NEUROVASCULAR VIOLATIONS, MEDIATORIAL-VASCULAR INFLUENCES AT NEUROCONDUCTIVITY OF SPINAL RADIXES, ASPECTS OF THEIR CORRECTION
DOI:
https://doi.org/10.11603/2415-8798.2019.2.10251Keywords:
compression of epidural-vascular plexus, inflammatory mediators and adhesion molecules, choline alfoscerateAbstract
Spondylogenic compression of the spinal cord roots (SCR) leads to impaired blood flow in the epidural vascular plexus (EVP), blood stasis, edema, and local vascular inflammation with impaired endothelial function. In this process, ET-1, nitric oxide, interleukins, coagulation factors, and mediators of EVP violation are of great importance. They bind to specific receptors on the membranes of smooth muscle cells, cause dysfunction of the vascular endothelium, induce vasoconstriction, which is one of the mechanisms of the development of ischemia in the SCR.
The aim of the study – to determine mediators of damage at the compression of epidural-vascular plexus (EVP) and to study opportunities of influence of choline alfoscerate at the process of neuroconductivity of spinal radixes.
Materials and Methods. In 31 patients with chronic form of compression EVP on the background of common therapy and in 27 patients with acute compression EVP on the background of common therapy with including choline alfoscerate and in 29 practically healthy people who were included to the group of control, before and after treatment determined the changes of indexes of endotheline-1, metalloproteinase-1, informative molecules and molecules of adhesion sVCAM-1 і sICAM-1.
Results and Discussion. Intercommunication was educed between the change of indexes of endotheline-1, increase of level of metalloproteinase-1, informative molecules and molecules of adhesion, that testified to immune-vascular inflammation that is one of mechanisms of compression of EVP. Under influence of choline alfoscerate there was marked the improvement of the state of patients, reducing pain intensity and restoring neuroconductivity.
Conclusions. In the acute form of compression of EVP there was an increase in endotheline-1 and the expression of sVCAM-1 and sICAM-1, matrix metalloproteinase-1, interleukin-1β and tumor necrosis factor-α. The high level of these indicators, especially sICAM-1 and matrix metalloproteinase-1, may indicate an activity of vascular inflammation EVP and give opportunity to increase effectiveness of treatment. Clinical-laboratory changes verify restoration of neuroconductivity under the effect of choline alfoscerate in patients with compression of spinal radixes.
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