[Molecular mechanisms of neuroretinoprotection in primary open-angle glaucoma]. / Molekuliarnye mekhanizmy neiroretinoprotektsii pri pervichnoi otkrytougol'noi glaukome.

PURPOSE: To evaluate the effectiveness of neuroprotective therapy in patients with primary open-angle glaucoma based on specific biochemical markers of neurotrophy and neurodegeneration. MATERIAL AND METHODS: In the course of the study, lacrimal fluid (LF) of 23 patients (46 eyes) with stage I-II primary open angle glaucoma (POAG) aged 66.3±10.8 was examined. The control group consisted of healthy individuals (12 control LF samples). Local antihypertensive therapy was complimented with 10 intramuscular injections of retinalamin (GEROPHARM LLC, St. Petersburg) - a complex of peptides isolated from cattle retinas, administered 5 mg once a day. Enzyme immunoassay (ELISA) method was used to test LF for concentrations of brain-derived neurotrophic factor (BDNF) and neuron specific enolase (NSE) before and after the treatment. RESULTS: In healthy subjects, the content of BDNF was 0.83±0.06 ng/mL, NSE - 0.51±0.06 ng/mL. In patients with POAG, the indices were higher: BDNF was 1.39±0.85 ng/mL (p>0.05), NSE - 4.31±2.02 ng/mL (p<0.05). The patients with stage II-III POAG had a significant increase of BDNF concentration (1.37±0.41 ng/mL and 1.52±0.40 ng/mL respectively in stages II and III) indicating compensatory capabilities at these stages of the disease. The NSE marker was also high in these stages (4.16±2.44 ng/mL and 5.78±2.80 ng/mL, p<0.05), which indicates the degeneration of retinal ganglion cells. After Retinalamin® therapy, patients with stage II POAG had control group levels of marker proteins, while in stage III patients NSE content remained high. CONCLUSION: There is a compensatory increase of BDNF level and a pathological increase of NSE content in LF of POAG patients. The change in the content of neurotrophins in the LF was determined to depend on the stage of POAG. Thus, in stages II and III POAG there is a marked increase of NSE and a compensatory increase of BDNF. After the complex therapy including retinalamin in patients with stage II POAG, a decrease in initially high concentrations of BDNF and NSE in LF down to the control group values was noted. In stage III patients, signs of neurodegeneration persist in the form of high NSE values. Taking into account the positive dynamics of the neuronal marker content in LF in the complex therapy of POAG with Retinalamin®, timely neuroretinoprotection is recommended.

[Serological markers of viral infections in patients with rheumatoid arthritis].

The authors carried out serologic examination of 202 patients with rheumatoid arthritis (RA) and 200 healthy persons for detecting of specific markers of infections caused with herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B and C viruses (HBV and HCV) and human T-cell lymphotropic retroviruses 1 and 2 (HTLV-1/2). It was demonstrated that detecting frequencies of HBsAg and total antibodies to HTLV-1/2, HSV and CMV among RA patients and healthy persons were practical equal--only anti-EBV were detected more often among RA patients than among healthy persons. But in the same time IgM-antibodies to HSV, CMV and EBV were detected more often among RA patients than among healthy persons. Authors concluded that most probable RA etiologically can be connected with chronic reproductive infections caused with HSV and EBV, which at least are able to participate in forming of predisposition to this disease by means of autoimmune reactions promotion.

[Bronchoscopy in inhalation burns]. / Bronkhoscopiia pri ozhogakh verkhnikh dykhatel'nykh putei.

The treatment of burns of various depth and location which are combined with thermoinhalation affections of the respiratory organs is a serious problem during the entire course of burn disease. Despite advances in modern treatment of burns, the death rate of pulmonary complications is still high. Pulmonary disorders encountered in inhalation of chemical toxic products of burning, smoke and its finely divided components increase the fatal outcomes by 30-100% in different periods of the burn disease. Until recently, thermoinhalation affections were not often taken into account in analysis of the causes of death of patients with burns, and the diagnosis was based on scanty historical data and late clinical symptoms. In works published from the beginning of the eighties, bronchoscopy was assigned secondary significance. Evaluation of the character of the lesion, the extent and depth of pathological changes in the tracheobronchial tree in thermoinhalation affections is based in most cases on the post-mortem findings. The purpose of this work was to evaluate clinically and by laboratory studies the role and significance of bronchoscopy in establishing the diagnosis in individuals with burns and thermoinhalation damage during life, in the treatment and prevention of the expected complications in the respiratory organs, and to promote wide use of a bronchoscope in this category of seriously ill patients. On the basis of the study, the authors revealed a close correlation between respiratory insufficiency of various degree and extent and the depth of the affection of the tracheobronchial tree. They also substantiated indications for systemic bronchoscopic treatment of thermoinhalation lesions.