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NEUROLOGY

INVENTION
Patent of the Russian Federation RU2286154

A METHOD FOR TREATMENT OF INFLAMMATORY DISEASES OF THE BRAIN

A METHOD FOR TREATMENT OF INFLAMMATORY DISEASES OF THE BRAIN

The name of the inventor: Shatrov Vladimir Alekseevich (RU); Stanislav Mozhaev (RU); Ostrejko Oleg Vikentievich (RU)
The name of the patent holder: Shatrov Vladimir Alekseevich (RU); Stanislav Mozhaev (RU); Ostrejko Oleg Vikentievich (RU)
Address for correspondence: 195253, St. Petersburg, Prospect Energetikov, 38, ap. 49, V.A. Shatrov
Date of commencement of the patent: 2005.02.17

The invention relates to medicine, namely to neurology and neurosurgery, and can be used to treat inflammatory diseases of the brain and its membranes caused by infectious agents. To do this, plasma leukocytapheresis is carried out from at least 1000 ml of the patient's blood with a 2-step sequential centrifugation at 800 rpm for 10 minutes and 2000 rpm for 10 minutes, autolyukocytes are obtained, antimicrobial preparation is added to them. They are irradiated with a helium-neon laser with a power of 2.2 mW, a wavelength of 0.63 μm with an exposure of 10 minutes, and intravenously injected auto-leukocytes with antimicrobial adsorbed on them every day for 7 days. The use of these parameters of laser irradiation allows preserving the antimicrobial properties of the drug with increasing its adsorption on autoleukocytes, strengthening the membrane of leukocytes, protecting it from the damaging effect of the antimicrobial drug.

DESCRIPTION OF THE INVENTION

The invention relates to medicine, namely to neurology and neurosurgery, and can be used in the treatment of inflammatory diseases of the brain and its membranes, caused by various pathogens.

A method for the treatment of inflammatory diseases of the brain by endolumbal administration of antimicrobial medications is known, for example endolumbal administration of a chain, oleandomycin, olemorphocycline (Gusev EI, Konovalov AN, Burd GS Neurology and Neurosurgery .- M .: Medicine, 2000.-P.317).

Disadvantages of the method: the need for lumbar punctures, the possibility of traumatizing the spinal roots with a puncture needle with the appearance of a violation of their function (numbness of the skin in the corresponding dermatome, a decrease in strength in the big toe, a decrease or fall of the knee, achillovye reflexes, the appearance of paresthesia in the corresponding traumatized spine dermatome (L4 , L5, S1)), the possibility of toxic damage to the lumbar and sacral roots by the antimicrobial drug administered.

Known is a method for treating inflammatory diseases of the brain by administering drugs in the common carotid artery through the superficial temporal artery (Mozhaev SV Treatment of the neuritic form of optohiasmal arachnoiditis by the method of long-term intraocarotide infusion of medications // author's diss .. candidate of medical sciences - L ., 1978, p.25). A cut of the skin is made in the temporal region, a superficial temporal artery is excised, its wall is cut, a polyvinylchloride catheter is inserted, the cannula is connected to the infusion system for a continuous (10-20 days) administration of antibacterial drugs.

Disadvantages of the method: the relative duration of treatment; The need to find a patient on bed rest during the entire infusion period; The possibility of hypocoagulation or other undesirable reactions to endoarterial administration of drugs.

The closest method of the same purpose to the claimed invention for a combination of features is a method for treating inflammatory diseases of the brain by parenterally administering antimicrobial drugs at therapeutic doses to the causative agent of the disease: in purulent inflammatory processes, cephalosporins, semisynthetic penicillins, aminoglycosides; When fungal - antimycotic antibiotics; Viral - zovirax (Diseases of the nervous system, Ed., Yakhno NN, Shtulman DR - M .: Medicine, 2001, T.1, C.315-318, 321, 325, 327-329, 357), which we accepted as a prototype.

However, the prototype is not effective enough, because:

- Only 5% of the antibiotic is adsorbed on the surface of neutrophils and is targeted to the inflammatory focus;

- up to 50% of the antimicrobial drug introduced binds to blood proteins and is inactivated (Russian Register of Medicines., Encyclopaedia of Medicines // M: RLS, 2003, issue 10, p.938, 940);

- up to 30% of the antimicrobial drug administered is excreted from the body in unchanged form (Russian Medicinal Register, Encyclopaedic Dermatology // M .: RLS, 2003, Issue 10, P.655; Instruction (information for a specialist) on the medical use of cefabol Dated 11.10.2001, approved by the Pharmacological Committee of the Ministry of Health of Russia);

- In addition, there is often a need for multiple intramuscular injections (up to 7-8 times a day with purulent meningitis), which can lead to an abscess at the injection sites.

