[Activity of α2-adrenergic and PAF receptors of platelets as risk factor of acute pyelonephritis during urolithiasis in eldery women.].

The aim of the study is to identify possible mechanisms that could provoke a recurrence of chronic obstructive pyelonephritis (COP) in eldery women, thus to find out - why age and sex can be risk factors for acute pyelonephritis in urolithiasis. The results of 43 women over 65 years of age (mean age 71±1,5 years) are presented in study. The 26 patients were examined in remission phase of COP; 17 patients were examined in recurrence phase. For platelet stimulation epinephrine and platelet activating factor (PAF) were used at an effective concentration (EC50). The formation of platelet-leukocyte aggregates (PLA) was modeled in vitro by incubation of stimulated platelets (epinephrine and PAF) and intact leukocytes. The number of intact PLA was examined after blood smears staining according to Romanovsky-Giemsa method. In women older than 65 years realization of acute inflammation in urinary tract with urolithiasis occurs on the background of normal sensitivity of α2-adrenergic receptors and hyperreactivity of the PAF-receptors of platelets. In remission phase of COP the hyporeactivity of α2-adrenergic and PAF receptors of platelets was revealed but under interaction of epinephrine and PAF activation of platelets are possible which accompanied by formation of PLA. In women over 65 years hypoactivity of platelets in remission phase of COP can be a risk factor for the acute pyelonephritis development, since the simultaneous action of epinephrine and PAF increases the number of PLAs that recruit leukocytes for the realization of acute inflammatory reaction in urolithiasis.