Aprepitant as a combinant with Dexamethasone reduces the inflammation via Neurokinin 1 Receptor Antagonism in severe to critical Covid-19 patients and potentiates respiratory recovery: A novel therapeutic approach

AbstractCorona virus infection is a respiratory infection, compromising the normal breathing in critical patients by damaging the lungs. The aim of this study was to evaluate the clinical outcomes of Substance P receptor Neurokinin 1 antagonist in Covid-19 patients against the usual treatments as controls.MethodsIt is a randomized clinical trial, open label, having two arms, one receiving normal management and care while other receiving Neurokinin-1 Receptor antagonist, Aprepitant, in addition. Dexamethasone, a corticosteroid is also administered orally to both the groups. PCR positive, hospitalized patients with more than 18 years of age, both genders, moderate to critical phase were included. 41 patients were randomly allocated in both arms, having 21 patients in group A and 20 patients in group B. Lab investigations were performed in both the groups before and after the intervention.ResultsMean age of patients in group A was 50 ±18 years while 55±11 years in group B. There were 14/21 males in group A and 15/20 in group B. There were 3 critical patients in group A and 5 in group B. Biochemical and hematological parameters in both groups didn’t show much difference except the C-reactive protein reduction in the intervention group, indicative of a reduced inflammation.ConclusionsThe findings of this current study give a strong clue for the therapeutic potential of Aprepitant. Patients who received a combination therapy of Aprepitant and Dexamethasone showed improved clinical outcomes, laboratory findings and reduced C-reactive protein which is an inflammatory marker.Trial RegistrationThis trial is registered inclinicaltrials.gov(NCT04468646). To Determine the Efficacy of Neurokinin 1 Receptor Antagonist as a Therapeutic Tool Against Cytokine Storm and Respiratory Failure in Covid-19 Patients

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Prognostic Significance of Substance P/Neurokinin 1 Receptor and Its Association with Hormonal Receptors in Breast Carcinoma

BioMed Research International ◽

10.1155/2021/5577820 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Riffat Mehboob ◽

Syed Amir Gilani ◽

Amber Hassan ◽

Sadaf ◽

Imrana Tanvir ◽

...

Keyword(s):

Breast Carcinoma ◽

Substance P ◽

Tumor Cells ◽

Prognostic Significance ◽

Positive Staining ◽

Ki 67 ◽

Neurokinin 1 Receptor ◽

Group A ◽

Neurokinin 1 ◽

Group B

Expression and immunolocalization of Substance P (SP)/Neurokinin-1 Receptor (NK-1R) in breast carcinoma (BC) patients and its association with routine proliferative markers (ER, PR, HER2/neu, and Ki-67) were evaluated. A cross-sectional study was performed on 34 cases of BC. There were 23 cases of group A (grade III), 8 of group B (grade II), and only 3 cases of group C (grade I). All samples were then processed for SP and NK-1R immunohistochemistry for few cases. 14/23 cases (61%) of group A, 7/8 cases (88%) of group B, and 2/3 (67%) cases of group C were SP positive. Overall, strong staining (≥10% tumor cells), labeled as “+3,” was observed in 9/14 (64.2%) cases of group A and 1/8 (12.5%) cases of group B. Moderate staining labelled as “+2” (in ≥10% tumor cells) was observed in 3/14 (21.4%) cases of group A and 4/8 (50%) cases of group B. Weak positive staining “+1” was observed in only 2/14 (14.28%) cases of group A, 2/8 (25%) cases of group B, and all 2/2 (100%) cases of group C. SP and NK-1R are overexpressed in breast carcinomas, and there is significant association between the grade of tumor and their overexpression.

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C-Reactive Protein Predicts Progression of Peripheral Arterial Disease in Patients with Type 2 Diabetes: A 5-Year Follow-Up Study

Journal of Medical Biochemistry ◽

10.2478/jomb-2014-0042 ◽

2014 ◽

Vol 33 (4) ◽

pp. 347-355

Author(s):

Ljiljana Popović ◽

Katarina Lalić ◽

Olga Vasović ◽

Danijela Drašković Radojković ◽

Nataša Rajković ◽

...

