rospedРоссийский педиатрический журнал имени М.Я. СтуденикинаM.Ya. Studenikin Russian Pediatric JournalФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/1560-9561-2021-24-2-96-101smiivzrosped-1209Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL INVESTIGATIONSМатриксные металлопротеиназы при неосложнённых компрессионных переломах позвоночника у детейMatrix metalloproteinases in children with uncomplicated compression fractures of the spinehttps://orcid.org/0000-0002-4679-0533СмирновИван ЕвгеньевичSmirnovIvan E.

Доктор мед. наук, проф., начальник методического отдела ФГАУ «НМИЦ здоровья детей» Минздрава России

e-mail: smirnov@nczd.ru

MD, PhD, DSci., Professor, Head of the Methodological department, National Medical Research Center for Children’s Health, Moscow, 119991, Russian Federation

e-mail: smirnov@nczd.ru

smirnov@nczd.ruhttps://orcid.org/0000-0001-9418-4418КарасеваОльга ВитальевнаKarasevaOlga V.

Доктор мед. наук, проф., зам. директора по научной работе, руководитель отделения сочетанной травмы «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения города Москвы

noemail@neicon.ruhttps://orcid.org/0000-0001-8586-7946ФисенкоАндрей ПетровичFisenkoAndrey P.

Доктор мед. наук, проф., директор ФГАУ «НМИЦ здоровья детей» Минздрава России

noemail@neicon.ruhttps://orcid.org/0000-0001-6287-8204КучеренкоАлла ГеоргиевнаKucherenkoAlla G.

Доктор мед. наук, проф. гл. специалист ФГАУ «НМИЦ здоровья детей» Минздрава России

noemail@neicon.ruhttps://orcid.org/0000-0001-6411-0709МитишВалерий АфанасьевичMitishValery A.

Доктор мед. наук, проф., директор «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения города Москвы

noemail@neicon.ruhttps://orcid.org/0000-0002-2396-8992ПорохинаЕкатерина АлександровнаPorokhinaEkaterina A.

Науч. сотр. отдела детской хирургии «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения города Москвы

noemail@neicon.ruhttps://orcid.org/0000-0003-3399-2715СаруханянОганес ОганесовичSarukhanyanOganes O.

Доктор мед. наук, руководитель отдела детской хирургии «НИИ неотложной детской хирургии и травматологии» Департамента здравоохранения города Москвы

noemail@neicon.ruФГАУ «Национальный медицинский исследовательский центр здоровья детей» Минздрава РоссииNational Medical Research Center for Children’s HealthГБУ «Научно-исследовательский институт неотложной детской хирургии и травматологии Департамента здравоохранения города Москвы»Research Institute of Emergency Pediatric Surgery and Traumatology20211001202524296101Copyright © Смирнов И.Е., Карасева О.В., Фисенко А.П., Кучеренко А.Г., Митиш В.А., Порохина Е.А., Саруханян О.О., 20252025Смирнов И.Е., Карасева О.В., Фисенко А.П., Кучеренко А.Г., Митиш В.А., Порохина Е.А., Саруханян О.О.Smirnov I.E., Karaseva O.V., Fisenko A.P., Kucherenko A.G., Mitish V.A., Porokhina E.A., Sarukhanyan O.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rosped.ru/jour/article/view/1209

Цель — определение изменений содержания матриксных металлопротеиназ (ММП) и их тканевого ингибитора (ТИМП-1) при неосложнённых компрессионных переломах позвоночника (НКПП) у детей.

Материалы и методы

Материалы и методы. Комплексно обследованы 85 детей, из них 69 больных с НКПП (средний возраст 12,3 ± 2,6 года), референтную группу составили 16 детей (средний возраст 11,8 ± 2,7 года) без патологии позвоночника. В течение диагностического периода 1–3 сут после травмы у всех детей иммуноферментным методом определяли изменения содержания матриксных металлопротеиназ (ММП) и их тканевого ингибитора (ТИМП-1) в сыворотке крови.

