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Aim: To investigate the features of allelic polymorphism, of several immune- and hemostasis-related genes in children with generalized, meningococcal infections and. to assess the usefulness of genotyping for prediction, of severe disseminated intravascular coagulation (DIC) and. multiple organ dysfunction, syndrome in these patients.Materials and methods: we studied. 20 children aged, from 8 months up to 17 years with generalized, meningococcal infections who developed DIC or/and multiple organ dysfunction syndrome. The control group consisted, of 200 blood, donors. Genomic DNA was isolated, from peripheral blood, leucocytes. Allelic variants of genes coding for plasma hemostatic factors (FI-A, FI-B, FXIII-A, PAI-1, ТРА) or pro-inflammatory cytokines (IL-6, IL-1B, TNF-A) were detected by PCR and. subsequent restriction, analysis. Allele and. genotype frequencies were calculated, by direct counting, and. their differences between the groups were assessed, by Fisher's exact test. For statistical analysis, the GraphPad. Prism, ver.4.0 software was used.Results: in the group of children with generalized, meningococcal infections, the frequency of heterozygotes for the IL-6 -174 G/C polymorphism, was 1.5-fold higher than in the controls (75.0% vs. 50.0%, respectively, OR=3.0; 95% CI: 1.1-8.6; p=0.037). Genotype TPA Del/Del was detected 4-fold more frequently in children who developed multiple organ dysfunction syndrome than in those with the more favorable disease course (45.4% vs. 11.1%, respectively, OR=6.7; 95% CI: 0.6-73.1; p=0.16). Moreover, among the patients having multiple organ dysfunction, syndrome, we observed, more frequently individuals who possessed, at least 2 unfavorable genetic variants (p=0.022).Conclusion: Simultaneous assessment of nucleotide variations in 8 studied genes could help to define the group of children with high, risk of multiple organ dysfunction, syn-drome.Genotype TPA Del/Del, associated, with decreased, production, of this factor, might serve as a marker of unfavorable DIC course and possible predictor of multiple organ dysfunction. syndrome in children with generalized, meningpcoc-cal infections.

Generally recognized factor, which complicates the course of sepsis, is the development of hypercoagulation syndrome. The increase of thrombin coagulation indicates on the elevation of risk of thrombus formation in microcirculation vessels, which could cause the formation of multiple organ failure. The thrombin generation assay is a new method of the evaluation of homeostasis system status. The test reflects the fermentation activity of thrombin and shows the functional condition, which arises in the interaction of procoagulant and anticoagulant. The diagnosis of generalized peritonitis had 30 patients (18 men and 12 women, aged 61±18,3 years) and they were included in the research. It was shown, that the use of thrombin generation assay in patients with the abdominal sepsis could give the well-timed analysis of hypercoagulation changes and the assessment of protein C system investment in the thrombin generation.

This study is aimed at exploring the use of thrombin generation assay (TGA) in platelet-poor plasma to assess the contribution of the protein C system to the hypercoagulation development in patients with coronary heart disease (CHD) after intracoronary stenting. The study material, the venous blood, was taken in 63 patients with CHD at the age of 53 to 77 before and on Day 1 after the planned percutaneous coronary intervention (PCI) who were treated with antiplatelet agents and antithrombotic agents in standard doses, and in 35 subjects of comparable age and sex without clinical manifestations of CHD who were not treated with these drugs for any other purpose. Laboratory examination included the standard coagulologic tests. To assess the effects of activated protein C system, the TGA in platelet poor plasma was modified by adding human recombinant trombomodulin (rh-TM) to the reaction mixture. The standard coagulologic tests revealed changes in hemostasis relevant to the pathogenesis of CHD and the effects of antithrombotic agents. The TGA results showed an increase in ETP and Peak Thrombin in patients with CHD after PCI with respect to the control and initial values which is evidence of the increased coagulation after the intervention. The test results also showed a reduction of TGA values per cent decline when adding TM. The ETR, Peak thrombin and ttPeak per cent decline was the most significant under the influence of TM which was evidence of the contribution of protein C activity reduction to the development of hypercoagulation after PCI. The modified TGA in platelet-poor plasma used in this study can be applied in clinical practice for estimating the plasma-coagulation hemostasis status and reduction in sensitivity to TM, which characterizes the protein C system activity by degree of decrease in results of the test that was performed in plasma without and with the addition of rh-TM.

Taking into account interrelations between inflammation and hemostasis, as well as immediate effects of IL-1β, IL-6 and TNFα upon blood coagulation system, one may suggest that their functional variantscould determine thrombosis risks both in arterial and venous circulation. The aim of this study was to assess possible role of allelic IL-1β, IL-6 and TNFα variants in pathogenesis of venous thromboembolism (VTE)in young patients. A retrospective analysis was performed for a group of 180 patients with early-onset VTE, and 150 healthy. In a sub-group with deep-vein thrombosis of lower extremities (DWTLE) complicated bypulmonary artery thromboembolia (PAT), we have revealed increased frequencies of IL-6 –174C homozygotes (30.8% vs 13.0%, p = 0.02) and IL-1β –31Т (61.5% vs 40.9%, p = 0.03), when compared with a subgroup of DWTLE. Among patients with “isolated” PAT a tendency for increased IL-1β –31ТТ ratio was found, as compared with DWTLE (53.8% vs 40.9%, р = 0,3), like as with control group (53.8% vs 40.7%, р = 0,3), These differences, however, were statistically insignificant. These data may suggest certain effects of IL-1β and IL-6 gene polymorphisms upon clinical characteristics of venous thromboembolism, rather than upon general VTE risk among young persons.

The article presents an assessment of anticoagulant effect of rivaroxaban in 35 patients with thromboembolic diseases. The results of expressed anticoagulant effect of rivaroxaban were obtained during a day (or more). The data of increase in sensitivity to thrombomodulin indicated about work enchancement of protein C system against the background of rivaroxaban therapy.