nature of the treatment of erosions and ulcers. The first group included 40 patients treated with standard therapy, and the second one included 69 patients who additionally received ACE inhibitor lisinopril at an average dose of 7.27±0.16 mg a day. Results. The therapy by lisinopril resulted in decreasing of pain and dyspeptic syndrome, especially in patients with acute erosions, compared with conventional treatment group. According to endoscopic examination, in patients treated with lisinopril, an acceleration of repair processes in the tissues of the gastroduodenal zone was observed. The depth and size of damages, a reduction in the period of persistence of microbleeding signs and inflammatory changes in the periulcerous zone were also less pronounced in lisinopril patient’s group. In patients with acute erosions a decrease in the number and size of erosive defects of the mucous membrane was observed. The study of the parameters of gastric secretion showed that gastroduodenal erosions and ulcers in UA revealed the activation of the acid-peptic factor and a decreasing in the production of gastromucoproteins. Increased production of pepsinogen and a sharply reduced formation of protective mucus was observed in patients after conventional treatment, despite some positive dynamics. Normalization in pepsinogen secretion with some inhibition of the production of mucopolysaccharides was observed in Lisinopril treated patients at the end of therapy. Acid production in both groups was reduced, which was associated with could be provoked by an uptake of antisecretory agents. Conclusion. The use of ACE inhibitor lisinopril in the complex therapy in patients with UA with gastroduodenal erosions and ulcers is pathogenetically justified and clinically effective. This combination helps to reduce the duration of clinical signs, accelerate the healing of defects and normalize the parameters of gastric secretion.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"128 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140504963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-26DOI: 10.31146/1682-8658-ecg-212-4-28-36
A. B. Krivosheev, M. Kondratova, A. Gurazheva, V. Maksimov
Purpose. To study the frequency of genotypes and alleles of C282Y and H63D mutations in the HFE gene in patients with porphyria cutanea tarde of the West Siberian region and their influence on the clinical and biochemical characteristics of the disease. Materials and methods. We observed 14 patients with porphyria cutanea tarde (PCT), who underwent a comprehensive general clinical and instrumental examination. The indicators of the excretory profile of porphyrin metabolism indicators were purposefully determined, a molecular genetic examination was carried out to determine the genotypes and alleles of the C282Y and H63D mutations of the hemochromatosis gene HFE. Results and discussion. Molecular genetic research found that the HFE gene mutation was found in 7 patients (50.0%). Polymorphism for the C282Y allele was found in 2 (14.3%) patients, and for the H63D allele - in 5 patients (35.7%). Risk factors for the manifestation of PCT included frequent alcohol consumption and chronic HCV infection. Genotype 1b was recorded more often (9 people), less often - genotype 3a (4 people). The excretory profile of porphyrin metabolism indices in patients of both groups exceeded the control values. Porphyrin metabolism parameters in patients without HFE gene mutations were significantly higher than those in patients without HFE gene mutations. Conclusions. Polymorphism of the hemochromatosis gene HFE in PCT was detected in 50% of patients. The most common mutation was the H63D allele. The level of porphyrin metabolism disorders in patients with HFE hemochromatosis gene mutations is significantly lower. The clinical picture of PCT in all observed patients did not differ. Chronic viral hepatitis C is assessed as a risk factor for the manifestation of PCT.
