INDICATORS OF CYTOKINE ACTIVITY AND BETA-ENDORPHIN PRODUCTION LEVEL IN ARTERIAL HYPERTENSION ASSOCIATED WITH ASTHENIC/NEUROTIC DISORDERS IN YOUNG MEN EMPLOYED IN STRESSFUL PROFESSIONS

At the present time, arterial hypertension is the most common somatic pathology among young and able-bodied persons. Development and progression of hypertension in young people occupied with stressful jobs presents a particular problem. Anxiety and depression arise quite commonly in such persons subjected to chronic stress. Direct pathophysiological effects of anxiety and depressive disorders upon cardiovascular system leads to development of disturbances of basic regulatory processes and life-threatening clinical forms of ischemic heart disease and hypertension. However, despite sufficient data about the impact of anxiety and depressive disorders on the course of cardiac pathology, some open questions remain concerning the degree of changes in neuropeptide-cytokine pool of immune system in young, intensively working hypertensive patients.
Moreover, there is lack of knowledge concerning interdependence in functioning of the major regulatory systems (autonomic nervous and immune) in such patients.
In this connection, the aim of this work was to study cytokines of the immune system, and the levels of betaendorphin production in hypertension, proceeding with astheno-neurotic disorders in young men of intensive specialties, as well as study of interactions between the indices of autonomic nervous system functioning, and immunity parameters in these patients. The following groups were under study: 1st (n = 34) included patients with hypertension and astheno-neurotic problems; 2nd (n = 20), patients with hypertension without psychological disorders, with acute or chronic stress in previous history (controls). Neuropeptide-cytokine profile of the immune system was evaluated by levels of proinflammatory cytokines (TNFα, IL-1β, IL-6), antiinflammatory cytokines (IL-4, IL-10), and β-endorphin.
In the course of clinical and laboratory examination, we have found that, in the patients with hypertension and astheno-neurotic disorders, activation of proinflammatory cytokines (TNFα, IL-1β, IL-6), suppression of anti-inflammatory cytokines (IL-4, IL-10), and reduced β-endorphin in the blood are registered. Moreover, the disturbances detected showed the mutual interactions between autonomic nervous and immune systems in these patients.

1. Белевитин А.Б., Никитин А.Э., Шамрей В.К., Курасов Е.С. Психические нарушения при гипертонической болезни у военнослужащих молодого возраста // Военно-медицинский журнал, 2010. № 4. С. 7-13. [Belevitin A.B., Nikitin A.E., Shamrei V.K., Kurasov E.S. Mental disorders in hypertension in young military personnel. Voenno-meditsinskiy zhurnal = Military Medical Journal, 2010, no. 4, pp. 7-13. (In Russ.)]

2. Давидович И.М., Афонасков О.В. Артериальная гипертензия у мужчин молодого возраста, офицеров сухопутных войск: психофизиологические особенности // Вестник Росздравнадзора, 2012. № 5. С. 53-57. [Davidovich I.M., Afonaskov O.V. Arterial hypertension in young men, army officers: psychophysiology aspects. Vestnik Roszdravnadzora = Journal Vestnik Roszdravnadzora, 2012, no. 5, pp. 53-57. (In Russ.)]

3. Довженко Т.В. Взаимосвязь аффективных и сердечно-сосудистых расстройств // Социальная и клиническая психиатрия, 2005. Т. 15, № 3. С. 69-80. [Dovzhenko T.V. The relationship of mood and cardiovascular disorders. Sotsialnaya i klinicheskaya psikhiatriya = Russian Society of Psychiatrists, 2005, Vol. 15, no. 3, pp. 69-90. (In Russ.)] 4. Васюк Ю.А., Довженко Т.В. Особенности патогенетической взаимосвязи депрессии и сердечно-со-

4. судистых заболеваний // Психические расстройства в общей медицине, 2007. Т. 2, № 1. С. 1-11. [Vasyuk Yu.A., Dovzhenko T.V. Features pathogenetic relationship of depression and cardiovascular diseases. Psikhicheskie rasstroystva v obshchey meditsine = Mental Disorders in General Medicine, 2007, Vol. 2, no. 1, pp. 1-11. (In Russ.)]

5. Гейн С.В., Баева Т.А. Роль опиоидных пептидов в регуляции пролиферации лимфоцитов и изменении Тh1/Тh2 цитокинового профиля // Проблемы эндокринологии, 2005. Т. 51, № 5. С. 49-51. [Gein S.V., Baeva T.A. Role of opioid peptides in the regulation of lymphocyte proliferation and the change of Th1/Th2 cytokine profile. Problemy endokrinologii = Problems of Endocrinology, 2005, Vol. 51, no. 5, pp. 49-51. (In Russ.)]

