lactoferrin and Soft-Tissue-Infections

Treatment results of 276 patients with generalized soft tissue infections are analyzed. Patients were divided in three comparable groups. Clinical effect (oligopeptide and lactoferrin blood concentrations) of intravenous delivered antibiotics and crystalloid solutions with nonsteroid anti-inflammatory drugs (NSAID) was compared with infusions of pent oxyfillin with glucose-potassium solution. Intravenous infusion of 10-12 ml/kg/day crystalloids and glucose-potassium solution showed better detoxication effect then 3-4 ml/kg/day saline with antibiotics combination. The use of pentoxyfillin demonstrated better anti-inflammatory effect then NSAID. Direct correlation between oligopeptide (r=0,89, p<0,05) and lactoferrin (r=0,93, p<0,05) concentrations and time of the systemic inflammatory reaction syndrome reduction was observed, which allowed the use of these substances in treatment efficacy monitoring.

Topics: Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Crystalloid Solutions; Cytokines; Drug Therapy, Combination; Follow-Up Studies; Free Radical Scavengers; Glucose; Humans; Infusions, Intravenous; Isotonic Solutions; Lactoferrin; Oligopeptides; Pentoxifylline; Potassium; Rehydration Solutions; Retrospective Studies; Soft Tissue Infections; Treatment Outcome

Dynamic measurements of blood TNF-a, IL-IRA, CRP, oligopeptide, and lactoferrin levels in patients with systemic and local soft tissue infections revealed direct correlation between them which allowed to use these indicators for the diagnosis of systemic infections. Results of clinical and laboratory analyses provided a basis for distinguishing short-term systemic inflammatory response syndrome and sepsis and developing relevant diagnostic criteria. Sepsis combined with systemic inflammatory response syndrome persisting for more than 72 hours after the onset of adequate therapy was characterized by CRP levels > 30 mg/l, oligopeptides > 0.34 U, lactoferrin > 1900 ng/ml, TNF-a > 6 pg/ml, ILL-IRA < 1500 pg/ml Patients with systemic inflammatory response syndrome for less than 72 hours had lower TNF-a, CRP, oligopeptide, and lactoferrin levels with IL-IRA > 1500 pg/ml. This new approach to early diagnosis of systemic infections makes it possible to optimize their treatment and thereby enhance its efficiency.

Topics: Biomarkers; C-Reactive Protein; Clinical Laboratory Techniques; Humans; Interleukin 1 Receptor Antagonist Protein; Lactoferrin; Oligopeptides; Soft Tissue Infections; Systemic Inflammatory Response Syndrome; Tumor Necrosis Factor-alpha

Plasma lactoferrin dynamics was investigated in 120 of the 2250 patients with local and generalized soft tissue infections. Systemic symptoms were observed in 15% of the patients with soft tissue infections, syndrome of systemic inflammatory response in 13%, and sepsis in 42%. In 89% of the patients with systemic inflammatory reactions the blood lactoferrin level was 1.1-1.3 times the normal one within 72 hours after the onset of therapy; it dropped to the normal value in 12-15 days. Normalization of blood lactoferrin in patients with mild and moderate systemic inflammatory reactions roughly coincided with the disappearance of symptoms of generalized infection. It occurred 5-6 days after the septic process was resolved in patients with severe inflammatory reactions. Normal blood lactoferrin levels were characteristic of a mild inflammatory reaction and local forms of infection. A rise in blood lactoferrin above 1400 ng/ml combined with the syndrome of systemic inflammatory reaction over 72 hr in duration was regarded as a diagnostic criterion of sepsis. It is suggested that monitoring blood lactoferrin during treatment of systemic inflammatory reactions and sepsis be used for the choice of therapeutic strategy and the assessment of efficiency of its efficiency.

Topics: Biomarkers; Diagnosis, Differential; Follow-Up Studies; Humans; Immunoenzyme Techniques; Lactoferrin; Necrosis; Prospective Studies; Sepsis; Soft Tissue Infections