Keyword(s):

Type 2 Diabetes ◽

Peripheral Arterial Disease ◽

Arterial Disease ◽

C Reactive Protein ◽

Reactive Protein ◽

Group A ◽

Hs Crp ◽

Group B ◽

Peripheral Arterial

Summary Background: Previous studies have indicated that high sensitivity C-reactive protein (hs-CRP) is a risk factor for the peripheral arterial disease (PAD) in diabetes. This study aimed to evaluate the possible predictive significance of hs-CRP for the development and progression of PAD in patients with type 2 diabetes (T2D). Methods: The study included 80 patients previously diagnosed with T2D, aged 45–70 years, divided into group A (T2D patients with PAD; n=38) and group B (T2D patients without PAD; n=42). After five years, all the patients were re-examined and divided into subgroups depending on de novo development of PAD or progression of previously diagnosed PAD. Ankle-Brachial Index (ABI) measurement was used for PAD diagnosis and hs-CRP was determined by nephelometry. Results: We found significantly higher hs-CRP levels in group A compared to group B, but only at baseline. Among the patients in group A, those with later progression of PAD (subgroup A1) had the highest levels of hs-CRP at baseline, although not significantly different from those in subgroup A2 (non-progressors). In contrast, hs-CRP level was significantly higher in subgroup B1 (progressors) in comparison to subgroup B2 (non-progressors) at both the first and second exam. Of all the investigated metabolic parameters, hs-CRP was the only independent predictor of PAD progression (OR=0.456, 95% CI=0.267–0.7815, p=0.004). The cut-off point for hs-CRP was 2.5 mg/L (specificity 75% and sensitivity 73.3%) with the relative risk for PAD of 2.93 (95% CI=1.351–6.3629). Conclusions: Our study implies that hs-CRP can be used as a reliable predictor for the progression of PAD in patients with T2D.

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Study of High sensitive C - reactive protein and Gamma-glutamyl transferase in Type 2 Diabetes Mellitus with Hypertension

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2494 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3478-3483

Author(s):

Ramya S ◽

Sureka Varalakshmi V ◽

Uma Maheswari K ◽

Chandan Bala R

Keyword(s):

Diabetes Mellitus ◽

Gamma Glutamyl Transferase ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

Group A ◽

Hs Crp ◽

Group B ◽

Glutamyl Transferase

C-reactive protein (CRP), produced by the hepatocytes is a primary inflammatory marker of T2DM. Higher levels of gamma-glutamyl transferase enzyme (GGT) and Hs CRP (High sensitive CRP)are associated with the complication of poor glycemic control.This study was aimed to find the association of Hs CRP and GGT for cardiovascular risk factors in Type 2 diabetes mellitus (T2DM)and Hypertension in the suburbs of Chennai. This study includes 57 subjects with T2DM and Hypertension (Group A) and 62 subjects with T2DM (GroupB) within the age group of 40-60 years. FBS, HbA1C, Hs CRP, GGT and blood pressure were determined. Statistical analysis was performed using Statistical Package for the SPSS 17 version. Mean values of FBS, blood HbA1C, Hs CRP and GGT were significantly higher among participants of Group A than Group B. Significant difference of FBS, HbA1C were found between the two groups. In contrast, no significant difference of GGT was found between the groups. Differences were considered statistically significant at two-sided P < 0.05. Within the group, Hs CRP shows the significance and positive correlation with FBS, SBP and DBP. Still, GGT does not show any significance in Group A. In contrast, in Group B, both Hs CRP and GGT shows the importance and positive correlation with FBS and HbA1C.It is concluded that high levels of HsCRP are associated with T2DM and Hypertension, indicating increased cardiovascular risk, and it should be included in regular monitoring of type-2 diabetic patients.

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A study of high sensitive C-reactive protein in rheumatoid arthritis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20205832 ◽

2020 ◽

Vol 9 (1) ◽

pp. 139

Author(s):

Priyanka Meena ◽

Sourabh Goswami ◽

Ajay Mathur ◽

Ramji Sharma

Keyword(s):