6. Гейн С.В., Баева Т.А. Эндогенные опиоидные пептиды в регуляции функций клеток врожденного иммунитета обзор // Биохимия, 2006. Т. 76, № 3. С. 379-390. [Gein S.V., Baeva T.A. Endogenous opioid peptides in the regulation of functions of innate immunity cells overview. Biokhimiya = Biochemistry, 2006, Vol. 76, no. 3, pp. 379-390. (In Russ.)]

7. Гейн С.В., Горшкова К.Г., Тендрякова С.П. Роль бета-эндорфина в регуляции продукции провоспалительных цитокинов моноцитами периферической крови in vitro // Бюллетень экспериментальной биологии и медицины, 2007. № 2. С. 175-178. [Gein S.V., Gorshkov K.G., Tendryakova S.P. The role of beta-endorphin in the regulation of the production of proinflammatory cytokines by monocytes in vitro peripheral blood. Byulleten eksperimentalnoy biologii i meditsiny = Bulletin of Experimental Biology and Medicine, 2007, no. 2, pp. 175-178. (In Russ.)]

8. Гейн С.В., Шаравьева И.Л., Тендрякова С.П. Роль δ-опиатных рецепторов в регуляции гуморального клеточно-опосредованного иммунного ответа при ротационном стрессе // Доклады академии наук, 2006. Т. 407, № 1. С. 127-129. [Gein S.V., Sharaveva I.L., Tendryakova S.P. The role of delta-opioid receptors in the regulation of cell-mediated humoral immune response in a rotary stress. Doklady akademii nauk = Proceedings of the Academy of Sciences, 2006, Vol. 407, no. 1, pp. 127-129. (In Russ.)]

9. Лишманов Ю.Б., Маслов Л.Н. Опиоидные нейропептиды, стресс и адаптационная защита сердца. Томск: Издательство Томского университета, 1994. 352 с. [Lishmanov Yu.B., Maslov L.N. Opioid neuropeptides, stress and adaptation of heart protection]. Tomsk: Publishing House of Tomsk State University, 1994. 352 p.

10. Горшкова К.Г., Гейн С.В., Тендрякова С.П. Роль бета-эндорфина в регуляции продукции IL-1β и IL-8 моноцитами и нейтрофилами периферической крови // Вестник yральской медицинской академической науки, 2006. Т. 14, № 3. С. 46-47. [Gorshkov K.G., Gein S.V., Tendryakova S.P. The role of beta-endorphin production in the regulation of IL-1β and IL-8 by monocytes and neutrophils peripheral blood. Vestnik yralskoy meditsinskoy akademicheskoy nauki = Journal of Ural Medical Academic Science, 2006, Vol. 14, no. 3, pp. 46-47. (In Russ.)]

11. Парцерняк С.А. Интегративня медицина: путь от идеологии к методологии здравоохранения. – СПб.: Нордмедиздат, 2007. 424 с. [Parcernyak S.A. Integrative Medicine: the path from ideology to the methodology of Health]. St. Petersburg: Nordmedizdat, 2007. 424 p.

12. Симоненко В.Б., Фисун А.Я., Овчинников Ю.В., Александров А.С. Артериальная гипертония при экстремальных ситуациях // Клиническая медицина, 2007. Т. 85, № 10. С. 4-10. [Simonenko V.B., Fisun A.Ya. Ovchinnikov Yu.V., Alexandrov A.S. Hypertension in extreme situations. Klinicheskaya meditsina = Clinical Medicine (Russian Journal), 2007, Vol. 85, no. 10, pp. 4-10. (In Russ.)]

13. Смулевич А.Б. Психокардиология. М.: Медицинское информационное агентство, 2005. 780 с. [Smulevich A.B. Psihokardiology]. Moscow: Medical News Agency, 2005. 780 p.

14. Черешнев В.А., Гейн С.В. β-эндорфин – эндогенный регулятор иммунных процессов // Российский физиологический журнал им. Сеченова, 2009. Т. 95, № 12. С. 1279-1290. [Chereshnev V.A., Gein S.V. β-endorphin – an endogenous regulator of immune processes. Rossiyskiy fiziologicheskiy zhurnal im. Sechenova = Russian Journal of Physiology, 2009, Vol. 95, no. 12, pp. 1279-1290. (In Russ.)]

15. Шпагина Л.А., Ермакова М.А., Волкова Е.А., Яковлева С.А. Клинико-функциональная и биохимическая характеристика артериальной гипертензии у военнослужащих в условиях хронического стресса // Медицина труда и промышленная экология, 2008. № 7. С. 24-29. [Shpagin L.A. Ermakova M.A., Volkova E.A., Yakovleva S.A. Clinical and functional and biochemical characteristics of hypertension in the military in conditions of chronic stress. Meditsina truda i promyshlennaya ekologiya = Occupational Medicine and Industrial Ecology, 2008, no. 7, pp. 24-29. (In Russ.)]