Dynamics of the levels of pro- and anti-inflammatory cytokines in patients with disseminated peritonitis in the postoperative period

<b>Introduction:</b> Peritonitis and abdominal sepsis are serious medical problems with high mortality. Abdominal sepsis causes the production of a variety of cytokines that are both pro-inflammatory and anti-inflammatory. Both proinflammatory and anti-inflammatory cytokines are a double-edged sword: on the one hand, they are crucial for eliminating infections, and on the other hand, their excessive production can cause tissue and organ damage. Therefore, the impact on the inflammation process and cytokine production in the treatment of peritonitis and abdominal sepsis is a very important aspect.<b>Aim:</b> The aim of the study is to determine the effect of the developed treatment of patients with peritonitis on the dynamics of cytokine levels and to substantiate the need for the use of the proposed drugs in the complex treatment of peritonitis.<b>Materials and methods:</b> The study included 124 patients with toxic and terminal stages of peritonitis, who were divided into 3 groups. Group I (main) included 39 patients whose complex treatment included cytochrome C. Group II (main) included 41 patients whose complex treatment included cytochrome C and a solution containing levocarnitine and arginine hydrochloride. The comparison group consisted of 44 patients who did not receive these drugs. Patients were tested for interleukin 1β (IL-1β), interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 10 (IL-10), and tumor necrosis factor (TNF).<b>Results:</b> Patients of all groups showed a significant increase in the content of proinflammatory cytokines on day 1 of the study. The obtained trends indicate the development of a pronounced inflammatory response. Subsequently, a tendency to optimize the production of proinflammatory mediators on days 3 and 7 of the study was established. At that time, an increase in the production of anti-inflammatory cytokines was detected, indicating that inflammation was controlled in patients of the first and second main groups. In the patients of the comparison group, the generalization of uncontrolled inflammation was determined.<b>Conclusions:</b> The use of cytochrome C and a solution containing levocarnitine and arginine hydrochloride in the complex treatment of patients with disseminated peritonitis helps to optimize the production of cytokines, which leads to a decrease in inflammation.