Результаты

Результаты. Установлено, что в острый период после травмы позвоночника существенно увеличивалось содержание в крови желатиназ (ММП-2 и ММП-9), стромелизина (ММП-3) и коллагеназ (ММП-8) по сравнению с их уровнями у детей референтной группы. При этом уровни ТИМП-1 и соотношения концентраций ММП/ТИМП-1 в крови больных с НКПП значительно уменьшались по сравнению с контролем, что указывает на преобладание протеолитического действия ММП. Анализ изменений содержания ММП в крови после НКПП у мальчиков и девочек не выявил значимых различий уровней изученных ММП и ТIМП-1 за исключением существенного повышения концентрации стромелизина (ММП-3) в сыворотке крови мальчиков по сравнению с его уровнем у девочек и в контроле. При различной тяжести течения НКПП у детей выявлено значимое увеличение концентраций ММП, связанное с нарастанием степени тяжести травмы, и существенное уменьшение содержания ТИMП-1 в крови больных по сравнению с его уровнями у детей с компрессионным переломом позвоночника 1–2 степени тяжести и в контроле.

Заключение

Заключение. Определение содержания ММП и TИMП-1 в крови после НКПП у детей позволяет мониторировать течение репаративного процесса после травмы тел позвонков.

Участие авторов

Участие авторов: Смирнов И.Е., Карасева О.В., Кучеренко А.Г. — концепция и дизайн исследования; Карасева О.В., Порохина Е.А., Саруханян О.О. — сбор материала; Кучеренко А.Г., Смирнов И.Е. — статистическая обработка; Смирнов И.Е. — написание текста; Фисенко А.П., Митиш В.А. — редактирование. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Информированное согласие

Информированное согласие. От родителей пациентов получено письменное добровольное информированное согласие на участие в исследовании.

Финансирование

Финансирование. Работа не имеет финансовой поддержки.

Конфликт интересов

Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.

Поступила 21

Поступила 21.04.2021Принята к печати 22.04.2021Опубликована 14.05.2021

The aim of the study was to determine changes in the content of matrix metalloproteinases (MMP) and their tissue inhibitor in children with uncomplicated compression fractures of the spine (UCFS).

Materials and methods

Materials and methods. Eighty-five children, including 69 patients with UCFS (average age 12.3 ± 2.6 years), were comprehensively examined. The reference group consisted of 16 children (average age 11.8 ± 2.7 years) without spinal pathology. During the diagnostic period for 1–3 days, changes in the MMP content and their tissue inhibitor (TIMP-1) in blood serum were determined by the enzyme immunoassay method in all children after trauma.

Results

Results. It was found that in the acute period after spinal injury, the blood levels of gelatinases (MMP-2 and ММР-9), stromelysin (MMP-3), and collagenases (MMP-8) significantly increased compared to their levels in children of the reference group. At the same time, the levels of TIMP-1 and the ratio of MMP/TIMP-1 concentrations in the blood of patients with UCFS significantly decreased compared to the control, which indicates the predominance of the proteolytic effect of MMP. Analysis of changes in the content of MMP in the blood in UCFS boys and girls did not reveal significant differences in the levels of the studied MMP and TIMP-1, except for a significant increase in the concentrations of stromelysin (MMP-3) in the blood serum of boys compared with its level in girls and the control. With different severity of the course of UCFS in children, a significant increase in MMP concentrations associated with an increase in the severity of the injury was revealed, and a substantial decrease in the content of TIMP-1 in the blood of patients compared to its levels in children with 1–2 degrees of severity and control.

Conclusion

Conclusion. The established patterns indicate that the determination of the content of MMR and TIMP-1 in the blood in UCFS children allows monitoring the course of the reparative process after injury to the vertebral bodies in children.

Contribution

Contribution: Smirnov I.Е., Каraseva О.V., Кucherenko А.G. — concept and design of the study; Каraseva О.V., Pоrоkhina Е.А., Sarukhanyan О.О. — collection of material; Кucherenko А.G., Smirnov I.Е. — statistical processing; Smirnov I.Е. — writing of the text; Fisenko A.P., Mitish V.A. — editing. All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Informed consent

Informed consent: written voluntary informed consent to participate in the study was obtained from the parents of the patients.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare that there is no conflict of interest.

Received

Received: April 21, 2021Accepted: April 22, 2021Published: May 14, 2021

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The authors declare that there are no conflicts of interest present.