Clinical features and immune status in patients with erysipelas

Abstract

The aim is to study the state of research on clinical, epidemiological and immunological features of erysipelas, to determine the directions for solving the problem of preventing relapses of the disease. Materials and methods – meta-analysis of databases with scientific publications (Pubmed / Medline, Scopus, Ebsco, Index Copernicus) was carried out, and a bibliographic and semantic research method was used. Erysipelas is an infectious and allergic disease caused by beta-hemolytic Streptococcus with the development of erythematous, bullous or hemorrhagic inflammation and is an urgent issue today. A significant role in its development is played by provoking factors and belonging of the patient to the risk group: diabetes mellitus, lymph and circulatory disorders, inactivity, bad habits and mycoses. Recently, there has been an increase in the number of clinical cases that are accompanied by a severe course and complications (the predominance of intoxication syndrome, the occurrence of hemorrhagic forms, a tendency to relapse), which in turn lead to disability of working-age patients and an increase in mortality among the elderly. Intoxication syndrome develops due to an increase in the level of endogenous toxins. Medium-molecular peptides are considered a universal marker of endogenous intoxication, the level of which reflects the degree of protein catabolism and correlates with the main clinical and prognostic criteria for metabolic disorders. Accordingly, excessive intensity of lipid peroxidation of biological membranes may be the result of increased activity of the pro-oxidant system or antioxidant insufficiency, as well as a combination of these factors. The role of ceruloplasmin as the main blood antioxidant that binds superoxide radicals and prevents lipid peroxidation of cell membranes was studied. The relationship of disorders of the balance of free radical oxidation, the antioxidant defense system and endotoxicosis with each other in the pathogenesis of erysipelas requires further study. The importance of lactoferrin in the development of an inflammatory response to bacterial agents was studied. It is a biologically active protein that plays an important role as a pro-inflammatory factor, but there are no data on its association with the development of relapses in erysipelas, which requires further research. Thus, despite the well-studied pathogenesis of erysipelas, the issue of preventing relapses remains relevant and unresolved, the search for a “universal” marker of intoxication did not give the desired results. There is no exhaustive information about lactoferrin and ceruloplasmin, the dependence of changes in the level of these blood enzymes as anti-inflammatory factors, with the development of relapses of erysipelas, the period of the disease, the frequency of the course, the presence of an unfavorable premorbid background and complications.