nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2023-27-1-61-68nefr-2197Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ (КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯ)ORIGINAL ARTICLES (CLINICAL STUDIES AND EXPERIMENTAL STUDIESВлияние блокатора α1а-адренорецептора на механизмы элиминации мелких конкрементов из средней трети мочеточникаInfluence of the α α1а-adrenoreceptor blocker on the mechanisms of limination of small stones from the middle third of the ureterhttps://orcid.org/0000-0002-8070-2242БариновЭ. Ф.BarinovE. F.

Эдуард Федорович Баринов, проф., д-р мед. наук, заведующий кафедрой

кафедра гистологии, цитологии и эмбриологии

83000

пр. Ильича, д. 16

ДНР

Донецк

Edward F. Barinov, Prof., MD, PhD, DMedSci, Head of the Department

Department of Histology, Cytology and Embryology

83000

Ilyich Ave., 16

DPR

Donetsk

barinov.ef@gmail.comhttps://orcid.org/0000-0002-8785-1662ГригорянХ. В.GrigoryanKh. V.

Хачен Владимирович Григорян, асс., канд. мед. наук

кафедра урологии

83000

пр. Ильича, д. 16

ДНР

Донецк

Khachen V. Grigoryan, Ass., MD, PhD

Department of Urology

83000

Ilyicha Ave., 16

DPR

Donetsk

khachengrigoryan@gmail.comhttps://orcid.org/0000-0002-7809-5260МалининЮ. Ю.MalininYu. Yu.

Юрий Юрьевич Малинин, канд. мед. наук, заведующий кафедрой

кафедра урологии

83000

пр. Ильича, д. 16

ДНР

Донецк

Yuriy Yu. Malinin, MD, PhD, Head of the Department

Department of Urology

83000

Ilyicha Ave., 16

DPR

Donetsk

jora2@list.ruДонецкий национальный медицинский университет им. М. ГорькогоРоссияDonetsk National Medical University named after M. GorkyRussian Federation2023070320232716168Copyright © Баринов Э.Ф., Григорян Х.В., Малинин Ю.Ю., 20232023Баринов Э.Ф., Григорян Х.В., Малинин Ю.Ю.Barinov E.F., Grigoryan K.V., Malinin Y.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/2197   ВВЕДЕНИЕ

   ВВЕДЕНИЕ. До настоящего времени механизмы элиминации мелких конкрементов при литокинетической терапии (ЛКТ) остаются не выясненными.

   ЦЕЛЬ ИССЛЕДОВАНИЯ – оценить активность рецепторов, контролирующих сокращение и релаксацию гладкомышечных клеток (ГМК) на фоне блокады α1А-адренорецептора в процессе ЛКТ у пациентов при локализации мелких конкрементов в средней трети мочеточника.

   ПАЦИЕНТЫ И МЕТОДЫ

   ПАЦИЕНТЫ И МЕТОДЫ. Исследование носило проспективный характер и включало 40 пациентов, которым проводили стандартную ЛКТ в связи с локализацией мелких конкрементов (≤ 6 мм) в средней трети мочеточника. Анализ функциональной активности рецепторов, модулирующих перистальтику мочеточника, выполнили in vitro на суспензии тромбоцитов. Использовали агонисты: АТФ, АДФ, аденозин, эпинефрин, ангиотензин-2 («Sigma-Aldrich Chemie GmbH», Германия) в концентрациях ЕС50 , вызывающих агрегацию на уровне 50 % у здоровых лиц. Оценку агрегации тромбоцитов проводили турбидиметрическим методом на анализаторе ChronoLog (USA).

   РЕЗУЛЬТАТЫ

   РЕЗУЛЬТАТЫ. Не выявлено различий частоты элиминации мелких конкрементов из средней трети мочеточника при наличии и отсутствии блокатора α1А-адренорецептора в составе ЛКТ. До начала ЛКТ обнаружена гиперреактивность α2-адренорецептора, нормореактивность пуриновых Р2Х 1 - и Р2Y-рецепторов, аденозинового А2-рецептора и ангиотензинового АТ 1 -рецептора. Через 9 дней ЛКТ при верифицированной элиминации конкрементов установлено повышение активности Р2Х 1 -рецептора и АТ 1 -рецептора (р < 0,001) независимо от назначения блокатора α1А -адренорецептора. Гиперреактивность Р2Y-рецептора проявлялась при наличии и нормореактивность при отсутствии блокатора α1А-адренорецептора в составе ЛКТ.

   ЗАКЛЮЧЕНИЕ

   ЗАКЛЮЧЕНИЕ. При литокинетической терапии, независимо от назначения блокатора α1А-адренорецептора, в траффике мелких конкрементов из средней трети мочеточника принимают участие компенсаторные механизмы, направленные на усиление сократительной активности и сохранение релаксации гладкомышечных клеток.

   BACKGROUND

   BACKGROUND. To date, the mechanisms of small stone elimination by lithokinetic therapy (LCT) have not been elucidated.   THE AIM of this investigation was to estimate the activity of receptors controlling the contraction and relaxation of smooth muscle cells (SMC) against the background of α1A-adrenoreceptor blockade during LCT in patients with small stones localization in the middle third of ureter.

   PATIENTS AND METHODS

   PATIENTS AND METHODS. The study was prospective and included 40 patients in whom standard LCT was done for localization of small concrements (≤6 mm) in the middle third of ureter. The functional activity of receptors modulating ureteric peristalsis was analyzed in vitro using platelet suspension. The agonists used were ATP, ADP, adenosine, epinephrine, angiotensin-2 (Sigma-Aldrich Chemie GmbH, Germany) at EC50 concentrations causing aggregation at 50 % in healthy subjects. Platelet aggregation was assessed by turbidimetric method on ChronoLog analyzer (USA).

   RESULTS

   RESULTS. No differences in the rate of small concrements elimination from the middle third of ureter was found in presence and absence of α1A-adrenoreceptor blocker in LCT. Before LCT, α2-adrenoreceptor hyperresponsiveness, normoreponsiveness of purine P2X1- and P2Y-receptors, adenosine A2-receptor and angiotensin AT1-receptor were found. After 9 days of LCT with verified elimination of concrements, an increase in P2X1-receptor and AT1-receptor activity (p < 0.001) was found regardless of the administration of α1A-adrenoceptor blocker. P2Y-receptor hyperresponsiveness was seen in the presence and normoreponsiveness in the absence of α1A-adrenoreceptor blocker in LCT.

   CONCLUSION

   CONCLUSION. At the lithokinetic therapy irrespective of α1A-adrenoreceptor blocker prescription, compensatory mechanisms, aimed at enhancement of contractile activity and preservation of smooth muscle cell relaxation take part in the traffics of small concrements from the middle third of ureter.

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The authors declare that there are no conflicts of interest present.