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Minerva Orthopedics 2022 June;73(3):287-93

DOI: 10.23736/S2784-8469.21.04126-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The role of cytokines in the mechanisms of regulation of reparative processes in modeling fractures of the proximal femur secondary to the correction of concomitant arterial hypertension

Sergey B. PAVLOV 1, Volodymyr O. BABALYAN 2, Mykyta V. VALILSHCHIKOV 2, Nataliia M. BABENKO 1, Marina V. KUMETCHKO 1 , Olga B. LITVINOVA 1, Nataliia G. SEMKO 1

1 Kharkiv Medical Academy of Postgraduate Education, Сentral Research Laboratory, Kharkiv, Ukraine; 2 Kharkiv Medical Academy of Postgraduate Education, Department of Traumatology, Anesthesiology and Military Surgery, Kharkiv, Ukraine



BACKGROUND: Treatment of patients with fractures of the proximal femur is an urgent problem of modern traumatology. Considering the relationship between low bone mass and cardiovascular diseases, it is urgent to study the regulation of violations of the processes of fracture repair by correcting concomitant hypertension. The aim of the study was to study the role of intercellular mediators (by the example of interleukin-1β [IL-1β], granulocyte-macrophage colony-stimulating factor [GM-CSF], and interleukin-4 [IL-4]) in the mechanisms of regulation of reparative processes in modeling fractures of the proximal femoral bones with intramedullary osteosynthesis secondary to the correction of concomitant hypertension.
METHODS: The experimental study was carried out in two groups of white rats. The first group of animals consisted of conditionally healthy normotensive Wistar rats. The second group comprised of animals with genetically determined arterial hypertension (SHR). Animals of both groups were divided into subgroups. Animals of subgroups 1.2, 2.2, 2.4 were exposed to the proximal femur. Animals of subgroups 2.3 and 2.4 underwent hypertension correction with enalapril. Registration of rat systolic blood pressure indices was carried out on the first and 14th days of the experiment. The levels of IL-1β, IL-4, and GM-CSF were determined in the blood serum of the animals. Femur preparations were examined after the removal of intramedullary fixation.
RESULTS: A decrease in systolic blood pressure was observed in groups of SHR animals that have enalapril. Concentrations of GM-CSF in the serum of SHR rats are higher than those of normotensive animals. The levels of IL-1β and GM-CSF are increased in the blood serum of normotensive rats after fractures of the proximal femur compared with the corresponding parameters in animals without surgery. The opposite trend is observed in SHR animals. IL-4 concentrations are increased in animals with a fracture of the proximal femur compared with those in animals without a fracture.
CONCLUSIONS: Reactivation of repair processes in fractures of the proximal femur against the background of correction of concomitant arterial hypertension occurs due to changes in cytokine levels: a decrease in GM-CSF concentrations and an increase in IL-4 concentrations. The use of the drug enalapril when modeling fractures helps to reduce the inflammatory process has a pronounced antiaggregatory effect.


KEY WORDS: Cytokines; Hip fractures; Hypertension; Rats, inbred SHR

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