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Azizov Yorkin Husanovich, head of laboratory, biochemical research, Central Research Laboratory; Tashkent Medical Academy, Tashkent, Republic of Uzbekistan Okhunov Alisher Oripovich, Head of the Department of General and Pediatric Surgery, Tashkent Medical Academy, Tashkent, Republic of Uzbekistan
Azizova Pokiza Husanovna, senior lecturer of Department of Internal Medicine -2 Tashkent Medical Academy, Tashkent, Republic of Uzbekistan
E-mail: evovision@bk.ru
METABOLIC ACTIVITY OF LUNGS IN THE DEVELOPMENT OF AN EXPERIMENTAL MODEL OF SURGICAL SEPSIS
Abstract: Analyzing the results obtained, it can be noted that on the first day of the reproduction of EMHS in the lung, the passage of blood through this organ was accompanied by a marked decrease in albumin and a-2 globulins. Against this background, the proportion of coarse proteins, gamma globulins, which play an important role in the immune responses of the body, increased. Apparently, this phenomenon is due to the increased synthesis of this fraction of blood in the lung tissue in this pathology. In the process of development of EMHS, a significant decrease in the total protein content in serum is observed, which may be due to a decrease in the synthesis of albumin in the liver.
Keywords: experimental model of surgical sepsis, protein fractions, albumin, globulins, mixed venous blood, arterial blood, venous-arterial difference.
The tendency to an increase in the incidence of sepsis in combination with the continuing high mortality contributes to the emergence of more and more new research in this area [1; 2].
Studies of the organ exchange of protein fractions in the lungs in sepsis are few. Meanwhile, there are enough prerequisites for close attention to these compounds [4; 5].
The aim of our work was to study the nature of the organ metabolism of protein fractions directly in the lungs during the development of an experimental model of surgical sepsis (EMHS).
Material and research methods. In the experiment, 47 outbred rabbits of both sexes weighing 1500-2500 g were used on the usual laboratory diet of the vivarium of the Tashkent Medical Academy, which meets the requirements of the sanitary epidemiological service.
All animals were divided in to 2 groups:
- control - 12 intact rabbits (without modeling the pathological process);
- the main - 35 rabbits with EMHS.
EMC, with its characteristic phase stages, was modeled according to the original method developed by us - "A method of modeling surgical sepsis with the systemic inflammatory response syndrome of the body" by introducing autoclave suspension into the soft tissues against the background of a
preliminary change in the organism's reactivity by analogy with the nature of the pathological process that occurs in clinical practice.
The content of protein fractions in blood samples obtained at the entrance to the lungs in mixed venous blood (CRS) and at the exit of the lungs, in arterial blood (AA) in intact animals (control) and on the 1st, 3rd, 7th, 14th day of the development of EMC.
The protein fractions of blood - albumin, a-1, a-2, p, and y-globulins (%) were separated by electrophoresis on agarose films.
Results obtained and their discussion. The study of protein fractions revealed an ambiguous relationship of metabolic lung function to albumin and to the total level of globulins. In the control series of experiments, the level of albumin in the CRS was 56.8 ± 1.42%, whereas at the exit from the lungs in AK, its level decreased to 52.4 ± 1.23%(p < 0.05). VAR, amounting to "-" 4.4 ± ± 0.02%, indicated the utilization of this substrate by the lungs. Unlike albumin, the total amount of globulins increased in the blood sample at the exit of the lung. VAR of the total level of globulins in the control series of experiments was positive and amounted to "+" 2.03 ± ± 0.05%. It should be noted that such changes were noted in all 12 animals studied in this series (Table 1).
Table 1.- The nature of changes in the content of albumin and globulins (%) in various blood samples in the dynamics of the development of EMHS
Blood Tests Series of experience
Control Dynamics of EMHS
1 day 3 day 7 day 14 day
Albumins (%)
ICV 56.8 ± 1.42 49.1 ± 1.54* 48.2 ± 1.39* 43.3 ± 1.21* 38.1 ± 1.13*
AK 52.4 ± 1.23 44.9 ± 1.12 43.4 ± 1.11* 37.4 ± 1.11* 32.0 ± 1.1*
Total hemoglobin level (%)
ICV 40.4 ± 1.23 50.7 ± 1.48 51.71 ± 1.98* 56.3 ± 1.12* 61.1 ± 1.13*
AK 42.43 ± 0.98 54.41 ± 1.23 54.5 ± 0.87 56.79 ± 1.11 56.46 ± 0.93*
*P < 0.05 reliable with respect to the control series of experim
On the first day of the development of EMHS, the level of albumin decreased as compared with the control series of experiments both in ICV (by 7.7%) and in AK (by 7.5%), respectively. The BAR at that time, which amounted to "-" 4.2 ± ± 0.07%, did not have significant differences compared with the control series of experiments. In this period of development of EMHS, the total level of globulins increased both in ICV (by 10.3%) and in AK (by almost 12%, respectively). BAR at this time increased compared with the control series of experiments in a significant value, reaching the level of "+" 3.71 ± 0.08% (p < 0.05).
