RELATIONS BETWEEN PRO-INFLAMMATORY CYTOKINES AND PROSTAGLANDINE E2 AT DIFFERENT HYPOTHALAMIC-PITUITARY-ADRENAL REACTIVITY IN PATIENTS WITH INCISIONAL ANTERIOR ABDOMINAL WALL HERNIAS
In order to study the relationship between the central and systemic mechanisms of reactivity of the hypothalamic-pituitary-adrenal axis, we analyzed the dynamics of the plasma level of cortisol, ACTH, pro-inﬂammatory cytokines and prostaglandin E2 in patients with incisional anterior abdominal wall hernias after allohernioplasty. Hyperreactive and hyporeactive variants of the response of the hypothalamic-adrenal gland were identi-ﬁ ed. The hyperreactive response of the HHNS to surgical trauma was manifested on the 1st day after the operation in the form of an imbalance in the increase in the content of ACTH and cortisol, which was accompanied by a decrease in the content of IL-1ᵦ and TNF-⍺ against the background of overproduction of PGE2. The hyporeactive response of the HHNS was manifested by a change in functional feedback on the 10th day after surgery and was associated with inhibition of IL-1ᵦ and ACTH production, despite a compensatory increase in blood TNF-⍺, and hypersecretion of PGE2, which suppresses IL-1ᵦ secretion to maintain cortisolemia.