[Immunopathomorphology of the human placental barrier in the first trimester of pregnancy complicated by the inflammation of the birth-ways].

The effect of ascending infection of birth-ways on transport of maternal immunoglobulins (Igs) through the placental barrier in humans during the first trimester of pregnancy was studied. The transport of Igs is seen already in 3.5-to 5-week-old embryos, and different cellular and biochemical compounds participate at each stage of this process. Transport of Igs through the trophoblast is carried out due to the secretory component (SC) and, perhaps, to some other receptors. Monocytes together with Igs penetrate into capillaries between the endothelial cells and are transported with the blood all over the body. It seems that SC and other receptors help Igs to penetrate into capillaries through the endothelium. Further, Igs are transported with erythroblasts. In the development without infection the transport of IgG was seen in all cases studied. Inflammation of the birth-ways is accompanied by an increase in transport of all Igs, already in early embryogenesis. Three groups were distinguished: 1) abortions without inflammation; 2) cases with signs of moderate inflammation (endometritis, deciduitis); 3) cases with intensive inflammation with necrosis and leucocytic infiltration. Transport of Igs was seen in 77.8% cases of the first group and in all cases of groups 2 and 3. Transport of IgM was not found in the first group, but was seen in 50% cases of group 2 and 66.7% of group 3.

[Morphofunctional characterization of the lymphoid system in fetuses and newborns with 23-28 weeks of gestation after intrauterine infection]. / Morfofunktsional'nye osobennosti limfoidnoi sistemy u plodov i novorozhdennykh 23-28 ned gestatsii pri vnutriutrobnom infitsirovanii.

Lymphoid organs (LO) of 75 foetuses and newborns (the 23-28th week of gestation) dying intranatally or within first 2 days of life were studied. Two types of lesions are found in the lymphoid organs after the intrauterine contamination: 1) immunogenesis activation in the form of hyperplastic changes in the lymphoid organs and IgM synthesis; 2) immunogenesis depression manifested mainly in the peripheral organs of immunogenesis (reduction of the lymphoid organs volume, lack of IgM synthesis).

[Clinico-immunologic characteristics of appendicitis in children]. / Kliniko-immunologicheskie osobennosti appenditsita u detei.

Inflammation of the appendix is primarily a local process with the development of localized subcompensation of immunogenesis in simple appendicitis. Decompensation of immunogenesis and a destructive process develop in progressive insufficiency of immune reactions, in immune reactions of considerable intensity the inflammation is arrested spontaneously, but atrophy of lymphoid tissue remains as a consequence. Frequent (48.7%) recurrent inflammation is attended by a more severe clinical course and rapid development of complications, owing to which appendectomy is recommended in simple appendicitis. The authors revealed changes of the general resistance of the organism, which were manifested by activation of leukocyte phagocytic activity and reduction of their content of cation proteins and by increase of the level of circulating immune complexes in the blood.

[Various hereditary immune deficiencies linked to the X-chromosome]. / Nekotorye nasledstvennye immunodefitsity, stseplennye s X-khromosomoi.

The organs of immune system in hereditary immunodeficiencies linked to X-chromosome, particularly in Nezelof's syndrome and chronic granulomatosis (4 cases) were studied histologically. The alterations of thymus found in Nezelof's syndrome suggest the disturbance of its morphogenesis at the embryonal stage, those found in chronic granulomatosis suggest the postnatal disturbance of thymus morphogenesis. The children die of polytopic infections foci. Generalized BCG-itis is observed in children with chronic granulomatosis.

[Immune complex diseases]. / Immunokompleksnye bolezni.

Immune complex diseases (ICD) include different diseases of infectious and noninfectious origin in the pathogenesis of which the leading role belongs to immune complexes circulating in the blood stream. Three variants of the ICD course are distinguished: fulminant, acute, and chronic. The main morphological manifestation of ICD is vasculitis (in the fulminant course--microangiothrombopathy) and its consequences in the form of various circulation disorders. Renal glomeruli are frequently involved (glomerulonephritis). Immunopathologic reactions in the form of hypersensitivity reaction or inhibition of immune response are important in ICD.

Vascular changes in hyperacute meningococcal sepsis as a manifestation of pathogenic action of immune complexes.

The analysis of post mortem examinations of 175 cases of meningococcal sepsis concentrates on a description of vascular changes as the chief manifestation of the given disease. The changes consisted in the destruction of the endothelium, mucoid swelling or fibrinoid changes of the wall of minute vessels, and disseminated intravascular blood clotting. In sum, these changes can be described as generalized microangiothrombopathy. In the affected vascular walls and in the thrombotic masses the presence of antigen-antibody immune complexes was found. It is therefore possible to regard hyperacute meningococcal sepsis as a manifestation of pathogenic action of immune complexes--as a consequence of massive blood invasion by antigen and of rapid formation of a great number of antigen-antibody complexes.

