[Characteristics of the immune status in specific and nonspecific prophylaxis of influenza in elderly persons].

The results of the comparative analysis of the immunological effectiveness of the anti-influenza vaccine Vaxigrip, the inferferon inductor Arbidol and their combination in 125 elderly persons are presented. In the process of investigations the immunomodulating activity of the preparations under study was noted; this activity was manifested by the increase of the absolute and relative number of cells, carrying markers CD3+, CD4+ and CD16+, but not CD8+, CD19+ and CD25+, the normalization of the immunoregulatory index and the stimulation of the phagocytic function in the absence of essential influence on the level of HLA-DR+ expression and the concentration of immunoglobulins of the main classes. An increase in the frequency of seroconversions and the multiplicity of growth in the titers of specific antibodies to influenza viruses A (H1N1 and H3N2) and B, most pronounced in persons immunized with the vaccine simulianeouslywith the injection of Arbidol, was established.

[Role of Chlamydia, mycoplasma and cytomegalovirus infection in the development of coronary artery disease]. / Rol' khlamidiinoi, mikoplazmennoi i tsitomegalovirusnoi infektsii v razvitii ishemicheskoi bolezni serdtsa.

AIM: To assess relationship between some infection factors and presence of coronary heart disease. MATERIAL: Patients with myocardial infarction (n=56), unstable angina (n=50), stable angina (n=50) and age - matched controls (n=49). METHODS: Levels of IgG, IgM, IgA antibodies to Chlamydia pneumonia, Chlamydia trachomatis, Chlamydia psittaci, IgG, IgM antibodies to Cytomegalovirus, and also of antibodies and antigen to Mycoplasma pneumoniae were measured in blood serum. RESULTS: Compared with controls patients with coronary heart disease had higher frequency of seropositivity to Chlamydia pneumonia, Mycoplasma pneumonia and Cytomegalovirus (p< 0.05 ) and similar levels of seropositivity to Chlamydia trachomatis and Chlamydia psittaci. Infectious burden (quantity of antibodies per one patient) was significantly higher in patients with myocardial infarction, unstable and stable angina than in controls (1.58, 1.42, 1.41 and 0.95, respectively). CONCLUSION: Our results confirm presence of association between infection and coronary heart disease.

[Associated infections in acute bronchopulmonary infections in children]. / Assotsiativnaia infektsiia pri ostrykh bronkholegochnykh zabolevaniiakh u detei.

A total of 189 children with bacterial complications of the acute respiratory viral infection (ARVI)--primarily with pneumonia and bronchitis--were dynamically examined for typical and atypical pneumotropic causative agents of the infection process (Mycoplasma pneumoniae, Chlamydia spp., Streptococcus pneumoniae, Haemophilus influenzae, Pneumocystis carini, and Citomegalovirus). A high frequency rate of the associative infection involving mycoplasmas and pneumocysts was registered (45-50%); it was lower in the cases involving Chlamydias, hemophilic bacteria, pneumococcus, and cytomegalovirus--up to 25-30%. No sharp difference was found between the indices of an infection degree and those of an active clinical infectious process involving the same pneumotropic agent: the biggest difference was observed in Chlamydia infections (9.4%) and the lowest one--in mycoplasma infections (3%). A dynamic comparison of different classes of immunoglobulins revealed that, in acute bronchitis and pneumonias, the Chlamydia and cytomegalovirus infections are, primarily, of the persistent nature; the hemophilic and pneumocystic infections are of a mixed nature; and the pneumococcus one is of the acute nature. The Mycoplasma infection, which is more often encountered in pre-school children, is of the primary type with a trend towards a prolonged clinical course. All pneumonias had a typical clinical course; the clinical picture was compared in 128 patients with the etiological factor (including a description of characteristic symptoms).

[Diagnosis of pulmonary lesions in acute respiratory insufficiency in patients with depressed hemopoiesis]. / Porazheniia lëgkikh pri ostroi dykhatel'noi nedostatochnosti u bol'nykh s depressiiami krovetvoreniia.

AIM: To analyse causes of acute respiratory failure (ARF) and methods of diagnosis of pulmonary lesions in patients with depressed hemopoiesis (DH). MATERIAL AND METHODS: 50 patients with DH and ARF were examined according to the protocol including x-ray, computed tomography, fibrobronchoscopy with bronchoalveolar lavage, cytological, bacteriological, virusological studies of the lavage fluid, biopsy of the lung. The algorithm of the protocol is provided. RESULTS: Sensitivity of the lavage fluid in diagnosis of fungal, bacterial, pneumocystic and cytomegaloviral infections was 84, 78, 93 and 93%, respectively. The cytologic examination of the lavage fluid may detect lung infiltration with blood tumors. In complicated diagnostic cases lung biopsy verified pulmonary lesion but its conduction aggravated the patients' condition. ARF patients with DH, bacterial flora, fungi, cytomegalovirus and pneumocystic infection, pulmonary tumor involvement, pulmonary lesions in ATRA-syndrome, non-infectious lesions of the lungs after bone marrow transplantation were found in 38, 18, 40, 18, 8 and 4% of cases, respectively. CONCLUSION: DH patients with ARF should be examined by the protocol including both non-invasive and invasive diagnostic methods. Accurate diagnosis of ARF causes is the basic reserve in the treatment of such patients.

