Influence of bestim immunomodulator on immune status and free-radical oxidation in patients with chronic pyelonephritis associated with urolithiasis

Aim of research is to study the influence of Bestim immunomodulator on indices of immune status and free-radical oxidation in patients with chronic calculous pyelonephritis depending on the phase of inflammation. Introduction. Changes in immune status and active processes of free-radical oxidation in patients with chronic secondary pyelonephritis (CSP) associated with urolithiasis (UL) are significant in the pathogenesis of underlying disease and its complications. Therefore, it is reasonable to supplement complex therapy with antioxidant and immunomodulatory agents, particularly with Bestim (γ-D-glutamyl-L-tryptophan sodium salt). Materials and Methods. We conducted short-term prospective randomized study of effectiveness of Bestim immunomodulatory agent application in patients with chronic secondary pyelonephritis associated with UL as a part of standard conservative therapy combined with surgical treatment. In accordance with inclusion and exclusion criteria we selected 164 patients with chronic secondary pyelonephritis associated with UL who were under medical treatment in the department of urology in the Road Clinical Hospital, Chelyabinsk, and in the department of urology in the Regional Clinical Hospital, Chelyabinsk. Results. It has been established that in patients with CSP associated with UL neutrophil leukocytosis is developed, absorbing lysosomal activity is enhanced, NBT-reductive capacity of neutrophils is decreased, concentration of IL-1β, IL-4, IL-8, and IFN-γ is increased, and activity of superoxide dismutase (SOD) b catalase is decreased. More expressed changes in immune status are observed in patients with UL-associated CSP in the active phase of inflammation. After standard combined therapy patients with active phase of CSP associated with UL have lower count of band neutrophils in blood; absorbing lysosomal activity is still enhanced, NBT-reductive capacity of neutrophils is decreased, concentration of IL-1β, IL-4, IL-8, and IFN-γ is increased, and activity of superoxide dismutase and catalase in plasma and erythrocytes is decreased. Conclusion. If the combined therapy in patients with CSP associated with UL is supplemented with Bestim the changes observed during the active phase of inflammation become more expressed: the count of band neutrophils in blood is decreased, absorbing activity is restored, NBT-reductive capacity of neutrophils keeps on decreasing, concentration of IL-1β, IL-8, and IFN-γ is decreased, and concentration of IL-2 and IL-4 in blood is increased.