[Immunomorphologic aspects of sepsis in children under 1-year-old]. / Immunomorfologicheskie aspekty sepsisa u detei pervogo goda zhizni.

Lymphoid system was studied morphologically in 61 infants aged under 1 year dying of sepsis, nonseptic inflammatory diseases and non-inflammatory processes. It was established that in sepsis generalization of the immune response and decompensation of the lymphoid system occurred in the development of which previous disorders of immune responsiveness (thymus pathology, immaturity of the lymphoid system of premature babies, respiratory viral infections) are of great importance. Unlike sepsis, local inflammatory processes are characterized predominantly by limited immune reaction and decompensation of lymphoid system has a local character. In babies of the first month of age reactions of the T-lymphocyte system predominate, in older babies those of the B-lymphocyte system.

[Pathogenesis of certain forms of sepsis]. / K patogenezu nekotorykh form sepsisa.

Morphology of the lymphoid system was studied in 69 fatal cases due to sepsis, 25 due to massive local inflammatory processes and 18 sudden deaths (norm). In contrast to local inflammatory processes, the main feature of sepsis is a generalized reaction of the lymphoid system with signs of immunogenesis decompensation. Decompensation of the afferent part of immunogenesis manifested in glycogenolysis disorders, degenerative and necrotic changes of macrophages, inhibition of phagocytosis is important in the pathogenesis of sepsis. Decompensation of the central and efferent parts in most severe cases of sepsis is manifested in depletion of the lymph nodes and spleen and inhibition of immunoglobulin synthesis. The main issue in the pathogenesis of fulminating meningococcal sepsis is the formation of antigen-antibody immune complexes leading to the involvement of the microcirculatory channel vessels and disseminated intravascular blood coagulation.

[Role of macrophages in the immune response to soluble protein antigen and in staphylococcal infection]. / Rol' makrofagov pri immunnom otvete na belkovyi rastvorimyi antigen i pri stafilokokkovoi infektsii.

In experiments on rabbits immunized with soluble protein antigen immune reactions were found to be accompanied by the production of lipofuscin in macrophages. This process was the morphological manifestation of the digestion of antigen by macrophages which thus acquired the ability to migrate in the organ and to form lymphoid follicules in the medullary zone of lymph nodes. The newly formed follicules seem to be the basis of pronounced specific immune response. In staphylococcal bacteriemia the phagocytic activity of macrophages was delayed, thus causing disturbances in lipofuscin production; as a result, the subsequent phases of immune response also lagged somewhat behind in time.

[Morphology of immune destruction of the erythrocytes in fetuses and newborn infants]. / Morfologiia immunnogo razrusheniia eritritsitov u plodov i novorozhdennykh.

In the second half of pregnancy destruction of erythrocytes as a result of immunological aggresion in the fetus may occur in different manners: hemolysis in the vessel bed, fragmentation of erythrocytes, phagocytosis of intact erythrocytes and their fragments. Intravascular hemolysis occurs in immature fetuses. At that, the products of erythrocyte decomposition (hemosiderin and lipofuscin) are accumulated in the epithelial cells of the liver and the kidneys, the pancreas, the thyroid and the thymus. Fragmentation of erythrocytes (anuclear forms alone) occurs in the red splenic pulp and less in the vessels of the other organs. This process has been observed in fetuses after 7 months of gestation. Phagocytosis of erythrocytes and their fragments is done mainly by macrophages of the red splenic pulp as well as macrophages of the bone marrow, lymph nodes, and the Kupffer cells of the liver. Massive and long-term effect of iso (rhesus) antibody results in inhibition of the phagocytary activity of macrophages. In such cases, destruction of erythrocytes occurs in the vessel bed by lysis.

[Vascular and immunological processes in the pathogenesis of meningococcal infection]. / Sosudistye i immunologicheskie protsessy v patogeneze meningokokkovoi infektsii

A pathomorphological investigation of 115 lethal cases of various forms of meningococcal infection was carried out. Meningococcemia, its instantaneous forms in particular, are characterized by acute decompensation of the lymphoid system and generalized microangiopathy with the thrombohaemorrhagic syndrome. Haemorrhagic necrosis of the adrenals and damage of the hypophysis represented manifestations of the acute decompensation of the hormonal regulation. Inflammatory changes in meningococcemia were observed not in all the cases (they were absent in 1/4 of the deceased). In meningitis (meningoencephalitis) without sepsis no generalized angiopathy was noted, immunomorphological changes were of a proliferative character. Previous sensibilization of the macroorganism was an important prerequisite for the development of meningococcal infection.