[Multifactorial evaluation of endogenous intoxication in patients with chronic viral hepatitis C].

The integral laboratory indices of endogenous intoxication (EI) (effective albumin concentration (EAC) and albumin binding reserve (ABR)) were studied in 104 patients with chronic hepatitis C (CHC) in the context of data on the current manifestations of the disease and the pattern of and association between different types of somatic pathology and toxic exposures. The patients with CHC were found to have significant changes in EI indices as compared with the control group wherein the indices were steady-state during conventional pathogenetic therapy. There was no clear correlation between the clinical symptoms of intoxication and EAC and ABR. More considerable changes were ascertained in CHC patients with degenerative diseases, biliary system diseases, and chronic constipation and in those with the signs of negative changes in the body's responsiveness.

[Serum albumin binding capacity values in the clinical evaluation of endogenous intoxication in acute viral hepatitis].

The fluorescence technique was used to determine the effective albumin concentration (EAC) and albumin binding reserve (ABR) in 130 patients with acute viral hepatitis A and B in order to establish their values in the evaluation of endogenous intoxication (EI). The most considerable EAC and ABR reduction was found in patients with previous comorbidity and with negative responsiveness changes underlying a high baseline EI level. Despite the resolution of the clinical symptoms of intoxication, the long existence of EAC and ABR changes in the course of the disease in these patients is associated with the tension of the body's key systems in impaired somatic regulation and determines the increased consumption of defense reserves and their rapid exhaustion. Thus, the informative value of the study biochemical parameters of EI increased within the multifactor system of its clinical evaluation.

[The body's responsiveness and the efficiency of antihomotoxic therapy for chronic opisthorchiasis: 2. Therapy].

The authors propose a new treatment policy for opisthorchiasis, which is intended for the body's self-regulation and based on the use of antihomotoxic therapy. Forty patients with the verified diagnosis of chronic opisthorchiasis were examined. Antihomotoxic therapy was found to have high clinical (85%) and parasitological (75%) effects, The application of an aggregate clinical estimate showed a positive role of episodes of development of acute inflammatory reactions, fever, and reversion of prior diseases, which favors the restoration of the body's responsiveness and the particular efficiency of the therapy performed. The results of helminthoovoscopy are interpreted in the context of clinical data. There was a significant increase in the count of HLA DR monocytes and in the level of IgA and a reduction in IgE and IL-4 with a substantial rise in the cellular production of other cytokines.

[The body's responsiveness and the efficiency of antihomotoxic therapy for chronic opisthorchiasis: an aggregate clinical estimate].

The authors have proposed an extended clinical evaluation system that calls for a study of the mechanisms of development and relationships of any symptoms and diseases, including those unrelated to opisthorchiasis. Forty patients who had been diagnosed as having chronic opisthorchiasis and had a long history were examined. There was a drastic reduction in the body's susceptibility to acute inflammations during progressive chronic degenerative diseases just at the age of 17-30 years, which is indicative of systemic responsiveness abnormalities. The practical application of the proposed aggregate clinical estimate system makes it possible to apply a holistic approach to analyzing the patients' health status, to substantially upgrade the quality of clinical diagnosis, and extend the capabilities of a differential approach to evaluating the severity of disease and planning therapy.

[Systemic responsiveness and the efficiency of antihomotoxic therapy for chronic opisthorchiasis. 3. Responsiveness].

The authors consider systematic responsiveness in chronic opisthorchiasis and a relationship between acute inflammation and responsiveness. A number of regularities that take place in the patho- and sanogenesis of chronic disease in general and that are important in the evaluation of the severity and prognosis of the disease and the efficiency of therapy are demonstrated on a model of severe opisthorchiasis. The reversion syndrome indicative of recovered responsiveness during therapy is described in detail. Differences in the interpretation of the helminthoovoscopic findings are shown in the context of the priority of clinical data.

[Specific features of the course of pulmonary tuberculosis concurrent with liver pathology]. / Osobennosti techeniia tuberkuleza legkikh u bol'nykh s patologiei pecheni.

The study was undertaken to reveal clinical, biochemical, morphological, and immunological features of pulmonary tuberculosis concurrent with liver pathology. Patients with pulmonary tuberculosis who suffered from liver diseases were found to have more marked clinical signs, such as subfebrile temperature, weight loss, elevated levels of aminotransferases and gamma-glutamyltransferase. Morphological studies of liver biopsy specimens indicated that the rates of necrosis and inflammatory infiltration were higher in patients with chronic hepatitis C (CHC) and chronic hepatitis B (CHB) and CHC and substantially lower in CHB and alcoholism. Impaired immunity involved primarily the phagocytic link.

[Experience of biologically active supplements to food containing indoles and isothiocyanates in patients with chronic viral hepatitis]. / Opyt ispol'zovaniia BAD k pishche, soderzhashchei indoly i izotiotsionaty, u bol'nykh khronicheskim virusnym gepatitom.

We have studied the effect of dietary supplement "ExPress" on clinical and biochemical parameters and on the activity of detoxification enzymes of liver in patients with chronic viral hepatitis B and C. 24 patients (19 females and 5 males aged 16-39 years) were enrolled in the study. Patients in case group received dietary supplement "ExPress" in addition to basic treatment. Average indices of total bilirubin in cases after treatment were 26.98 +/- 2.85 mmol/l, while in controls--34.31 +/- 5.72 mmol/l (p > 0.05). Average indices of alanin-aminotransferase and aspartate-aminotransferase were 78.75 +/- 11.25 and 160.75 +/- 23.67 units while in controls--208.5 +/- 56.4 and 330.25 +/- 65.14 units respectively (p < 0.05). In case group we observed full normalization of thymol test--from 9.99 +/- 1.51 to 4.03 +/- 0.73 units (p = 0.001), while in controls--from 7.9 +/- 1.56 only to 5.2 +/- 1.15 units (p = 0.194). Contents of non-metabolized antipyrine in cases decreased from 9.76 +/- 1.2% (p = 0.0002) whilst in controls--from 9.38 +/- 1.28% only to 3.93 +/- 1.18% (p = 0.01). Results of the study show that dietary supplement "ExPress" induces the activity of detoxification enzymes of liver and increases the efficiency of basic treatment.