The invention is directed to the development of a method for treating inflammatory diseases of the brain, which improves the effectiveness of treatment by achieving a high concentration of the drug in the inflammatory focus as a result of intravenous administration of an antimicrobial drug adsorbed on neutrophils.

Said technical result in the practice of the invention is achieved in that in a known method of treating inflammatory brain diseases by administering an antimicrobial drug, the feature is that the antimicrobial preparation is adsorbed on autoleukocytes obtained by plasma leukocytapheresis, irradiated with a helium-neon laser, and administered intravenously. The peculiarity of the delivery of the antimicrobial drug determines the possibility of its targeted delivery to the focus of inflammation through the use of the effect of chemotaxis.

The use of plasma leukocytapheresis allows the adsorption of the antimicrobial drug to 20% of neutrophils circulating in the blood, isolated from the collection of 2 doses of blood (1000 ml), which is 20% of the total blood. In the inflammatory process, neutrophils under the influence of chemotaxis, caused by complement molecules, exit the venules and, while moving to the focus of inflammation, the antimicrobial drug is targeted. This method allows you to create a high dose of an antimicrobial drug in the focus of inflammation, where the pathogen is located.

The therapeutic plasma leukacitapheresis with antimicrobial therapy makes it possible to create an effective concentration of the drug in the inflammatory focus and achieve a rapid clinical effect. In addition, the intravenous route of administration of the antimicrobial drug prevents the occurrence of post-injection abscesses.

The method is carried out as follows. Blood is taken from the peripheral vein of the patient in a volume of 2 doses (1000 ml) and at once intravenously drip crystal solutions in the volume of 400 ml are introduced as plasma substituting agents. On a refrigerated centrifuge, serial blood centrifugation at 800 rpm for 10 minutes and 2000 rpm for 10 minutes divides patient's blood into plasma containing toxins resulting from the transferred infectious process, erythrocytic mass and leukocyte layer. The plasma is removed. The allocated red blood cells are returned to the patient intravenously drip. The leukocytes of the patient after the addition of an antimicrobial drug (the choice of which depends on the etiology of the pathogen of inflammation) in a daily dosage, are irradiated with light of a helium-neon laser with a power of 2.2 mW, a wavelength of 0.63 μm, with an exposure of 10 minutes, and injected intravenously with the patient. The procedures are repeated daily, once a day. The number of procedures depends on the clinical effect, but not more than 7 per course.

The claimed method of treating inflammatory diseases of the brain was clinically tested in the treatment of 2 patients with postoperative meningitis, and 1 patient with exacerbation of herpetic infection.

Here is an example of an extract from the medical history No. 215-04. Patient K., 53 years old, diagnosis: neurinoma of the right VIII craniocerebral nerve. Condition after operation of decompressive trepanation of the posterior cranial fossa, tumor removal. Postoperative meningitis, manifested clinically headaches, general weakness, moderate meningeal symptoms, fever to 38 ° C. The examination revealed inflammatory changes in the cerebrospinal fluid in the form of an increased content of neutrophils (total cytosis 2708/3, of which segment neutrophils 75%, lymphocytes 25%). According to the claimed method, 5 procedures of therapeutic plasm-leukocytapheresis with cefatoxime at a dose of 2.0 g per procedure were performed. During each procedure, 1000 ml of blood was withdrawn from the peripheral vein. With the help of sequential centrifugation, the blood was separated into plasma, red blood cells and leukocytes. During the centrifugation, 200 ml of a 0.9% solution of sodium chloride and 200 ml of haemodesis were dripped intravenously intravenously, after which the erythrocytes and adsorbed on autoleukocytes cefotaxime were injected. The use of this method allowed obtaining a positive clinical effect for 5 days in the form of normalization of the CSF composition, regression of inflammatory changes in the blood test, normalization of body temperature and well-being of the patient. The next day after 5 leukocytapheresis procedures, the number of cells in the cerebrospinal fluid was 636/3, while the proportion of segmented neutrophils decreased to 58%, and the lymphocyte count was 42%, respectively.

CLAIM

A method for treating inflammatory diseases of the brain and its membranes caused by infectious agents by administering an antimicrobial drug characterized in that plasma leukocytapheresis is carried out from at least 1000 ml of the patient's blood in a 2-stage sequential centrifugation at 800 rpm for 10 Min and 2000 rpm for 10 minutes, autoleukocytes are obtained, an antimicrobial preparation is added, they are irradiated with a helium-neon laser with a power of 2.2 mW, a wavelength of 0.63 μm with an exposure of 10 minutes, and intravenously injected autoleukocytes with adsorbed onto them Antimicrobial drug daily once a day for 7 days.

print version
Date of publication 06.01.2007gg