Ishchuk T. The involvement of proteolysis processes in the development of experimental burn of the esophagus.

The presented thesis work is devoted to the research on the involvement of proteolysis system in the development of the chemical burn of the esophagus. There was displayed the model of experimental alkaline burns of the esophagus of I and II degree. The study revealed reduction in the concentration of albumin and total protein, as evidenced by the development of hypoproteinemia of blood serum of experimental animals under the conditions of the development of esophagus burn. The displayed increase in concentration of urea, creatine and metabolic imbalance of electrolytes may indicate the renal dysfunction. Increased activity of aminotransferases may be indicative of the impaired hepatic synthetic function of rats from the research group. Obtained results of the histologic studies and specified changes in key biochemical values point out that the experimentally reproduced conditions are adequate models of alkaline burn of I and II degree in children aged from 1 to 8 years. The thesis work considers the issue of involvement of proteolysis system in the development of the experimental burn of the esophagus of immature rats. The obtained data pointed out that the cicatrical changes in the esophagus in the process of development of the burn of II degree are accompanied by a significant increase in metallopeptidase inhibitor-1 (TIMP-1) against the background of decreased activity of matrix metalloproteinases (MMP) in the mucous coat of esophagus. Also there was established the increased activity of alfa-2-macroglobulin, MMP in the bloodstream on the 21st day of experiment, which evidences the inflammatory process. As a result of the functional impairment of proteolytic enzymes the development of esophageal burns accompanied by the appearance of autoantibodies in the bloodstream, as indicated by the increase of the IgG level. We also recorded the increased concentration of mid-molecular and low-molecular circulating immune complex, which evidences the development of general process. The study demonstrated changes in the level of albuminous fraction of the blood serum of rats with alkaline burns, which evidences the suppression of protein-synthetic function of the liver due to burn injuries. Changes in the level of low molecular fractions may be associated with an increase in the degradation processes of tissue proteins as a result of increased activity of proteolytic enzymes of different specificity. The author established that the alkaline burns of the esophagus of I and II degree are accompanied by increased content of middle-mass molecules, which evidences the endogenous intoxication of the organism. Thus, the development of the healing process of the after-burn wounds is characterized by the interrelated processes, and the leading ones are: proteolysis, endogenous intoxication, immunological reactivity of the organism. The obtained data allow taking up the position that the development of cicatrical changes is accompanied by the ratio distortion of proteinases and their inhibitors in damaged tissues and bloodstream. The results of the thesis work have scientific and practical value for the development of the pathogenetically oriented methods of treatment of the wound process after the chemical burn of the esophagus, depending on the stage and degree of the burn process.