Rheumatoid Arthritis ◽

C Reactive Protein ◽

Dmard Therapy ◽

Random Blood Sugar ◽

Reactive Protein ◽

Early Ra ◽

Group A ◽

The Mean ◽

Hs Crp ◽

Group B

Background: Rheumatoid arthritis (RA) is not only merely limited to joints but has many extraarticular features. The major cause of mortality in RA is cardiovascular disease (CVD). Inflammation in RA predispose them to succumb to CVD. The aim of this study to observe whether therapy with disease-modifying anti-rheumatic drugs (DMARD) decreases inflammation and if it does so than it can be said that decrease the risk to develop CVD. Aim and objectives were to assess hs-CRP level in early and established RA both at diagnosis and again at 3 months of DMARD therapy and compare between them.Methods: Total 58 early RA (group A) and 58 established (group B) DMARD naïve RA patients were included in the study. Age, BMI, haemoglobin, random blood sugar, lipid profile, ESR, hs-CRP, RA factor and anti-CCP were measured. All of them were treated with DMARD and hs-CRP was again assessed after 3 months.Results: The mean hs-CRP level at diagnosis was 6.14±1.90 mg/l in group A while it was 10.39±3.13 mg/l in group B. The mean hs-CRP level after 3 months of DMARD was 2.56±1.35mg/l in group A while it was 7.91±3.13 mg/l in group B. The mean reduction in hs-CRP level in early RA (3.58±0.99 mg/l) was statistically significantly (p<0.001) higher than that in established RA (2.48±0.09 mg/l). Conclusions: DMARD decreases level of inflammation in RA more efficiently if initiated early in the course of the disease.

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Prognostic significance of Substance P/ Neurokinin 1 receptor and its association with hormonal receptors in breast carcinoma

10.1101/2020.06.27.175083 ◽

2020 ◽

Author(s):

Riffat Mehboob ◽

Syed Amir Gilani ◽

Amber Hassan ◽

Imrana Tanvir ◽

Rizwan Ullah Khan ◽

...

Keyword(s):

Breast Carcinoma ◽

Substance P ◽

Positive Staining ◽

List Type ◽

Ki 67 ◽

Neurokinin 1 Receptor ◽

Group A ◽

Neurokinin 1 ◽

Group B ◽

Grade Iii

AbstractTo evaluate the expression and Immunolocalization of Substance P (SP)/ Neurokinin-1 Receptor (NK-1R) in Breast Carcinoma (BC) patients and it’s association with routine proliferative markers (ER, PR, HER2/ neu and Ki-67).MethodsA cross-sectional study was performed on 34 cases of BC. There were 23 cases of group A (Grade III), 8 of group B (Grade II) and only 3 cases of group C (Grade I). Age range comprised of patients from 20-80 years and the mean age of patients was 45.74 years. HE, ER, PR, HER2 and Ki-67 staining was performed as routine biomarkers. Samples were then processed for immunomarkers study of Substance P and NK-1R immunohistochemistry was performed for few cases.Results14/23 cases (61%) of group A, 7/8 cases (88%) of group B and 2/3 (67%) cases of group C were SP positive. Overall, strong staining (≥ 10% tumors cells), labeled as “3+”, was observed in 9/14 (64.2%) cases of group A and 1/8 (12.5%) case of group B. Moderate staining labelled as “2+” (in ≥ 10% tumor cells) was observed in 3/14 (21.4%) cases of group A, 4/8 (50%) cases of group B. weak positive staining “1+” was observed in only 2/14 (14.28%) cases of group A, 2/8 (25%) cases of group B and all 2/2 (100%) cases of group C.ConclusionsSP and NK-1R is overexpressed in breast carcinomas and there is significant association between grade of tumor and their overexpression. It may serve as a novel biomarker for grading of BC. We also suggest that NK-1R antagonists as a potential therapeutic strategy to inhibit and manage BC.Key PointsImmunohistochemical expression of Substance P and Neurokinin 1 Receptor in breast carcinoma tissue was evaluatedIt was strongly expressed in grade III, with maximum intensityIt may be investigated further for its role as prognostic and diagnostic markerTherapeutic potential of Neurokinin-1 Receptor antagonists must be explored

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A comparative study between two techniques of subtotal laparoscopic cholecystectomy in goats

The Iraqi Journal of Veterinary Medicine ◽

10.30539/iraqijvm.v38i2.232 ◽

2014 ◽

Vol 38 (2) ◽

pp. 114-122

Author(s):

M. J. Eesa

Keyword(s):

Laparoscopic Cholecystectomy ◽

Liver Function ◽

Cystic Duct ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Liver Function Tests ◽

