ARTICLE
TITLE

Tnfa and tgfß1 level in blood of patients with acute appendicitis and abdominal tuberculosis

SUMMARY

Introduction. Differential diagnosis of acute appendicitis with abdominal tuberculosis is ?n urgent problem of medicine. ?he immune system is involved ?n the pathogenesis of diseases, and cytokines are the regulators of inflammation.The aim of the study – to determine the level of cytokines with the pro- and anti-inflammatory potential of TNFa and TGFß1 and their correlation in the blood of patients with acute appendicitis and abdominal tuberculosis in order to improve diagnosis and treatment tactics. Research Methods. 51 patients with urgent abdominal pathology were examined, 21 of them with phlegmonous form of acute appendicitis, 30 patients with histologically confirmed diagnosis of abdominal tuberculosis. The content of TNFa ? ?GFß1 in serum was examined by the ELISA method by the reagents “Diaclone” and “DRG Diagnostic”.Results and Discussion. The results of studies have shown that the development of acute and chronic inflammatory process in the abdominal cavity is determined by activation of the macrophage-monocytic system, manifested by a significant increase in the serum level of TNFa. It was established that in patients with abdominal tuberculosis on the background of increased serum level of TNFa ((17.57±1.05) vs. (4.97±0.18) pg/ml) the TGFß1 level does not differ from the control ((16.52±1.15) vs. (17.94±0.71) ng/ml) at that time, as with acute appendicitis, its level decreased ((11.32±0.65) vs. (17.94±0.71) ng/ml). ?GFß1/TNFa ratio during the abdominal inflammation was much lower than control, but in abdominal tuberculosis in 1.5 times higher than in acute appendicitis.Conclusions. The serum level and ratio of monocyte-macrofage derived TNFa and ?GFß1 determines the type of inflammation and may be useful in differential diagnostic of acute appendicitis and abdominal tuberculosis.

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