{"title":"HFE hemochromatosis gene polymorphism and porphyria cutanea tarda","authors":"A. B. Krivosheev, M. Kondratova, A. Gurazheva, V. Maksimov","doi":"10.31146/1682-8658-ecg-212-4-28-36","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-212-4-28-36","url":null,"abstract":"Purpose. To study the frequency of genotypes and alleles of C282Y and H63D mutations in the HFE gene in patients with porphyria cutanea tarde of the West Siberian region and their influence on the clinical and biochemical characteristics of the disease. Materials and methods. We observed 14 patients with porphyria cutanea tarde (PCT), who underwent a comprehensive general clinical and instrumental examination. The indicators of the excretory profile of porphyrin metabolism indicators were purposefully determined, a molecular genetic examination was carried out to determine the genotypes and alleles of the C282Y and H63D mutations of the hemochromatosis gene HFE. Results and discussion. Molecular genetic research found that the HFE gene mutation was found in 7 patients (50.0%). Polymorphism for the C282Y allele was found in 2 (14.3%) patients, and for the H63D allele - in 5 patients (35.7%). Risk factors for the manifestation of PCT included frequent alcohol consumption and chronic HCV infection. Genotype 1b was recorded more often (9 people), less often - genotype 3a (4 people). The excretory profile of porphyrin metabolism indices in patients of both groups exceeded the control values. Porphyrin metabolism parameters in patients without HFE gene mutations were significantly higher than those in patients without HFE gene mutations. Conclusions. Polymorphism of the hemochromatosis gene HFE in PCT was detected in 50% of patients. The most common mutation was the H63D allele. The level of porphyrin metabolism disorders in patients with HFE hemochromatosis gene mutations is significantly lower. The clinical picture of PCT in all observed patients did not differ. Chronic viral hepatitis C is assessed as a risk factor for the manifestation of PCT.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82213789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-26DOI: 10.31146/1682-8658-ecg-212-4-107-112
G. F. Mukhammadieva, T. Yakupova, D. Karimov, Y. Valova, E. F. Repina, E. R. Kudoyarov
The aim of the study was to study the effect of oxymethyluracil complex compounds on the expression of glutathione-S-transferase genes in rat liver under conditions of its toxic damage by acrylamide. Materials and methods. The animals were divided into 5 groups of 6 animals each: control, acrylamide, acrylamide + complex compound of oxymethyluracil with ascorbic acid (MG-1), acrylamide + complex compound of oxymethyluracil with sodium succinate (MG-2), acrylamide + complex compound of oxymethyluracil with acetylcysteine (MG-10). The drugs were administered 1 hour before exposure to the toxicant for 28 days. After the end of the experiment, the animals were decapitated, the liver was removed, which was frozen in liquid nitrogen. Real-time reverse transcription polymerase chain reaction was used to analyze gene expression. Results. Exposure to acrylamide did not significantly affect the expression of the GSTP1, GSTT1, and GSTM1 genes in the liver of rats, however, for all the studied genes, there was a tendency to increase the value of the studied indicator. Prophylactic administration of a complex compound of oxymethyluracil with sodium succinate (MG-2) led to a statistically significant decrease in the transcriptional activity of the GSTM1 gene under conditions of toxic damage to the liver by acrylamide. Conclusion. The results of the study indicate the ability of the MG-2 drug to suppress the expression of the GSTM1 gene in the liver of rats when exposed to acrylamide. Further research is needed to better understand the molecular mechanisms of acrylamide-induced toxicity and to develop new therapeutic approaches to treat liver pathology.
{"title":"Dynamics of glutathione- S-transferase gene expression in subacute liver damage caused by acrylamide and on the background of correction","authors":"G. F. Mukhammadieva, T. Yakupova, D. Karimov, Y. Valova, E. F. Repina, E. R. Kudoyarov","doi":"10.31146/1682-8658-ecg-212-4-107-112","DOIUrl":"https://doi.org/10.31146/1682-8658-ecg-212-4-107-112","url":null,"abstract":"The aim of the study was to study the effect of oxymethyluracil complex compounds on the expression of glutathione-S-transferase genes in rat liver under conditions of its toxic damage by acrylamide. Materials and methods. The animals were divided into 5 groups of 6 animals each: control, acrylamide, acrylamide + complex compound of oxymethyluracil with ascorbic acid (MG-1), acrylamide + complex compound of oxymethyluracil with sodium succinate (MG-2), acrylamide + complex compound of oxymethyluracil with acetylcysteine (MG-10). The drugs were administered 1 hour before exposure to the toxicant for 28 days. After the end of the experiment, the animals were decapitated, the liver was removed, which was frozen in liquid nitrogen. Real-time reverse transcription polymerase chain reaction was used to analyze gene expression. Results. Exposure to acrylamide did not significantly affect the expression of the GSTP1, GSTT1, and GSTM1 genes in the liver of rats, however, for all the studied genes, there was a tendency to increase the value of the studied indicator. Prophylactic administration of a complex compound of oxymethyluracil with sodium succinate (MG-2) led to a statistically significant decrease in the transcriptional activity of the GSTM1 gene under conditions of toxic damage to the liver by acrylamide. Conclusion. The results of the study indicate the ability of the MG-2 drug to suppress the expression of the GSTM1 gene in the liver of rats when exposed to acrylamide. Further research is needed to better understand the molecular mechanisms of acrylamide-induced toxicity and to develop new therapeutic approaches to treat liver pathology.","PeriodicalId":12262,"journal":{"name":"Experimental and Clinical Gastroenterology","volume":"52 Pt 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83915001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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