Unlike albumin, VAR of the total level of globulins did not change unequivocally. In particular, on the 1st day ofthe development of EMHS, the level of BAP increased from "+" 2.03 ± ± 0.05% in the control series of experiments to "+" 3.71 ± 0.08% during the study period (p < 0.05). At the same time, the 3rd day of the development of the pathological process was characterized by a decrease in VAR compared with the previous experiment period to "+" 2.79 ± 0.07%, however, it was higher than the control values. Subsequently, VAR, in terms of the total level of globulins, progressively decreased, and on the 14th day of the development of the pathological process, VAR changed from a "plus" value in favor of a "minus" one, reaching to the level "-" 4.64 ± 0.03% (p < 0.05). This circumstance testified to the predominance of catabolic processes over anabolic in the lungs with respect to the substrate under study. On the other hand, a comparative approach to the study of the content of the main fractions of the total protein in various blood samples indicated a high specificity of the metabolic activity of the lungs in relation to globulins, which determined the need for a detailed study of the fractions of globulins.
The study of globulin fractions in ICS showed the most significant changes with respect to a1 - and to a2-globulins (Table 2). Their level in ICS progressively increased with the
development of AMHS. At the same time, on the 14th day of the disease, the level of the above fractions in the ICS increased by 1.9-2.0 times compared with the control series, whereas the level of a1 - and a2 -globulins was 1.5 and 1.2 times, respectively (p < 0.05).
Among all the studied globulin fractions, a1 - globulins distinguished themselves by relative instability. Their level in SVK increased by the 1st day of the development of the pathological process 1.4 times, and over the next 3-7th day it relatively stabilized. In the next 14 days of observation, the level of this fraction of globulins in the ICS increased again to 14.9 ± 1.2% and reached its maximum value for the entire study period. Regarding a1-globulins, it is necessary to note a gradual increase in its level in ICS, which by the 14th day of development of AMHS had a significant value (p < 0.05) in relation to its level in the control series of experiments.
The study of the distribution of globulin fractions in AK showed the following: a progressive type of increase in its level compared with the control series of experiments was noted in relation to the a1 - and a2-globulins. Moreover, in the case of a-globulin, the level of its concentration in AA increased from the control series on the 14th day of the disease by 1.6 times, then the level of a 2-globulins increased by the 14th day of the pathological process by 1.8 times, that is, more significantly compared with the control series of experiments.
Regarding the change in the concentrations of a1 - and a-globulins in AK at the exit from the lungs, it can be noted that their dynamics were wave-like. In particular, the relative increase in the level of a1-globulins in arterial blood on the 1-3rd day of the development of EMHS in the subsequent observation period decreased and was below the control values.
Table 2.- The nature of changes in the content of globulin fractions (%) in various blood samples in the dynamics of the development of AMHS
Globulin Fractions (%) Series Of Experience
Control Dynamics of EMHS
1 day 3 day 7 day 14 day
ICV
5.3 ± 1.1 6.0 ± 1.9 7.8 ± 1.1* 8.5 ± 1.9* 10.1 ± 2.1*
«2 7.2 ± 1.8 11.1 ± 2.8 11.11 ± 2.3* 13.9 ± 2.3* 14.5 ± 1.9*
3 10.2 ± 1.5 14.6 ± 2.2* 13.4 ± 2.7 13.9 ± 2.9* 14.9 ± 1.2*
Y 17.7 ± 1.9 19.0 ± 2.3 19.4 ± 2.2* 20.0 ± 2.8* 21.6 ± 1.2*
AK
7.65 ± 1.19 8.21 ± 1.81 8.2 ± 1.13 6.41 ± 1.12 7.82 ± 0.92
«2 7.42 ± 1.44 11.42 ± 1.78 11.23 ± 1.2 13.25 ± 1.4* 13.21 ± 2.11*
ß 12.21 ± 1.93 18.2 ± 1.23* 18.1 ± 2.11* 15.6 ± 1.37* 11.0 ± 1.92
Y 15.15 ± 2.31 16.58 ± 2.34 16.97 ± 1.8* 21.53 ± 2.3* 24.43 ± 1.32*
*P < 0.05 reliable with respect to the control series of experim
Similar metabolic activity of the lungs was also shown in relation to a2-globulins. However, in this case, the leveling of VAR occurred against the background of an increase in its physiological parameters on the 1st day of the development of EMHS. At the same time, the modified BAR on the 14th day of the development ofAMHS was 5.9 times higher compared with the control series of experiments, whereas in the case of a1-globulins only 1.1 times.