C Reactive Protein ◽

Reactive Protein ◽

Group A ◽

Group B

A comparison between two techniques of subtotal laparoscopic cholecystectomy was studied to find the best technique for treating severe cholecystitis and to study the fate of the remaining part of the gallbladder. All experimental animals had inducing cholecystitis by clipping the cystic duct for five days which was enough for inducing cholecystitis in goats. 24 adult female goats were used in this study, which were divided randomly into two equal groups; subtotal laparoscopic cholecystectomy with cystic duct and cystic artery clipping by titanium clips (group A) and laparoscopic subtotal cholecystectomy with cystic duct clipping only (group B). Operations were performed under general anesthesia by using thiopental sodium at a dose of 15 mg/Kg. B.W. intravenously to maintain the inhalation anesthesia by endotracheal tube with a mixture of halothane (1.5- 2.5 %) and oxygen (2-3 %). The intraabdominal pressure with CO2 was used at a low pressure 8-10 mmHg. The liver function tests including; alkaline phosphates (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total serum bilirubin and C- reactive protein were measured in different intervals; before operation (zero day) and at 1hr, 1st, 3rd, 5th and 7th postoperative day. The liver function tests showed a significant elevation (P< 0.05) in alkaline phosphates (ALP) and in the total bilirubin values in group B (P> 0.05) comparison with group A and no significant difference in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and C- reactive protein between all experimental groups as well as time intervals. The biopsies were taken at the 3rd, 7th and 15th postoperative day for histopathological of the remaining part of gallbladder which showed that subtotal cholecystectomies could be performed successfully with the two techniques, appeared degeneration in the remaining part of the gallbladder and offers best in the healing stages.

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Effectiveness of Dual Antibacterial Therapy and Effectiveness of Recommendation Criteria as a Diagnostic Tool in Children with Uncomplicated Acute Appendicitis

Acta Chirurgica Latviensis ◽

10.2478/chilat-2020-0008 ◽

2020 ◽

Vol 18 (1) ◽

pp. 31-35

Author(s):

Liene Taurina ◽

Zane Liepina ◽

Astra Zviedre ◽

Arnis Engelis ◽

Aigars Petersons

Keyword(s):

Emergency Department ◽

Acute Appendicitis ◽

Antibacterial Therapy ◽

Moderate Correlation ◽

C Reactive Protein ◽

Reactive Protein ◽

Group A ◽

Group B ◽

Uncomplicated Acute Appendicitis ◽

Suspected Acute Appendicitis

SummaryIntroductionAcute appendicitis (AA) – acute inflammation and infection of the appendix – is one of the most common cause for abdominal surgery in pediatrics. Appendectomy has been the gold standard since 1735, but in recent years there have been several studies that investigate antibacterial therapy for uncomplicated acute appendicitis. In 2016 new recommendations for suspected AA were implemented in emergency department setting of Children's Clinical University Hospital (CCUH).Aim of the StudyTo evaluate whether diagnostic criteria for patients with a suspected acute appendicitis is effective as a diagnostic tool and to evaluate whether dual antibacterial therapy is safe and effective as first line treatment for children with diagnosis of uncomplicated acute appendicitis in CCUH.Material and methodsA retrospective study was made in CCUH from January 2017 to December 2017. Patients aged 7 to 18 with suspected uncomplicated acute appendicitis were identified and data were collected from an internal hospital management system and patients’ medical records. Patients were divided into two groups – A and B. In group A were patients who met the criteria of uncomplicated AA, and in group B – patients who met the criteria of complicated AA. Both groups received ampicillin and metronidazole. For statistical analysis IBM SPSS Statistics 22 program was used.ResultsFrom 98 patients majority were boys (51% (n=50)) with mean age 12.6 years. As a result of antibacterial therapy clinical condition improved in 93% (n=89) of patients who were discharged without surgery. 7 patients did not improve and underwent surgery within 48 hours after admission, another 2 had elective appendectomy. There was a significant positive moderate correlation between C–reactive protein (CRP), white blood cell count (WBC), basophil granulocytes (BASO) and appendix diameter at admisson and after 48 hours of dual antibacterial therapy (r=0.31, p=0.003 vs. r=0.37, p<0.001 vs. r=0.41, p=0.017 vs. r=0.51, p=0.013). In group A (68% (n=67)) there was a significant positive moderate correlation between CRP, WBC and appendix diameter at admission and after 48 hours of dual antibacterial therapy (r=0.31, p=0.003 vs. r=0.37, p<0.001 vs. r=0.51, p=0.013). In group B (30% (n=31)) 7 patients underwent appendectomy and 2 patients received a broad spectrum antibacterial therapy prior to elective appendectomy. There is evidence of significant association between ALVARADO score (p=0.004), rebound tenderness (p<0.001), WBC (p=0.004), CRP (p<0.001) and stage in which appendicitis has progressed to.ConclusionsAntibiotic-alone treatment may be a safe and effective initial management choice in children with uncomplicated acute appendicitis. However, to fully evaluate effectiveness of antibacterial therapy and diagnostic criteria, further follow–up research is needed.A normal C–reactive protein value does not rule out uncomplicated acute appendicitis, therefore it can not act as a single marker to diagnose AA or to differentiate between complicated and uncomplicated AA.Recommendations of treatment of UCAA are acceptable for use in emergency department as they act as a unified tool that allows pediatricians and pediatric surgeons to quickly assess suspected acute appendicitis.

