PREDICTING THE EFFECTIVENESS OF THE TREATMENT IN PATIENTS OF GASTROENTEROLOGICAL PROFILE WITH CANDIDOSIS OF THE MUCOSA OF THE UPPER PART OF THE DIGESTIVE TRACT

Considering the importance of indices changes of cytokine status for immune response regulation during macroorganism interaction from Candida albicans, the aim of our study was to investigate the possibility of predicting the results of treatment of candidiasis mucosa of the upper part of the digestive tract based on cytokines level.

Materials and methods. It was determined the level of cytokines of IL-1b, IL-4, IL-6, IL-8 and tumor necrosis factor (TNF-α) before and after treatment in 29 patients with із oropharyngeal and superficial candidiasis of the mucosa of esophagus and stomach and in 26 patients with invasive growth of Candida albicans.

Results. It was shown the level of IL-4 decrease, and the level of IL-8 was increased in both groups before therapy. Dynamics of IL-6 and TNF-α defined different changes in both groups. The use of the model of logistic regression demonstrated, that the level of IL-4 in patients of both groups gives an opportunity to prognosis 66.64% of satisfactory and 70,00% of negative response on treatment [OR 4.08], (χ2=6.66, р=0.036). The level of IL-4 in patients with oropharyngeal and superficial candidiasis predicts the result of therapy with such efficacy as 72.73% [OR 7.5], (χ2=5.45, р=0.065). For patients of this group the level of TNF-α gives an opportunity to prognosis 100,00 % of negative results of treatment and 40.00% of satisfactory ones (χ2=5.61, р=0.060), and dynamics of the level of IL-8 defines the positive result in 999 cases from 1000 (χ2=13.64, р=0.001). Changes of cytokine balance in patients with fungi invasion didn’t have significant level for prognosis.

Conclusions. Changes of cytokine’s level which depend on the depth of the damage of the mucosa define the role of cytokine balance in the formation of disease degree. In patients with candidiasis of the mucosa the level of TNF-α and the level of IL-4 in general, and in patients with oropharyngeal and superficial candidiasis of IL-8, IL-4 and TNF-α in dynamics of treatment allow predicting therapy effectiveness.