Dynamics of inflammatory response markers in comprehensive treatment of chronic salpingo-oophoritis

I n t r o d u c t i o n. Pelvic inflammatory diseases are often accompanied by the development of chronic pelvic pain, infertility and pregnancy complications, therefore they are an important medical and social problem. In the site of inflammation in chronic salpingo-oophoritis (CSO), microcirculation disorders and tissue hypoxia develop. The treatment modalities that improve blood circulation in tissues have a pathogenic basis. The use of magnetic field and laser therapy, which has an effect due to infrared laser radiation and a magnetic field, seems promising. Physiotherapeutic effects modulate the phases of the immune response during inflammation, which is reflected in the dynamics of immunogram indicators.

A i m. Based on the determination of the inflammatory response markers, to evaluate the effect of comprehensive treatment of CSO using physiotherapy.

M a t e r i a l s a n d m e t h o d s. The treatment results of 60 patients with the exacerbation of CSO were assessed based on the analysis of clinical, laboratory and immunological parameters. The patients were divided into 2 groups: group 1 (n = 30) included women who received pharmacologic treatment and physiotherapy; group 2 (n = 30) included patients who received pharmacologic treatment alone. The pharmacologic treatment included antimicrobial therapy with third-generation cephalosporins for 7 days, nonsteroidal anti-inflammatory and antiallergic agents. The treatment of patients in group 1 was supplemented by a course of 10 sessions of magnetic field and laser therapy. The levels of interleukin-1β and interleukin-4 were determined by enzyme immunoassay on the 1st and 8th days from the disease onset.

R e s u l t s. The comprehensive treatment of CSO with the use of magnetic field and laser therapy leads to the relief of the main clinical manifestations and a decrease in spontaneous levels of pro-inflammatory cytokines in a shorter time.

C o n c l u s i o n. The use of magnetic field and laser therapy in the treatment of the CSO exacerbation is accompanied by a favorable course of the inflammatory response.

1. Savaris R.F., Fuhrich D.G., Maissiat J. et al. Antibiotic therapy for pelvic inflammatory disease. Cochrane Database Syst. Rev. 2020;8(8):CD010285. DOI: 10.1002/14651858.CD010285.pub3.

2. Selikhova M.S., Soltys P.A. Modern accents in the diagnostics of inflammatory diseases of the pelvic organs. V.F. Snegirev Archives of Obstetrics and Gynecology, Russian Journal. 2020;1(7):37-42. DOI: 10.18821/2313-8726-2020-7-1-37-42. (In Russ.)

3. Shatunova E.P., Fedorina T.A. Lineva O.I., Kuznetsova L.V. Clinical and pathomorphological characteristics of patients with purulent inflammation of the uterine appendages. Obstetrics and Gynecology. 2021;(10):118-124. DOI 10.18565/aig.2021.10.118-124. (In Russ.)

4. Ravel J., Moreno I., Simón C. Bacterial vaginosis and its association with infertility, endometritis, and pelvic inflammatory disease. Am. J. Obstet. Gynecol. 2021;224(3):251-257. DOI: 10.1016/j.ajog.2020.10.019.

5. Belyakova I.A., Nikiforova O.Yu., Urazova O.I. et al. Dynamics of the cytokine profile in children and adolescents with tuberculosis of the intrathoracic lymph nodes in the course of field-modulated infrared therapy. Journal of Siberian Medical Sciences. 2018;4:4-12. DOI: 10.31549/2542-1174-2018-4-4-12.

6. Salov I.A., Arzhaeva I.A., Tyapkina D.A. Application of laser radiation in treatment of inflammatory diseases of the uterine appendages. Obstetrics, Gynecology and Reproduction. 2022:16(5):552-566. DOI: 10.17749/2313-7347/ob.gyn.rep.2022.323. (In Russ.)

7. Maltseva L.I., Sharipova R.I., Zhelezova M.E. Chronic endometritis – changing conventional thinking. Practical Medicine. 2018;16(6):99-105. (In Russ.)

8. Moreno I., Cicinelli E., Garcia-Grau I. et al. The diagnosis of chronic endometritis in infertile asymptomatic women: a comparative study of histology, microbial cultures, hysteroscopy, and molecular microbiology. Am. J. Obstet. Gynecol. 2018:218(6):602.E1-602.E16. DOI: 10.1016/j.ajog.2018.02.012.

9. Inflammatory diseases of female pelvic organs: Clinical guidelines. 2021. URL: https://cr.minzdrav.gov.ru/schema/643_1 (accessed 26.02.2024).

10. Mukim-Zoda T.M., Hojamurodova D.A. Inflammatory diseases of pelvic organs and longed use of intrauterine contraception (clinical case). Medical Alphabet. 2019;2(14):47-51. DOI: 10.33667/2078-5631-2019-2-14(389)-47-51. (In Russ.)

11. Curry A., Williams T., Penny M.L. Pelvic Inflammatory disease: diagnosis, management, and prevention. Am. Fam. Physician. 2019;100(6): 357-364.

12. Machairiotis N., Vasilakaki S., Thomakos N. Inflammatory mediators and pain in endometriosis: a systematic review. Biomedicines. 2021;9(1):54. DOI: 10.3390/biomedicines9010054.

13. Fan L., Liu Z., Zhang Z. et al. Identifying the clinical presentations, progression, and sequela of pelvic inflammatory disease through physiological, histological and ultrastructural evaluation of a rat animal model. Ann. Transl. Med. 2021;9(23):1710. DOI: 10.21037/atm-21-3345.

14. Ozolinya L.A., Ovsepyan N.R. Prevention of inflammatory complications after spontaneous miscarriage. Capabilities of modern methods of physiotherapy. Treatment and Prevention. 2018;8(2):48-55. (In Russ.)