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Імунологічний статус пацієнтів із переломами щелеп на тлі генералізованого пародонтиту

CLINICAL DENTISTRY ◽

10.11603/2311-9624.2017.3.8056 ◽

2017 ◽

Author(s):

Y. L. Bandrivsky ◽

O. O. Bandrivska ◽

K. O. Dutko

Keyword(s):

Phagocytic Index ◽

Maxillofacial Injuries ◽

C Reactive Protein ◽

Immunological Parameters ◽

Reactive Protein ◽

Cellular Factors ◽

Jaw Fractures ◽

Group A ◽

Group B ◽

The Individual

Prevention, diagnosis and treatment of lesions of the maxillofacial area is one of the most urgent modern medical and social problems, the signifi cance of which is determined by the constant increase in the frequency of maxillofacial injuries, which averages from 6.0 to 16.4 % of all traumas of peacetime.The aim of the study – to learn the individual immunological parameters in patients with fractures of the jaws against the background of generalized periodontitis.Materials and Methods. The article presents the analysis of individual parameters of cellular factors (phagocytic index, phagocytic count, phagocytosis completeness, NK-cells) and humoral immunity (total protein, globulin fractions, albumin, C-reactive protein, titre of lysozyme, immunoglobulins A, G, M) in serum in patients with jaw fractures on the background of generalized periodontitis (GP) (group A) and in patients with traumatic jaw lesions without periodontal tissue pathology (group B). The obtained values were compared with the data of the average norm.Results and Discussion. Investigation of changes in cellular factors of congenital immunity was performed in 45 patients with fractures of the jaws against the background of generalized periodontitis II-III stages (group A) and 41 patients with jaw fractures without concomitant periodontal pathology (group B). The obtained results were compared with the data of the average norm. The obtained results were processed statistically.Conclusions. As a result of the studies of the main parts of non-specifi c immunity in patients with jaw fractures, certain violations of humoral and cellular factors, which manifested themselves both in decreasing and dangerous increase of most of the studied parameters, were found, and in the patients with traumatic jaw lesions on the background of GP this tendency was worn more pronounced character.

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FEATURES OF THE DYNAMIC OF ACUTE C-REACTIVE PROTEIN AND INDICATORS OF THE BODY’S IMMUNE SYSTEM AND THEIR RELATIONSHIP WITH THE CLINICAL PICTURE IN ELDERLY PATIENTS WITH ULCERATIVE GASTROINTESTINAL BLEEDING

Kharkiv Surgical School ◽

10.37699/2308-7005.5-6.2021.09 ◽

2021 ◽

pp. 41-46

Author(s):

A. V. Chukhriienko ◽

M. V. Trofimov

Keyword(s):

