Saratov JOURNAL of Medical and Scientific Research

Gladkova E.V.

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery of Saratov State Medical University n.a. V I. Razumovsky Head of Department of Fundamental, Clinical and Experimental Studies, Candidate of Biological Sciences

Growth factors of fibroblasts and vascular en-dothelium in the early stages of knee osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 583-586
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Puchinyan D.M., Gladkova E.V., Karyakina E.V., Romakina N.A., Belova S.V.
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Aim: to compare and study the relationship between the maintenance of vascular endothelial growth factor and acidic fibroblast growth factor in individuals with the initial clinical and radiological manifestations of the degeneration of the hyaline cartilage of the knee joints and healthy people. Material and Methods. 27 women with initial symptoms of knee osteoarthritis (main group, average age

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The state of the hemocoagulation system and endothelial dysfunction in benign and malignant skeleton neoplasms

Year: 2018, volume 14 Issue: №3 Pages: 574-578
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Ponamarev I.R., Puchinyan D.M., Gladkova E.V., Korshunov G.V.
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Aim: to study the functional status of the vascular endothelium and the activity of the hemocoagulation system, as well as the relationship between some indicators characterizing their state in patients with benign and malignant skeleton neoplasms. Material and Methods. 62 patients with benign (45) and malignant (17) bone neoplasms and 10 healthy individuals of the control group were examined. The coagulation properties of blood plasma and the content of vascular endothelial growth factor (VEGF), intercellular adhesion molecules of sICAM and adhesion molecules of vascular endothelium (sVCAM) in blood serum were investigated. Results. In patients with benign bone tumors, prothrombinase formation mechanisms were activated, the concentration of soluble fibrin-monomer complexes (FSC) was

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The role of pro- inflammatory cytokines and the enzyme element of antioxidant system in the destruction of hyalin cartilage at the early stages of primary gonarthrosis

Year: 2018, volume 14 Issue: №3 Pages: 545-549
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Karyakina Е.М., Gladkova Е.М., Puchinyan D.M., Romakina N.A., Belova S.V.
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Aim: comparative assessment of the state of joint (hyaline) cartilage, pro-inflammatory component of cytokine profile and enzyme element of blood antioxidant system in healthy individuals and patients at the early stages of gonarthrosis. Materials and Methods. The content of cartilage oligomeric matrixprotein (COMP), superoxide dismutase-2 (mitochondrial) (SOD-2) and interleukin-1 (3 (IL-1 (3) was studied in 34 individuals with initial signs of gonarthrosis (main group) and in 20 conventionally healthy individuals (control group) in blood serum by ELISA. Results. In the serum of patients with GA, the content of COMP (Me=20.67 pg/ml; 25% quartile 14.70; 75% quartile 27.15) and IL-1(3 (Me=4.74 pg/ml; 25% quartile 3.93; 75% quartile 5.90) was statistically significantly higher (p<0.05) than in the control group: COMP (Me=15.27 pg/ml; 25% quartile 8.86; 75% quartile 20.76 and IL-1(3 (Me=3.59 pg/ml; 25% quartile 2.75; 75% quartile 3/83). A correlation analysis in the control group revealed a positive strong correlation between COMP and IL-113 (r=+0.70; p=0.01) and a tendency toward a negative moderate association between COMP and SOD2 (r=-0.43; p=0.08); in the main group between these indicators, the connections were weak, statistically insignificant. Conclusion. Patients in the early stages of primary GA compared with healthy individuals confirmed the presence of destructive processes in the articular (hyaline) cartilage and the activation of the proinflammatory element of the cytokine profile and the enzyme level of the antioxidant system of the blood. The correlation analysis revealed a decrease in the strength of functional links in patients with GA, between the indicators of COMP — IL-1 (3 and COMP — SOD2, which indicated a change in the regulatory effects of proinflammatory cytokines and the enzyme element of the antioxidant system of the blood on the structural-metabolic state of the articular (hyaline) cartilage in the initial stage process.

The correlation between structural changes in articular hyaline cartilage and the parameters of systemic manifestations of inflammatory reaction in the pathogenesis of early stages of primary osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 518-523
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gladkova Е.М., Ivanov A.N.
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Aim: to study the correlations of structural disorders of articular hyaline cartilage with changes in concentration of pro- and anti-inflammatory cytokines at the early stages of osteoarthritis. Material and Methods. Ultrasound and MRI investigations of knee joints (T2*-relaxometry) were performed to 67 females of main group aged 35-50 with initial manifestations of (0-1 stages) of primary osteoarthritis and 30 conventionally healthy individuals. The level of interleukin-1 (3 was determined in blood serum with multi-parameter system MAGPIX (Luminex Corporation), Urine CTX-II was identified in urine and YKL- 40, interleukin-4 — in blood serum of the subjects by ELISA. Results. The levels of Urine CTX-II: 32.5 (30.9; 35.1) ng/ml, interleukin-1 (3: 6.09 (4.81; 7.69) pg/ml and YKL-4064.1 (58.1; 77.0) ng/ml of main group patients were higherthan in the comparison group. The correlation force between Urine CTX-II and cartilage glycoprotein YKL-40 (R=0.7); interleukin-1 (3 and cartilage glycoprotein YKL-40 (R=0.3) was lower; and the correlation force between YKL-40 and CTX-II (R=0.4 (p<0.05)) the connection was higher. Conclusion. Early stages of primary osteoarthritis are accompanied by degenerative changes inhyaline cartilages that is verified by T2*-relaxometry results, and increased excretion of Urine CTX-II on  the background of pro-inflammatory mediators hyperproduction, more significant increase in the concentration of cartilage glycoprotein YKL-40 compared to interleukin-1 (3 which comes together with the alteration of the system of correlations between the levels of pro-inflammatory cytokines and the parameters of degenerative dystrophic changes in articular cartilage.