[Spectrum of pneumotropic pathogens in pediatric patients with acute bronchitis and pneumonia]. / Spektr pnevmotropnykh vozbuditelei pri ostrykh bronkhitakh i pnevmonii detei.

One hundred eighty nine children with acute bronchopulmonary infectious pathological processes were examined bacteriologically and serologically for typical pneumotropic pathogens, 47 of them being as well examined for atypical organisms. Microbial associations mainly with Mycoplasma and Pneumocystis and to a lesser extent with Chlamydia were isolated from the majority of the children. Reactivation of the cytomegalovirus infection was observed in 25 per cent of the children. Pneumonia and bronchitis due to Mycoplasma pneumoniae either as a monoagent or in associations were mainly stated in children over 7 years of age. No significant changes between the indices of the infection due to a definite organism and the active progression of the infectious process of the same etiology were revealed, though in the cases of chlamydiosis the changes reached almost 10 per cent. In cases of acute bronchitis and pneumonia the chlamydial or cytomegalovirus infection could be assumed to be of the persisting nature, mainly acute in cases of pneumococcal infection, mixed in cases of hemophilic or pneumocystic infection, primary contamination with a tendency to prolonged in cases of mycoplasmic infection. The findings of the examination and the clinical and anamnestic data showed that the clinical picture of acute pneumonia had specific features associated with the supposed etiological agents, still it could change under the action of associations of pneumotropic pathogens.

[Persistence of pneumotrophic infective agents in acute bronchopulmonary diseases in children]. / Persistentsiia pnevmotropnykh vozbuditelei pri ostrykh bronkholegochnykh zabolevaniiakh u detei.

175 children with acute bronchopulmonary pathology were examined for the presence of the pneumotropic infective agents by serological and bacteriological methods. In most children microbial associations with the prevalence of mycoplasmas, pneumocycts and, to a lesser extent, chlamydiae were detected. The considerable activation of cytomegalovirus (CMV) infection in children with pneumonia and bronchitis was noted. Taking into account the results of the examination and the clinico-anamnestic data, the character of infections could be established: chlamydial and CMV infections were mainly persisting; pneumococcal infection was mainly acute, hemophilic and pneumocyst infections were mixed. The clinical picture of acute pneumonia cases had characteristic features determined by the supposed etiological agent, but this picture could change under the influence of pneumotropic infective agents.

[Clinical manifestations, diagnosis and course of Pneumocystis carinii pneumonia in patients with hematologic diseases]. / Klinicheskie proiavleniia, diagnostika i techenie pnevmotsistnoi pnevmonii u bol'nykh s zabolevaniiami sistemy krovi.

AIM: To characterize clinical, diagnostic and course features of pneumonia caused by Pneumocystis carinii (PC) in hematologic inpatients. MATERIALS AND METHODS: 27 patients with blood diseases were studied. 22 of them had acute respiratory insufficiency and 5 had unclear lung affection. The data from bronchoalveolar lavage (BAL), lung biopsy, serum tests for IgG, IgM anti-PC-antibodies were used for diagnosis of PC-pneumonia. RESULTS: PC-pneumonia was diagnosed in 8 of 27 patients. Clinical manifestations characteristic for PC-pneumonia were not found. In 5 patients the diagnosis was made on the evidence provided by BAL. Lymphocyte count in BAL was elevated to 27.7 +/- 8.7%. Open biopsy of the lung and transbronchial biopsy diagnosed PC-pneumonia in 2 and 1 patients, respectively. Previous BAL examinations failed to detect PC-pneumonia in 2 of them. In all the patients PC-pneumonia was associated with another infection (bacterial, cytomegaloviral). Histologically, the picture of the disease was determined by the severity of the lung affection or its complications. 5 of 8 patients failed treatment with trimethoprim-sulphamethoxazole and died. Marked respiratory insufficiency was registered at PC-pneumonia diagnosis in all the lethal cases. CONCLUSION: Clinical and x-ray pictures of PC-pneumonia in hemoblastosis patients are not specific. All such patients with symptoms of lung infection resistant to antibacterial and antifungal therapy should be examined for PC-pneumonia.

[The diagnosis and clinical characteristics of cytomegalovirus infection in HIV-infected subjects]. / Diagnostika i klinicheskaia kharakteristika tsitomegalovirusnoi infektsii u VICh-infitsirovannykh lits.

Out of 180 HIV carriers active cytomegalovirus (CMV) infection was found in 30 patients, in 16 cases the infection manifested clinically. Most of the latter were patients with HIV infection IIIb or IIIc stage against persistent lowering of CD4-lymphocyte count under 100/mm3. Active CMV infection may be determined most significantly by the following criteria: high or moderate concentrations of CMV DNA in the blood, low concentrations of blood CMV DNA in the presence of long-term (at least 3 months) persistence of anti-CMV IgM and isolation of urinary CMV. CMV infection manifested usually as a generalized disease with typical signs of retinitis, myelitis, erosive-ulcerative colitis. Most patients had thrombocytopenia, functionally defective platelets. CNS involvement predicts poor prognosis in CMV-infected HIV carriers.