[Lymphocyte subpopulations and level of the proinflammatory cytokines in the blood of patients with hepatitis C and with combined variant of hepatitis C and B]. / Subpopuliatsii limfotsitov i uroven' provospalitel'nykh tsitokinov v krovi bol'nykh virusnym gepatitom C i sochetannym variantom C + B.

Subpopulation of cytotoxic lymphocytes CD8 having both secretory and cytolytic antiviral activity is supposed to play the essential role in the virus elimination. Inflammatory reactions are also of importance in the hepatitis C pathogenesis, their intensity being regulated by anti-inflammatory cytokins. This study was aimed at determination of lymphocyte subpopulation indices--the relative content of cells carrying markers CD4, CD8, CD16, CD19, CD72, the parameters of the phagocytic activity of granulocytes and monocytes, as well as serum concentrations of anti-inflammatory cytokines IL-1, IL-6 and TNF-alpha. These indices were evaluated in a group 132 patients with confirmed hepatitis C or mixed hepatitis B + C diagnosis, depending on the disease form and markers of the infectious process activity (as determined in the PCR test for hepatitis C virus RNA) in comparison with a group of healthy donors. In patients with variant hepatitis under study a growth in anti-inflammatory mediators concentration was observed along with decreased indices of lymphocyte subpopulations responsible for cell-mediated immunity and the phagocytosis parameters. In the case of mixed hepatitis these differences were shown to be more manifested.

[Level of Tx1- and Tx2-type cytokines in blood sera of hepatitis C patients]. / Soderzhanie tsitokinov Tx1 i Tx2 tipa v syvorotke krovi bol'nykh gepatitom C.

The content of cytokines of type Tx1 (IL-2 and IFN-gamma) and type Tx2 (IL-4) in blood sera of 132 patients with hepatitis C and the combined form of hepatitis B + C was studied. For control, blood sera taken from healthy donors were used. A significant increase, in comparison with the control, in the content of IL-4 in all subgroups of the patients was registered. The content of IFN-gamma reached the maximum level in patients with acute hepatitis C with the positive result of the polymerase chain reaction (PCR) for the virus (216.4 and 46.4 pg/ml respectively) and was somewhat lower in acute hepatitis C with the negative PCR-result (77.7 and 9.6 pg/ml), mean while in the chronic course of hepatitis C these data were within the limits of control values irrespective of the results of PCR. In case of mixed infection in the acute clinical form a significant increase in the concentration of IFN-gamma (34.4 pg/ml) in comparison with the control (25.3 pg/ml) was observed. The content of IFN-gamma in patients with acute hepatitis C and the positive result of the test for NS antibodies also reached the maximum level (207.3 and 42.7 pg/mg respectively). But in contrast to hepatitis C in the acute form with the negative results of PCR in patients with hepatitis C in the acute form and the negative results of the NS test these data were within the limits of control values, as well as in the chronic course of hepatitis C irrespective of the results of the NS antibodies serum test. In case of mixed infection a significant increase in the concentration of IFN-gamma was registered in the subgroup of patients with the acute form of NS+ (39.9 pg/ml). The data obtained in this study were indicative of significant changes in the serum profile of serum cytokines of types Tx1 and Tx2 in different forms and courses of virus hepatitis. This makes it possible to believe that the chronization of the process was associated with the prevalence of the Tx2 function.

[The clinical immunogenetics of viral hepatitis C in a Caucasoid population of western Siberia]. / Klinicheskaia immunogenetika virusnogo gepatita C v populiatsii evropeoidov Zapadnoi Sibiri.

The analysis of the immunogenetic studies on hepatitis C patients among the Caucasoid population of western Siberia has revealed a significant increase in the detection rate of antigens HLA-A10 and HLA-DR5, the combinations of DR2-DR5, DR5-DR7, DR1-B27 and the complete absence of antigen HLA-DR4, which is indicative of the fact that susceptibility and resistance to the development of the disease is associated with the genes of the main histocompatibility complex. In hepatitis of mixed etiology, B and C, a significant increase in the occurrence of HLA antigens: -A1, -B8, -DR1 and -DR3, as well as the combinations of A1-DR1, A1-DR3, A3-DR3, A9-A10, DR1-DR3, B8-DR3 is noted; at the same time a decrease in the occurrence of antigen DR4 and its combination with antigen HLA-A2 is observed.

[Markers of hepatitis C and its various genotypes in patients from Novosibirsk]. / Markery virusa gepatita C i razlichnky ego genotipov u patsientov Novosibirska.

Study of the prevalence of hepatitis C virus (HCV) markers in 153 patients of Municipal Infectious Diseases Clinical Hospital No. 1 in Novosibirsk revealed anti-HCV in 88.2% patients and viral RNA in 69.3% samples. For 93 Siberian HCV isolates 5'-UTR regions were amplified and sequenced. Comparison of these nucleotide sequences with databank showed that 63.4% HCV isolates belonged to subtype 1b, 7.5% to genotype 2, and 18.3% to genotype 3. In the rest HCV isolates the 5'-UTR sequences contained heretofore undescribed nucleotide substitutions, insertions, or deletions.