Immune System ◽

Elderly Patients ◽

Gastrointestinal Bleeding ◽

Clinical Picture ◽

The State ◽

C Reactive Protein ◽

Cardiovascular Pathology ◽

Reactive Protein ◽

Group A ◽

Group B

The aim. Improve the effectiveness of treatment of elderly patients with ulcerative gastrointestinal bleeding by studying the dynamics of the level of C-reactive protein (CRP) and immune system parameters, their relationship with the clinical picture. Materials and methods. 35 elderly patients in the period from 2019 to 2021 (according to the WHO classification — 61-90 years) with ulcerative gastrointestinal bleeding complicated by cardiovascular pathology. The gender distribution is as follows: men — 19 (54%), women — 16 (46%). The average age of the patients was 76.3 years. This category of patients was divided according to the methods of treatment of concomitant cardiovascular pathology: group A — patients who received therapy according to the standard scheme (n = 20), B — double (n = 15). As a control category of patients (n = 50) was selected. There are relatively healthy (donors), who were similar to the study group in terms of age, gender, and the method for determining indicators. Results. The state of local endoscopic hemostasis in group “A” was investigated: Forrest II was detected in 14 (70%) patients, Forrest III — in 6 (30%) patients; in group “B”: Forrest I — in 7 (47%) patients, Forrest II — in 8 (53%) patients. These results indicate that using of dual therapy leads to a change in the rheological properties of blood, which, in turn, leads to a decrease in the stability of local endoscopic hemostasis and an increased risk of recurrent bleeding compared with standard antihypertensive therapy (the studied groups are represented, respectively, 100% each). Conclusions. We have analyzed the C-reactive protein, interleukin-6 and interleukin-4. The main result of the study was the identification of the dynamics of markers in groups A and B. On the seventh day, normalization of these indicators was not revealed (in group B, it was especially pronounced). But the state of the latter was influenced by the therapy of concomitant pathology in patients with cardiovascular pathology. The clinical significance of immune indicators has been proven in many clinical examples and can be one of the objective criteria for assessing the patient’s condition, predicting the disease and correcting the treatment started.

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Peculiarities of dynamics of level of the acute phase C-reactive protein and its connection with the immune system of organism in patients, suffering the ulcer gastro-intestinal hemorrhage with concurrent cardio-vascular pathology

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2021.3-4.35 ◽

2021 ◽

Vol 88 (3-4) ◽

pp. 35-39

Author(s):

M. V. Trofimov ◽

V. P. Kryshen ◽

A. V. Chukhrienko

Keyword(s):

Blood Loss ◽

Vascular Pathology ◽

Interleukin 4 ◽

C Reactive Protein ◽

Reactive Protein ◽

Intestinal Hemorrhage ◽

Group A ◽

Cardio Vascular ◽

Group B

Objective. To improve the investigated efficacy of treatment in elderly and senile patients, suffering the ulcer gastro-intestinal hemorrhage, in accordance to dynamics of levels of C-reactive protein, the immune system indices, and in connection with clinical picture studied. Materials and methods. Prospective investigation was conducted in 35 patients of elderly and senile age (in accordance to classification of The World Health Organization – 61 - 90 yrs old), suffering the ulcer gastro-intestinal hemorrhage, the course of which was complicated by cardio-vascular pathology – an acute coronary syndrome (angina pectoris, atrial fibrillation, extrasystole, arrhythmia of various genesis) and an acute myocardial infarctionі in 2019 - 2021 yrs. There were 16 (46%) women and 19 (54%) men. Average age of the patients have constituted 76.3 yrs old. This category of patients was distributed in accordance to methods of treatment of coexistent cardio-vascular pathology: Group A – 20 patients, who took hypotensive therapy in accordance to standard scheme, Group B – 15 patients, who took a «double» therapy. The control group consisted of 50 relatively healthy persons (donors), who have had approximately equal age, the gender distribution with the patients investigated, while procedure of the indices determination in them was the same. Results. Degree of the blood loss in accordance to classification of Marino (1998) was investigated. In Group A a small blood loss was observed in 7 (35%), and a middle one – in 13 (65%) patients. In group B big blood loss was noted in 9 (60%), while a massive one – in 6 (40%) patients. The term before admittance to hospital and preparations, which the patients took for treatment of cardio-vascular pathology – anticoagulants, antiaggregants, hypotensive, and their combinations as well – have impacted the blood loss degree. The dynamics of levels of C-reactive protein, іnterleukin-6 and іnterleukin-4 in these groups of patients was determined. Conclusion. On the 7th day in groups A and B normalization of levels of the acute phase index of C-reactive protein, proinflammatory interleukin-6 and proinflammatory interleukin-4 (in group B especially expressed) was not revealed. Potent interrelationship between levels of С-reactive protein and interleukin-6 was revealed, but it was statistically nonsignificant due to small size of statistical sample of the groups. Level of interleukin-4 was sharply reduced without a tendency to normalization (p <0,01). At the same time, therapy of comorbidities in patients with cardio-vascular pathology influenced a state of interleukins mentioned above. Clinical significance of immune indices was proved on multiple clinical examples and may constitute one of objective criteria for estimation of the patients’ state, prognostication of the disease course and correction of the treatment initialized.

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