Hritsun Y. Clinical immunological and biochemical substantiation of use of antioxidants in patients with scleroma

Based on a comprehensive study involving 92 (33 men, 59 women) patients with infiltrative, atrophic and cicatricial scleroma, the feasibility of including the antioxidant and immunomodulat or acetylcysteine in the treatment of patients with various forms of scleroma was substantiated. The effectiveness of the developed modified therapy of scleroma with the inclusion of acetylcysteine, which reliably provided the solution of certain therapeutic problems (reduction of dryness of the mucous membranes of the respiratory tract, hoarseness, difficulty breathing, infiltrates and the number of purulent crusts in the nasal cavity), optimization of indicators of quality of life in patients with various forms of scleroma. There was found that the use of the drug acetylcysteine significantly improve quality of life: physical functioning (p=0.039), the role of physical and emotional problems in limiting life (p<0.001), social activity (p = 0.003), increasing the integral physical component of health in compared with traditional therapy (p<0.001). There has been proven for the first time that the inclusion of the antioxidant acetylcysteine in the treatment regimen effectively corrects the signs of lipoperoxidation of proteins and lipids, increases the activity of antioxidant enzymes (catalase, superoxide dismutase) and the level of reduced glutathione in patients with various sclerotic forms. It was found, that the addition of acetylcysteine significantly contributes to the modulation of the body's immune response. Based on the data of the study of the spectrum of pro- and anti-inflammatory cytokines (interleukins 1? and 10) in the serum and oropharyngeal secretion, the dynamics of changes in the cytokine profile of the blood in patients depending on the stage of scleroma. In patients receiving combination therapy with the addition of acetylcysteine, an effective reduction of systemic, local disorders of cytokine imbalance, normalization of serum immunoglobulin levels (p <0.001), and oropharyngeal secretion in patients with various forms of scleroma.