THE STATE OF SYSTEMIC PRO-INFLAMMATORY IMMUNE FACTORS, AUTOIMMUNE REACTIONS TO NEUROANTIGENS, AND STRESS INDICATORS IN PATIENTS WITH FRONTOBASILAR INJURY IN THE IMMEDIATE PERIOD AFTER SURGICAL TREATMENT UTILIZING A BIOCOMPOSITE MATERIAL

Abstract

Background: Surgical treatment of frontal bone injuries (FBI) involving skull defects requires meticulous monitoring of systemic inflammation and immunological response to evaluate the efficacy of the biocomposite materials utilized.

Objective: To evaluate the dynamics of cortisol levels, pro-inflammatory cytokines (interleukin-1, interleukin-8, macrophage inflammatory protein-1 beta, and the intensity of autoimmune reactions to specific neuroantigens (myelin basic protein (MBP) and S100 protein) in the blood serum of patients with frontal bone injury at admission, on the 10^th day, and 1 month post-surgery, depending on whether a standard technique or the "Syntekistka" biocomposite material was utilized.

Materials and Methods: The study enrolled 30 patients aged 19-59 with frontal bone injuries (FBI). Depending on the surgical approach, the patients were divided into two clinical groups: Group 1 (n = 10) included patients treated via the conventional technique (removal of bone fragments followed by the application of cranioplastic materials); Group 2 (n = 10) comprised patients with FBI who underwent bone fragment repositioning combined with the application of the "Syntekistka" biocomposite material. The control group consisted of 10 practically healthy male individuals (blood donors). In all patients, cubital vein blood sampling was performed prior to treatment initiation to obtain serum for determining cortisol levels, pro-inflammatory cytokines, and the intensity of autoimmune reactions to specific neural tissue proteins.

Results: Serum cortisol levels in patients with frontal bone injuries (FBI) from both groups were found to exceed control values throughout the entire monitoring period (up to 1 month). No signs of pronounced allergic reactions to neural tissue alloantigens were detected during follow-up. The level of the pro-inflammatory chemokine interleukin-8 remained elevated compared to the control group for 1 month. The content of macrophage inflammatory protein-1 beta was elevated on the 10^th day of observation; however, subsequently, similarly to the interleukin-8 level, it approached the norm in patients of Group 2.

Discussion: The impact of frontal bone injury (FBI) on blood serum cortisol levels as a stressor factor was identical in both groups regarding both dynamics and the duration of the elevation period. The decline in cortisol levels by the end of the first month post-injury in both groups may reflect characteristic features of the traumatic disease course, independent of the selected treatment approach. Allergic reactions to neural tissue alloantigens (MBP and S100 protein) were poorly pronounced, indicating a low rate of autoimmunity in this type of FBI, which fully aligns with published scientific data. Fluctuations in the levels of various pro-inflammatory cytokines over the 1-month period demonstrated a more favorable clinical and laboratory dynamics in Group 2 patients, particularly within the chemokine pathway. This serves as indirect evidence of the transition from cellular inflammatory responses toward regenerative processes. The utilization of the "Syntekistka" biocomposite material demonstrates superior efficacy in the surgical management of frontal bone injuries compared to conventional techniques.