 

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Metabolic shifts in subjects with potential risk of primary osteoarthritis

Year: 2018, volume 14 Issue: №3 Pages: 511-514
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belova S.V., Gladkova Е.М., Ulyanov V.Yu., Blinnikova V.V.
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The Aim of the study was to estimate metabolic disorders in subjects with potential risk of primary knee osteoarthri-tis development. Material and Methods. The study included 27 patients: 10 men (37%), 17 women (63%) aged from 33 to 68 years, and 20 healthy people (8 men and 12 women). Traditional biochemical indexes characterizing certain metabolic aspects (total protein, urea, cholesterol, glucose, uric acid, amylase and bilirubin) were studied alongside with the assessment of articular cartilage state by the level of COMP (cartilage oligometric matrix protein), malondial-dehyde and ceruloplasmin. Results. In the course of our investigation we observed elevated COMP (Me=871,4 (792,2; 912,5)), malondialdehyde (Me=5,1 (4,7; 5,5)) and ceruloplasmin (Me=48,4 (41,2; 55,4)) levels. Conclusion. Negative metabolic shifts in the form of cartilage tissue metabolic disorders, activated lipid peroxidation and relative failure of body antioxidant system were observed in patients with potentially high risk of knee osteoarthritis without clinical manifestations of the disease.

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The estimation of biocompatibility of polycaprolactone matrices mineralized by vat-erite in subcutaneous implantation tests in white rats

Year: 2018, volume 14 Issue: №3 Pages: 451-456
Heading: Physiology and Pathophysiology Article type: Original article
Authors: Ivanov A.N., Kurtukova М.О., Kozadaev M.N., Tyapkina D.A., Kustodov S.V., Saveleva M.S., Bugaeva I.O., Parakhonsky B.V., Galashina E.A., Gladkova E.V., Norkin I.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky
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Aim: to estimate biocompatibility of matrices produced from polycaprolactone (PCL) and mineralized by vaterite (CaC03) by studying local and systemic manifestations of inflammatory reaction in subcutaneous implantation tests in white rats. Material and Methods. The experiment was conducted on 40 rats divided into four equal groups: control, comparison (rats with imitation of implantation), negative control (rats with implanted non-biocompatible matrices) and experimental group, comprised of animals with implanted PCL/CaC03-matrices. Local inflammatory manifestations were analyzed by morphological assay of implantation area tissues. Systemic inflammatory manifestations were estimated by TNF-a concentration and interleukin-lp (IL-1) in blood serum by ELISA. Results. The changes in cellular population content demonstrate that a PCL/CaC03-matriceonthe21 day after the implantation to rats is evenly colonizing by fibroblast cells and vascularizing. This type of matrices does not provoke intense inflammatory reaction seen in negative control animals and accompanied by systemic manifestations such as statistically significant rise in TNF-a and IL-1 concentrations. Conclusion. The data obtained in the study proving the biocompatibility of PLC/CaC03-scaffolds experimentally substantiate the potential for their use in tissue engineering.

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Peculiarities of remodeling of hyalin cartilage at early stages of development of degenerative-distrophic processes of knee joints

Year: 2018, volume 14 Issue: №1 Pages: 70-75
Heading: pathological anatomy Article type: Original article
Authors: Gladkova E.V., Romakina N.A., Ananyeva O.E., Belova S.V., Babushkina I.V., Persova E.A., Karyakina E.M.
Organization: Saratov State Medical University
Summary:

