Screening of metabolic function of neutrophil granulocytes in assessing the severity of acute appendicitis in patients
https://doi.org/10.21518/akh2025-058
Abstract
Introduction. Among acute surgical pathologies, acute appendicitis (AA) occupies a leading place with a tendency to transform the clinical picture due to an increase in complicated forms.
Aim. To evaluate the clinical effectiveness of recording the metabolic function of neutrophil granulocytes (NG) as part of complex diagnostic monitoring of the severity of AA.
Materials and methods. A total of 127 patients diagnosed with AA (59 with complicated disease and 68 with localized disease) and 32 ageand gender-matched volunteer donors (conditionally healthy controls) were studied. Peripheral blood was collected upon admission to the clinic. The level of metabolic function of NG was tested using luminol-dependent chemiluminescence (LDCL) in both spontaneous (sLDCL) and induced (iLDCL) modes. Endotoxin (E) concentration was assessed using the micro-LAL assay and immunofluorescence analysis.
Results. A radical restructuring of the killing function of the NG was observed in complicated cases of OA, to a greater extent in those hospitalized at late stages of presentation to the clinic. In patients with a localized form of the disease, the iLZHL indices were 137.72 ± 22.48 imp/min; with widespread purulent inflammation, the biocidal activity of NG was 107.26 ± 27.48 (p = 0.0261); in late stages of hospitalization – 87.21 ± 8.6 imp/min. A strong negative correlation was found between the iLZHL level and the E concentration (r = -0.77, p = 0.0009). A positive correlation was observed between the sLZHL indicators and the lipopolysaccharide level (r = +0.46, p = 0.0285), reflecting intestinal microbiome dysbiosis and the massive E release into the bloodstream.
Conclusions. Screening of the metabolic function of the NG in combination with diagnostic examination expands the verification of the severity of the purulent abdominal process in patients with OA and the effectiveness of surgical treatment.
About the Authors
A. V. Pikuza
Kazan State Medical University;
Republican Clinical Hospital
Russian Federation
Russian Federation
Aleksey V. Pikuza, Cand. Sci. (Med.), Doctor of the Highest Qualification Category, Associate Professor of the Department of Surgical Diseases, 49, Butlerov St., Kazan, 420012;
Surgeon, 138, Orenburgsky Tract, Kazan, 420064
A. M. Zakirov
City Clinical Hospital No. 7 named after M.N. Sadykov
Russian Federation
Russian Federation
Azat M. Zakirov, Doctor of the Highest Qualification Category, Surgeon, Department of Surgery,
54, Marshal Chuikov St., Kazan, 420103
Sh. S. Khachetlov
Kazan State Medical University
Russian Federation
Russian Federation
Shamil S. Khachetlov, Student of the Pediatric Faculty,
49, Butlerov St., Kazan, 420012
E. E. Terziyan
Kazan State Medical University
Russian Federation
Russian Federation
Eduard E. Terziyan, Student of the Faculty of Medicine,
49, Butlerov St., Kazan, 420012
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Review
For citations:
Pikuza A.V., Zakirov A.M., Khachetlov Sh.S., Terziyan E.E. Screening of metabolic function of neutrophil granulocytes in assessing the severity of acute appendicitis in patients. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2025;22(2):208-215. (In Russ.) https://doi.org/10.21518/akh2025-058
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