Changes of some immune and metabolic indices as burdening criterion of chronic systemic inflamation in the presence of the essential hypertension comorbidity

Abstract

The article highlights the cytokine profile features, severity of oxidative stress, changes of endothelium functions in patients with isolated course of essential hypertension and its combination with duodenal peptic ulcer. It describes evaluation of chronic systemic inflammation data: the level of serum cytokines (tumor necrosis factor -α, interleukins -1β, -6, -10), content of intermediate and end products of lipid peroxidation in blood (conjugated dienes, malondialdehyde), activity of antioxidant defense enzymes (superoxide dismutase, catalase), change of endothelium function (level of stable metabolites of nitrogen oxide in blood serum and severity of ristomycin-induced platelet aggregation). It was discovered that in the presence of tendency to increasing of interleukin-10 (р>0,05) , content of tumor necrosis factor -α, interleukins -1β and -6 in patients under condition of comorbidity significantly exceeded the reference data (р<0,001) and the data of patients with isolated course of essential hypertension. Thus was predetermined significant increase of ratio of pro-inflammatory cytokines to interleukin-10 that emphasized the presence of the highest pro-inflammatory activity of blood in patients with comorbid pathology. Later on in patients with comorbid pathology were identified the most significant manifestations of oxidative stress that was reflected in the highest level of conjugated dienes and malondialdehyde (р<0,001). It also turned out that the process of lipid peroxidation was proceeding under the condition of superoxide dismutase and catalase activity deficit that caused the greatest decrease of integrated indscator of the antioxidant capacity of the blood (р<0,001). It was discovered the negative relationship between high pro-inflammatory activity and low antioxidant ability of blood, reflecting the commonality of immune and metabolic processes in the mechanisms of the comorbid pathology development. This was also confirmed by the presence of inverse relationship between low total content of stable metabolites of nitrogen oxide in blood, as a reflection of the severity of endothelium dysfunction, and high pro-inflammatory blood activity (р<0,01) that also had a direct relationship with high ristomycin-induced platelet aggregation (р<0,01), as a high thrombogenic risk indicator in this category of persons. Therefore, identifying the relationship between indicators of chronic systemic inflammation in patients with essential hypertension in combination with duodenal peptic ulcer should be considered as a manifestation of a single mechanism of comorbid pathology formation, and most of their severity - as a burdening criterion of essential hypertension comorbidity.