Моніторинг перебігу гострого пієлонефриту, ускладненого цукровим діабетом, в експерименті

The study of the pathogenesis of the dysfunction of the urinary system in АP nowadays includes the study of the body’s reaction in response to a transient infection, the level of molecular mediators of inflammation and protective cellular mechanisms under the conditions of the action of uropathogens, taking into account the nature of the course of the disease, which justifies the need to develop new approaches to complex treatment. The objective: to determinate the pathogenetic role of eicosanoids in the implementation of apoptosis processes in the structural elements of the kidneys by using a mathematical model for predicting the course of АP and concomitant hyperglycemia under drug exposure. Materials and methods. Experimental studies were conducted on Wistar line rats weighing 200-300 g at the age of 8-9 months. The animals were divided into 8 groups. The experiment was carried out in accordance with the “General Ethical Principles for Experiments on Animals”. To determine the correlations between the content of prostaglandin E2, leukotriene B4 and the level of fragmented DNA (fDNA) in the kidneys, the experimental data obtained during the determination of the proinflammatory effects of eicosanoids and the level of fragmented DNA in acute pyelonephritis in rats complicated by hyperglycemic state under conditions of pharmacocorrection were used. Rats with AP complicated by hyperglycemic state (type II) received etiotropic drug treatment (EDT) – intramuscular antibacterial drug of cephalosporin series (cefoperazone sodium salt) at a dose of 60 mg/kg animal weight per day and etiopathogenic drug treatment (EPDT) – intramuscular antibacterial drug (cefoperazone sodium salt), and orally – a drug of the group of immunomodulators, metabolism-correcting, energotropic action – ribonucleic acid at the rate of 21 mg/kg per day and intramuscularly a drug of the group of antiaggregants, inhibitors of free radical processes, membrane protector, (2-ethyl-6-methyl-3 – hydroxypyridine succinate) 4.5 mg/kg of animal weight per day for 14 days after modeling of AP. The content of prostaglandin E2, leukotriene B4 and fDNA in the kidneys of rats was studied 28 days after the start of the modeling. Results. Data on the presence of a direct correlation between pro-inflammatory factors – eicosanoids (prostaglandin E2 and leukotriene B4) and the level of fragmented DNA (fDNA) in the kidney tissue of rats with acute pyelonephritis (AP) complicated by diabetes mellitus (DM) in the experiment are given. In the kidneys of animals, with АP, a significant increase in the level of fragmented DNA and the above-mentioned eicosanoids was found relative to the norm. In rats with АP, concomitant diabetes of type II and especially type I contributed to a significant increase in the level of fDNA in the kidneys and an increase in the content of pro-inflammatory eicosanoides – prostaglandin E2 and leukotriene B4 compared to the norm. At the same time, the presence of a high positive correlation between the level of DNA degradation and the accumulation of prostaglandin E2 and leukotriene B4 in the kidney tissue was established in АP with concomitant type I and II diabetes, which convincingly testifies to the pathogenetic role of pro-inflammatory factors of eicosanoids in the implementation of apoptosis processes. Conclusion. The data obtained can be considered as a clinical and biochemical experimental justification of the informative value of establishing the relationship between the nature of the course of the infectious and inflammatory process in the kidneys in conditions of concomitant DM by the content of eicosanoids and the level of DNA fragmentation in the kidneys and the possibility of using the correlation between these indicators in predicting the course of AP and concomitant DM, as well as in assessing the effectiveness of etiopathogenetic drug treatment. The used mathematical model with logistic regression makes it possible to predict the probability of an unfavorable course of the disease and the effectiveness of medication based on the obtained data regarding the presence or absence of laboratory signs of the studied pathological condition.