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Macrophages dysfunction and recurrent gastric ulcer bleeding

M. Gorky Donetsk National Medical University . Macrophages dysfunction and recurrent gastric ulcer bleeding . Ground. Diagnostics an prediction of outcome Location of ulcer Size of ulcer Forrest class Age and sex Comorbifities Ulcer anamnesis Number of erythrocytes

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Macrophages dysfunction and recurrent gastric ulcer bleeding

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  1. M. Gorky Donetsk National Medical University Macrophages dysfunction and recurrent gastric ulcer bleeding

  2. Ground Diagnostics an prediction of outcome • Location of ulcer • Size of ulcer • Forrest class • Age and sex • Comorbifities • Ulcer anamnesis • Number of erythrocytes • Hematocrite • Hemoglobine • Gastric ulcer bleeding M. Gorky Donetsk National Medical University Antonina Kalmykova

  3. Ulcer bleeding risk factors 1 Age 2 Comorbid pathology (portal hypertension, cancer, diabetes mellitus etc.) 3 Size of ulcer more than 2 sm 4 Low hemoglobine concentration at hospital admission M. Gorky Donetsk National Medical University Antonina Kalmykova

  4. Research questions: Why? Why? Why? Reasons of un-sustained hemostasis? Mechanisms of insufficient regeneration? Determinants of recurrent bleeding development? M. Gorky Donetsk National Medical University Antonina Kalmykova

  5. Solving th problem Inflammation Injury Regeneration M. Gorky Donetsk National Medical University Antonina Kalmykova

  6. Targets for investigation Pathogen-associated inflammation Reactivity of organism Epinephrine 5-HT Thrombine LPS Alternative mechanisms Classic mechanisms iNOS of Macrophages M. Gorky Donetsk National Medical University Antonina Kalmykova

  7. GOAL Estimate the role and some mechanisms of macrophage dysfunction in gastric ulcer bleeing M. Gorky Donetsk National Medical University Antonina Kalmykova

  8. APPROACH Clinical and laboratoty data Pathomorphology of ulcer margin Endoscopy (size, location, hemostasis) State of monocytes-macrophage lineage OUTCOME OF ULCER BLEEDING M. Gorky Donetsk National Medical University Antonina Kalmykova

  9. Desighn of investigation 1st group Groups 2nd group Age Sex Comorbidity Preliminary treatment Endoscopic features Laboratory tests data Clinical criteria M. Gorky Donetsk National Medical University Antonina Kalmykova

  10. Materials and methods • Morphological investigation • Histological specimens • Staning: hematoxylin and eosin Ishemia Infiltration • Immunohistochemistry Number anddistributionof CD68 positive cell • Biochemical analysis of iNOS activity in monocytes Monocytes + 0 Monocytes + LPS Monocytes + alternative regulators (thrombin and epinephrine). M. Gorky Donetsk National Medical University Antonina Kalmykova

  11. Results of investigation M. Gorky Donetsk National Medical University Antonina Kalmykova

  12. Results of investigation M. Gorky Donetsk National Medical University Antonina Kalmykova

  13. Distribution of macrophages В. Г

  14. 2nd group gastric mucosa В. Г

  15. Results of investigation M. Gorky Donetsk National Medical University Antonina Kalmykova

  16. Results Nitrites concentration in supernatant of un-stimulated monocytes (nmol NO2-/ml) M. Gorky Donetsk National Medical University Antonina Kalmykova

  17. Results Basal and LPS-stimulated activity of iNOS in intact and of stimulated monocytes (nmol NO2-/ml) M. Gorky Donetsk National Medical University Antonina Kalmykova

  18. Results Nitrites concetntration in supernatant of stimulated monocytes (nmol NO2-/ml) Gastric bleeding Healthy volontiers M. Gorky Donetsk National Medical University Antonina Kalmykova

  19. Conclusion Gastric ulcer bleeding is accompanied with proinflammatory activation of peripheral blood monocytes and increase of macrophages recruitment into the gastric mucosa. 2. This changes are associated with desregulation of monocytes-macrophages activity and disbalance in L-arginine metabolism. 3. Hyperactivation of these cells can be concidered is one of the reason of recurrent bleeding M. Gorky Donetsk National Medical University Antonina Kalmykova

  20. The main from Ukrain! M. Gorky Donetsk National Medical University Antonina Kalmykova

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