ANALYSIS OF THE BACKGROUND LEVEL OF CYTOKINES M1 AND M2 OF THE MACROPHAGE PHENOTYPE IN PATIENTS WITH REVISION RHINOPLASTY AFTER THE USE OF THE DRUG PDRN

Polydeoxyribonucleotide (PDRN) drugs are actively used in global practice after rhinoplasty. Current research focuses on analyzing the immunological aspects of the inflammatory response and the effect of PDRN on tissue repair. 63 patients who underwent revision rhinoplasty using a rib graft were under supervision. Patients were divided into two groups for further studies according to the fibrinogen levels. All patients were evaluated for cytokines levels TNF-α, TGF-β1 “DRG Diagnostic Inc.” (Germany), IL-6, IL-10, IL-13 “IBL International” (Germany), IL-12, IL-18 “ElabScience” (USA). In patients with revision rhinoplasty in whom an increased level of fibrinogen was found, after the use of PDRN there was a decrease in the concentration of M1 cytokines of the macrophage phenotype (IL-6, IL-12, IL-18, and TNF-α) and an increase in the concentration of M2 cytokines of the macrophage phenotype (IL-10, IL-13, TGF-β1). In patients with revision rhinoplasty in whom the level of fibrinogen was normal, the use of PDRN did not affect the level of cytokines, which was characterized by the absence of probable changes in the serum concentration of cytokines M1 (IL-6, IL-12, IL-18) and M2 of the macrophage phenotype (IL- 10, IL-13, TGF-β1). In patients with an elevated level of fibrinogen, there is also a decrease in the level of the angiogenic factor VEGF, the use of the drug PDRN led to an increase in its level. The obtained results may represent a new therapeutic approach to reducing the number of complications in reconstructive rhinoplasty. However, further research is needed to understand the mechanisms of action of PDRN, as well as possible advantages or disadvantages of its use.