[Suppression of cytotoxic cellular reactions by the production of antibodies to rhamnose determinants of streptococcal group A polysaccharide cross-reacting with antigens of the skin epithelium]. / Supressiia tsitotoksicheskikh kletochnykh reaktsii pri produktsii antitel k ramnoznym determinantam polisakharida streptokokka gruppy A, perekrestno-reagiruiushchikh s antigenami épiteliia kozhi.

By the BALB/c mice after different periods of immunization with the streptococci group A, treated with pepsin, antibodies belonging to autoantibodies to the determinants (DT) of polysaccharide (A-PS), cross-reactive (CR) with the epithelial skin cells, were investigated. In one of the mice groups, in the autologous system, on the target cells--macrophages of lymph nodes, the suppression of cytotoxic (CT) reactions was obtained. The CR are bound with the delayed type hypersensitivity appearing after the sensibilization with BCG. The suppression effect correlate (z-0.95) with the presence in the sera antibodies to the rhamnose DT'S of A-PS, which cross-react with the cells of basal and superbasal layers of skin epithelium. Antibodies to the group specific of the A-PS, cross-react only with the basal skin layer and not produce the suppression of CT reactions. It is possible that they also prevent the suppression of CT reactions, bound with the CR antibodies to the rhamnose DT-S of A-PS. The obtained data corroborate the earlier supposition that the autoantibodies to the CR DT'S of A-PS reacting with the skin epithelial cells as a rule common the thymus epithelial cells. It is possible that different IRD'S can prevent or stimulate the development of autoimmune processes by the infections with the streptococci group A.

[Choice of the suitability criteria of polystyrene-based solid-phase carriers for performing immunoenzyme analyses]. / Vybor kriteriev prigodnosti tverdofaznykh nositelei na osnove polistirola dlia provedeniia immunofermentnogo analiza.

The authors discuss a tentative approach to the choice of criteria indicating the optimal suitability of different solid-phase carriers made of polystyrene for use in the enzyme immunoassay (EIA), viz. the dependence of specificity, sensitivity, reproducibility and reliability of EIA results on the adsorption properties, transparency expressed in percent and transparency variations of the plates under test. The evaluation of the carriers by four parameters is proposed with the use of assay plates manufactured by Nunc A/S (Denmark) for control. To ensure the objective evaluation of the suitability of polystyrene plates for use in EIA, the choice of uniform criteria is necessary.

[Immunoenzyme analysis. The isolation and characteristics of Soviet reagents for detecting the surface antigen of the hepatitis B virus in blood sera]. / Immunofermentnyi analiz. Poluchenie i kharakteristika otechestvennykh reagentov dlia indikatsii poverkhnostnogo antigena virusa gepatita B v syvorotkakh krovi.

A method for the preparation of highly specific conjugates on the basis of antibodies obtained as a result of dissociation of the immune complex HBsAg--anti-HBsAg, formed in vitro, is proposed. ELISA was performed according to Walters with some modifications in the concentration of the assay ingredients and in the time of incubation. The technique of the assay of blood sera for the presence of HBsAg with the use of reagents manufactured in the USSR has been worked out.

[Description of the effect of polyclonal mitogens on a population of splenic lymphocytes in the presence of serum against isologous aggregated mouse immunoglobulins]. / Osobennosti deistviia poliklonal'nykh mitogenov na populiatsiiu limfotsitov selezenki v prisutstvii syvorotki k izologichnym agregirovannym immunoglobulinam myshi.

Antiserum against isologous aggregated mouse immunoglobulins was shown to be mitogenic for spleen cells during the first 48 hours of culture. The mitogenic effect of the serum factor is mediated through T lymphocytes and may be macrophage-dependent. Whe incubated with spleen cells the serum was demonstrated to inhibit the DNA synthesis in B cells in response to sulfate dextran and lipopolysaccharide. Experiments with B cells and the thymidine "suicide" test suggest that the target cells for the serum factor may reside in the population of radiosensitive and highly proliferating B lymphocytes. The degree of suppressing by the antiserum factor depends on the differentiation stage and the presence of antigen-binding receptors on the membrane of B cells.

[Comparative analysis of gamma globulin preparations isolated by means of DEAE-Sephadex and DEAE-cellulose]. / Sravnitel'nyi analiz preparatov gamma-globulina, vydelennykh s pomoshch'iu DEAE-sefadeksa i DEAE-tselliulozy

Preparations of rabbit gamma-globulin obtained with the aid of ion-exchange chromatography on DEAE-Sephadex contained an admixture of other serum proteins revealed by disc-electrophoresis in acrylamide gel. This impurity can be eliminated by rechromatography of gamma-globulin preparations of DEAE-cellulose in the same buffer solutions which were used for purification of gamma-globulin on DEAE-Sephadex. Better purification of gamma-globulin on DEAE-cellulose can supposedly be attributed to the effective absorption on cellulose basis of euglobulin aggregates which form in the solutions with a low ionic power used for chromatographic isolation of gamma-globulin on ion-exchangers.