[Proinflammatory cytokines - as a marker of the effectiveness of neuroprotection in children with perinatal nervous system damage].

Abstract

Objective: To evaluate the effectiveness of complex rehabilitation measures using the peptidergic drug Cortexin in children with perinatal CNS damage based on the study of serum levels of proinflammatory cytokines.

Material and methods: 146 children (86 boys, 60 girls) aged from 20 days to 6 months (the average age of boys was 2.7±1.2, and girls 2.9±1.1 months) with CNS PP were examined. Depending on the severity of CNS PP, patients were divided into 3 groups: the 1^st (n=50) included patients with severe CNS PP, the 2^nd (n=58) - moderate and the 3^rd (n=38) - with mild severity. By random sampling, each group was divided into 2 subgroups: patients of subgroups 1A, 2A, and 3A were prescribed Cortexin in addition to standard therapy in accordance with current clinical guidelines. Patients in subgroups 1B, 2B, and 3B received only standard therapy. During the treatment, the concentration of TNF-α and IL-Iß in the blood serum was determined.

Results: In subgroup 1A, the concentration of IL-Iß decreased by 1.5 times after treatment (p=0.022), and TNF-α by 1.4 times (p=0.033), which was statistically significantly higher than the similar changes in subgroup 1B. In subgroup 2A, the concentration of IL-Iß decreased by 1.4 times, TNF-α by 1.2 times (p=0.038) by 3 months (p=0.037) from baseline values, whereas in patients of subgroup 2B, no correction of cytokine levels was observed. In subgroup 3A, the dynamics of IL-Iß and TNF-α concentrations had a positive trend and exceeded similar indicators in subgroup 3B.

Conclusions: In patients with CNS ASD of varying severity, the inclusion of Cortexin in treatment regimens leads to a significant shift in IL-Iß and TNF-α levels 3 months after the start of treatment, which significantly exceeds the results of standard treatment.