The aim is to develop methods for detection of hyaline cartilage metabolic imbalance in patients with initial degenerative dystrophic changes in the substantiated pathogenetically knee. Material and Methods. Subject of inquiry: 50 women aged from 35 up to 57 (49.1 ±2.4), among them 36 patients with an early stage of knee osteoarthrosis made up an experimental group, 14 women without any musculoskeletal disease clinical presentations made up a control group. We carried out a complex examination including physical assessment, study of orthopaedic status, interview with the use of KOOS (Knee Injury and Osteoarthritis Outcome Score) scale, roentgenography and MRI of the knee and also a number of laboratory tests: enzyme-linked immunosorbent assay determination of the content of cytokine profile indices (IL-1, TNF-a, IL-6), cartilage oligomeric matrix protein (COMP) and bone (SerumCrossLaps and bone isozyme of alkaline phosphatase (BAP)) tissue metabolism markers in blood serum in all the groups of patients. Results. In all the patients of the experimental group the roentgenologic stage of osteoarthrosis was defined as 0-1 according to J. Lawrence and J. Kellgren, but at the same time knee degenerative changes were objectivized on the series of MR images in the form of MR signal changes of the articular cartilage, erosions and cysts, degenerative meniscus. We observed increased serum cartilage oligomeric matrix protein (COMP) in the same group and that is characteristic of hyaline cartilage destruction activation. We also detect disorders in bone tissue remodeling in the form of bone resorption intensification (Serum CrossLaps), osteogenesis increase (BAP) and activation of proinflammatory cytokine system link (IL-1, TNF-a). Conclusion. The leading pathogenetic links of the early degenerative changes of the knee are hyperproduction of proinflammatory cytokines (IL-1, TNF-a), destruction of the hyaline cartilage and disorder in bone tissue remodeling. Assessment of biochemical predictors of cartilage and bone tissue degradation along with the instrumental methods of diagnosis is of great theoretical and practical importance in the system of early detection of incipient osteoarthrosis.

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The peculiarities of bone and cartilage tissue remodeling in patients after hip joint replacement

Year: 2017, volume 13 Issue: №3 Pages: 723-727
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Gladkova Е.М., Karyakina E.V., Tsareva Е.Е., Persova Е.А., Belova S.V.
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The aim: to study the peculiarities of structural and metabolic state of bone and cartilage tissue in patients in the first 12 months after total hip replacement with respect to their immune state and lipid peroxidation activity. Material and Methods. Significant laboratory predictors of initial signs of aseptic instability were singled out allowing estimating the peculiarities of bone tissue remodeling as well as humoral and cellular immunity state. Results. The obtained results demonstrated that impairments in T-lymphocyte system in patients with initial signs of aseptic instability of en-doprosthesis were accompanied by reduction of its total number (CD3+), among that due to the population of cytotoxic (CD3+CD8+) cells with simultaneous increase of T-helpers (CD3+CD4+) number. Activation of serum proosteoclasto-genic factors (TNF-a and IL-1(3) was noticed on the background of anti-inflammatory humoral immunity failure (IL-10). Conclusion. The estimation of cellular immunity state, content of pro- and anti-inflammatory cytokines in blood serum combined with the bone tissue state markers and indexes of lipid peroxidation and antioxidant system as well as dual-energy absorptiometry allows identifying patients with high risk of further development of aseptic instability in hip joint implant in the period of up to 12 months postsurgically which can be useful while planning prevention management of implant or its components instability.

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Prognostic opportunities for infectious inflammatory complications in primary endoprosthesis of large joints

Year: 2017, volume 13 Issue: №3 Pages: 715-719
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Belova S.V., Mamonova I.A., Puchinyan D.M., Babushkina I.V., Gladkova E.M., Adilov R.G.
Organization: Saratov State Medical University
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The aim: to study prognostic and diagnostic opportunities for infectious inflammatory complications of primary endoprosthesis of hip and knee joints on the basis of cellular immunity indices. Material and Methods. 174 patients with large joint osteoarthrosis aged 61 ±13 yrs which had undergone total joint replacement were enrolled into the study. The experimental group consisted of 22 patients with infectious inflammatory complications emerging from 6 up to 12 months postsurgically. The comparison group included 152 patients with favorable postsurgical period. We carried out WBC differentiation by subpopulations (lymphocytes, monocytes, granulocytes) and their immunophenotyping. 40 conventionally healthy individuals comprised the control group. The outcomes were estimated using the worked-out score system. Results. In patients with favorable postsurgical period total value of indices equaled not more than 4-6 points. In all the other cases the risk of infectious inflammatory complications is significantly higher and reaches its maximal values in patients with 10-12 points. Conclusion. The assessment of laboratory indices reflecting immune response of the body allows estimating the risk of infectious inflammatory postsurgical complications and diagnosing them in III grade large joint osteoarthorisis patients after total replacement.

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Comparative study of complex powdery preparations for soft tissue regeneration

Year: 2017, volume 13 Issue: №3 Pages: 705-710
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Babushkina I.V., Gladkova Е.М., Mamonova I.A., Belova S.V.
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The aim: comparative study of regenerative activity of powdery preparations for local treatment of soft tissue injuries developed from copper and silver nanoparticles in comparison with traditional powders containing antibiotics within the conditions of an experimental conditionally aseptic wound. Material and Methods. The investigation was carried out on 80 albino rats with an experimental conditionally aseptic wound. Copper and silver nanoparticles obtained by the plasma-chemical method, sterile starch, zinc oxide, Baneocin were used. Planimetric and bacteriological research methods were applied. Results. Treatment with the developed preparations in comparison with the traditional ones containing antibiotics supplied more effective course of reparative processes as evidenced by the data of the planimetric indices. Conclusion. Besides the developed preparations due to the evident antibacterial action supplied reliable prevention of the secondary infection which is a compulsory condition for the course of reparative regeneration processes. The use of metal nanoparticles for this purpose allowed to prevent the adverse reactions which are characteristic of similar preparations containing antibiotics.

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