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18THE ROLE OF MODERN BIOMARKERS FOR THE STUDY OF VARIOUS DAMAGES OF THE BRAIN
1 2 3
Muhamadieva L.A. , Rustamova G.R. , Kudratova Z.E.
1Mukhamadieva Lola Atamuradovna - MD, Head of Department; 2Rustamova Gulnoza Rustamovna - Assistant, DEPARTMENT № 3 OF PEDIATRICS AND MEDICAL GENETICS;
3Kudratova Zebo Erkinovna - Assistant, DEPARTMENT OF CLINICAL LABORATORY DIAGNOSTICS, SAMARKAND STATE MEDICAL INSTITUTE, SAMARKAND, REPUBLIC OF UZBEKISTAN
Abstract: biomarker studies for the diagnosis of various brain lesions have been going on for many years, but at the present time the ideal biomarker has not been found. Among biochemical markers, the determination of the level of neurospecific proteins is being actively studied. Given the large number of neuropeptides that are currently being studied, the aim of our work is to consider only some of them, which, in our opinion, are of the greatest interest. This is protein S100fi, it is actively being studied to detect, determine the prognosis and severity of strokes, traumatic brain injuries, chronic cerebral ischemia, brain tumors, on cognitive violation at diabetes, cognitive disorders in neurodegenerativnyh diseases, epilepsy, perinatal by expressions of the nervous system, including cerebral postoperative complications [1, 6].
Keywords: prognosis, perinatal damage to the nervous system, neurodegenerativen disorders, cognitive impairment.
UDC: 616.8-07
Among biochemical markers, the determination of the level of neurospecific proteins is actively being investigated.The major part of them is autoantigens, getting into the blood stream may cause the appearance of autoantibodies that are in violation function hemato-brain barrier from the blood vessel to enter the brain and cause morphological changes, destructive processes in neurons and the development of non-specific acute phase reactions of edema type or inflammation [3,4].
Protein S100B is a glial biomarker , the most studied and included in laboratory diagnostics due to its neurospecificity. Mostly it contains glutamic and aspartic acids, phenylalanine and, in small amounts, tryptophan, tyrosine and proline [6]. These proteins relate to Ca-binding proteins. It is found in the cytoplasm of astrocytes, Schwann cells, adipocytes, chondrocytes, melanocytes. Considering that this protein is widely present in cells of various types, it is believed to be considered a marker of generalized damage to the blood-brain barrier, and not from oiled glia damage [6, 7]. At low concentrations, S100P exhibits neuroprotective properties, blocking NMDA receptors and acting as a growth and differentiation factor for neurons and glia. And at high concentrations it triggers the synthesis of pro minute inflammatory cytokines and lead to apoptosis of neurons [1].
These proteins are involved in the regulation of the basic membrane, cytoplasmic and nuclear metabolic processes associated with the perception and integration of information entering the nervous system, affect the binding activity of acetylcholine receptors, y-aminobutyric acid, norepinephrine, dopamine, serotonin, and are involved in the assembly of cytoskeleton, mitosis and cell cycle interphase [2]. They also stimulate growth, proliferation, cell migration, inhibit apoptosis under physiological conditions, activate astrocytes in case of brain damage and neurodegenerative diseases, which plays an important role in reparative processes, stimulating the growth of axons, dendrites, mesencephalic serotonergic neurons, ganglia of the dorsal roots of the spinal roots [1, 3,7].
Thus, S100 is a paracrine neurotrophic factor in the central nervous system that affects brain formation, glial cell proliferation and neuronal maturation, contributing to cell survival under stressful conditions, and counteracts the effects of neurotoxins [4].
Protein S100 is the most studied and is often used as a marker of brain damage in various studies. So, its increase is noted in strokes of diabetes mellitus, brain tumors [7], perinatal injuries of the nervous system [9].
This protein is actively used to analyze brain damage during various operations, including coronary artery bypass grafting. The serum S100 protein content is normally less than 0.2 ^g / L. The development of cerebral complications in the patient in the postoperative period is evidenced by a content of more than 0.5 ^g / l [8]. It is also noted that in serum, the lowest concentration of S100 is observed immediately before induction in anesthesia and significantly increases during IR, reaching its maximum values at the end, and then decreases on the first operating day [4]. According to some reports, the level of this peptide returns to its original level 18 hours after surgery [9].
In modern studies, a comparison of postoperative cognitive dysfunction (PCD) and the S100P content in patients after coronary artery bypass grafting with or without cardiopulmonary bypass is actively performed. Their results demonstrate that in the group with IR, the level of PKD and S100P is significantly higher than in the group without IR 24 hours after surgery, but its concentration subsequently levels out between the groups [6, 9].
100p protein is a very convenient biochemical indicator because of its short (25 minutes) half-life, and also because the concentration in the serum is independent of age and gender. In addition, serum concentration does not change with an overdose of alcohol, moderate renal dysfunction, or hemolysis [3].
However, the likelihood that S100P protein can be released from extracerebral localization (not only from the brain) limits its use as a marker for brain damage [3,6,8]. So, it can be released with significant physical exertion, acute damage to muscle tissue [2], melanoma and sepsis-associated encephalopathy [2,3].
Despite the fact that no ideal markers of brain damage have been found, an increase in the content of neurospecific proteins in the blood and other biological fluids can be associated with signs of early neurological disorders, the amount of brain damage, early clinical deterioration, prognostic signs of the outcome of the disease. Although the determination of individual neuropeptides may not have sufficient diagnostic significance necessary for the accurate diagnosis of brain damage, the simultaneous determination of several markers is diagnostically significant [10,11].
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