Nikolayenko M. Peculiarities in the changes of proinflammatory and anti-inflammatory cytokines and gelatinase B in uveitis, complicated by a lesion of the optic nerve.

3. The thesis deals with an urgent problem of ophthalmology: improvement of the efficiency in diagnosis and anti-relapse treatment of uveitis, complicated by a lesion of the optic nerve. It is for the first time that information was received about changes in the blood serum content of matrix metalloproteinase-9 (MMP-9) (gelatinase B) in patients with uveitis, complicated by an inflammation of the optic nerve, and relationships of the above changes with presence or absence of a partial atrophy of the optic nerve within a remote period. It was found out that the concentration of MMP-9 during the active stage of the disease was almost 3.5 times higher versus controls (p<0.05). At the same time the acute stage of the disease in the patients, who had developed a partial atrophy of the optic nerve during two years, revealed a reliably higher blood serum concentration of MMP-9 (122.9±18.3 ng/ml; p<0.05) versus patients without an atrophy of the optic nerve (64.4±17.1 ng/ml). It was also found that there was a strong direct correlation between the development of a partial atrophy of the optic nerve and the concentration (during the acute period) of MMP-9 in blood serum (r = 0.70103; p<0.05). It was revealed that during the active stage of their disease the patients, who within two years had developed relapses of uveitis, complicated by an inflammation of the optic nerve, had reliably higher blood serum contents of TNF-? - 19.8±1.55 pg/ml, р<0.05 (by 84.2 %) - and interleukin-1? - 83.2±6.1 pg/ml, р<0.05 (by 44.4 %) - with a reliably lower content of interleukin-10 - 0.96±0.53, р<0.05 (by a factor of 3.4) versus patients with a favourable course of uveitis (respectively, 10.9±1.62, 57.6±5.85, 3.31±0.61). There was a correlation between a relapse of uveitis, complicated by an inflammation of the optic nerve, and the blood serum concentration of interleukin-10 (r = -0.7327; p<0.05). The use of Inflamafertin in compliance with the suggested method for prophylaxis of relapses of uveitis made it possible to prevent appearance of exacerbations of uveitis, complicated by an inflammation of the optic nerve, in 86.4% of cases and reduced the rate of the disease relapses from 34.1% down to 13.6% (p<0.05).