Cytokine Profile in Dynamics of Arterial Hypertension Treatment

Kravchun P. G., Shelest A. N., Kovaleva Yu. A., Shelest B. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

The purpose of the research is optimization of antihypertensive therapy with Ramipril and identifica­ tion of ІL­1β level in patients with non­complicated forms of AH. Materials and Methods. 43 patients, including 18 men and 25 women aged from 44 to 74 years old (59,3 ± 5,27) (treatment group) have been involved into the clinical trial. According to the criteria of European (2007) and Ukrai­ nian (2008) scientific societies of cardiologists, Grade I AH has been detected in 17 cases and Grade II AH in 26 cases. Results and Discussion. Before Ramipril intake of patients with arterial hypertension (AH) a systolic blood pres­ sure (SBP) was 29,4 % higher as compared with control group, and diastolic blood pressure (DBP) was higher by 25,85 %. In 2­3 weeks of treatment under the effect of Ramipril a SBP lowered by 16,81 % (from 162,4 ± 9,6 mmHg to 135,1 ± 10,mmHg, р < 0,05), having reached the rate of control group; DBP lowered by 12,5 % (from 98,8 ± 6,5 mmHg to 86,4 ± 4,1 mmHg). In essential hypertension the level of 1β­interleukin was within 45,54­64,27 pg/ml. In 12 patients the level of 1β­interleukin was lower and in 31 patients it was higher than 5,4 pg/ml. In 3 months after the treatment with Ramipril began, the rate of SBP constituted 139,6 ± 5,7 mmHg in 41patients, that is 13,9 % lower the basal value (р < 0,01). At the same time the rate of DBP constituted 86,3 ± 2,4 mmHg, that is 7,8 % lower the basal value (р < 0,05). Currently, significant studies of the role of cytokines in the formation and clinical course of AH have been carried out. It has been proved that among cytokines, which are crucial for coordination of immunological response in AH, a significant place is given to interleukins, i. e., proteins that are produced by activated cells of immune system and responsible for communication between cells. The most typical effect is the proliferation induction. Possessing a wide range of biological characteristics, they are powerful communication system, which stimulate and regulate inflammatory processes of all organs and systems. Interleukins (they are about 20) are designated numerically, not assigned to a single subgroup of cytokines, binding with similar functions. The name “interleukin” is given to a mediator in compliance with criteria, developed by the Nomenclatorial Committee of International Association of Immunological Societies: molecular cloning and expression of the gene of factor under study; the presence of a unique nucleotide and corresponding amino acid sequence; obtaining of the neutralizing monoclonal antibodies; production by cells of the immune system, the avail­ ability of important biological function in regulation of the immune response. Patients with AH experience disturbances in immune status, as well as changes of cytokine profile of the organ­ ism. Great attention is paid to 1β­ interleukin due to the fact that this anti­inflammatory cytokine initiates secretion of other cytokines and is one of the mediators of acute stage of the process. Conclusions. Concentration of IL­1β is significantly elevated in patients with arterial hypertension, as compared with control group. The level of IL­1β in patients with arterial hypertension is correlated with blood pressure, to a considerable degree with SBP and less with DBP. In treatment with Ramipril the level of IL­1β in patients with arterial hypertension is lowering simultaneously with lowering of blood pressure. Perspectives of further research are related to subsequent study of the nature of correlation between rates of alterations of inflammatory mediators in different variants of clinical course of arterial hypertension.

arterial hypertension, blood pressure, interleukin, Ramipril

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«Bulletin of problems biology and medicine» Issue 3 part 2 (111), 2014 year, 152-155 pages, index UDK 616. 12­008. 331. 1­056. 52­085. 225. 2:612. 017. 1