The metabolic activity of the lungs in relation to the tao6-globulins was characterized by a progressive increase in VAR at the 1-3 day of development ofAMHS by 1.8 and 2.3 times, respectively. In the subsequent periods of experiments, VAR for this indicator decreased sharply, retaining its "positive" value. This tendency led to a leveling of the relationship of the metabolic activity of the lungs to the a -globulins, decreasing to "-" 3.9 ± 0.1%, that is, by the 14th day of the development of the pathological process, the lungs begin to actively utilize the a -globulins, apparently, for own synthetic needs.
This conclusion we made was not casual, since with respect to the metabolic activity of the lungs to a -globulins it changed in the opposite sense. With relative stability and nature ofVAR in this indicator on the 1-3rd day of development of AMHS in the subsequent periods, we found a tendency for VAR in the relation of the metabolic activity of the lungs to this indicator. She acquired a "plus" value and gradually increased. That is, the lungs in this case synthesized a -globulins, increasing their level in AK at the exit of the lungs.
An assessment of the dynamics of the albumin / globulin ratio showed that with the development of AMHS, there was a progressive decrease in its CRS and at the entrance to the organ, and in the AK at the exit of the lungs.
On the 3rd day of the development of EMHS, the level of this index in the ICS slightly increased (from 3.4 ± 0.1 units
to 3.6 ± 0.2 units), whereas in AK it did not actually change, decreasing insignificantly from 2 5 ± 0.8 units up to 2.4 ± 0.9 units Against the background of the relative stabilization of the level of this coefficient in AA, on the 7th day of the development ofAMHS, there was a significant decrease in the CRS at the entrance to the lungs. That is, against the background of a progressive decrease in this coefficient at the entrance to the lungs, the metabolic activity of the lungs maintained its level within the previous period of the experiments.
Subsequently, on the 14th day of the development of the pathological process, the albumin / a - globulin ratio decreased in the CRS, leading to an increase in its level in AK at the exit of the lungs.
In contrast to the changes in the coefficients described above, an analysis of changes in the albumin / a - globulin curve correlation revealed ambiguity with respect to AK at the exit from the lungs. The progressive reduction of this coefficient in the SVK at the entrance to the lungs was accompanied by ambiguous changes in its arithmetic value in the AK at the exit from this organ. An intensive decrease in the level of this coefficient in AK was accompanied by a decrease in its VAR. At the same time, starting from the 7th day of the development of AMHS, we identified the leveling by the lungs of this coefficient. The lungs led to a progressive decrease in the level of albumin / a - globulin coefficient in AK due to an increase in the proportion of - globulins against the background of a decrease in albumin. When the level of fluctuations of this coefficient in the VBC in the range of 2.2 ± 0.1 units on the 7th day of the disease up to 1.8 ± 0.07 units. on the 14th day of the pathological process, its level in AK decreased to 1.7 ± ± 0.07 units. on the 7th day, and up to 1.3 ± 0.03 units. on the 14th day of the development of EMHS. This, in turn, indicated that the hypermetabolic processes occurring in the lung tissue
during these periods of development of the AMHS were a consequence of the progression of the purulent-septic process, whereas changes in the ICS were a consequence of the generalization of the process of the 7-14th day of the disease.
Analyzing the obtained results, it can be noted that on the first day of reproduction of EMHS in the lung, the passage of blood through this organ was accompanied by a pronounced decrease in albumin and a-2 globulins. Against this background, the proportion of coarse-grained proteins, gamma
globulins, which play an important role in the immune responses of the body, increased [5; 6; 10].
Apparently, this phenomenon is due to the increased synthesis of this fraction of blood in the lung tissue in this pathology.
In the process of development of EMHS, a significant decrease in the total protein content in serum is observed, which may be due to a decrease in the synthesis of albumin in the liver, which is also confirmed by literature data [10].
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