Apoptotic Bodies of Cardiomyocytes and Fibroblasts - Regulators of Directed Differentiation of Heart Stem Cells.

We studied the effects of apoptotic bodies of cardiomyocytes (ApBc) and fibroblasts (ApBf) on myocardial regeneration and contractility in rats and the dynamics of RNA concentrations in cardiomyocytes and fibroblasts at different stages of apoptosis. ApBc increase the contractility of rat myocardium, while ApBf reduce it. ApBc stimulate the development of clones of cardiomyocyte precursors in the myocardium, while ApBf stimulate the formation of endothelial precursor clones. In doxorubicin cardiomyopathy, ApBc, similar to the reference drug (ACE inhibitor) improve animal survival, while ApBf produce no such effect. RNA concentrations in cardiomyocytes and fibroblasts before apoptosis and at the beginning of cell death significantly differed, while in apoptotic bodies of these cells, it was practically the same. It has been hypothesized that RNA complex present in ApBc and ApBf represents an "epigenetic code" of directed differentiation of cardiac stem cells.

[Introduction into PPPM: experience of the past and tomorrow's reality].

Health service today is on the verge of broad changes. The intensive practical application of the achievements of genomics, proteomics, metabolomics and bioinformatics has significantly deepened and continues to deepen our view of the pathological processes taking place at a level of biostructures. In the nearest future this progress will give medical practitioners the opportunity to focus on a subclinical stage of the disease, i.e. on the earliest stages of the pathological process. This will require the prediction of disease development risks, subclinical diagnostics with the precise staging of the pathological process, and, finally, the application as early as possible of targeted pharmacotherapeutic methods in order to prevent the manifestation of the disease or its progression into more severe stages. All these principles create the framework of a fundamentally new "3P" strategy in medicine: predictive, preventive and personalized medicine.

[Proteomics as a fundamental tool for subclinical screening, tests verification and assessment of applied therapy].

Proteomics is a science which studies proteins of the body, interactions of proteins and their biological functions. Today, it is an essential partner in establishing preclinical diagnosis protocols. In conjunction with other sciences such as genomics and bioinformatics it will be possible to diagnose diseases on the earliest stages before its clinical onset or to gain the dynamics of pathological processes in the body and response to drug therapy. This article discusses general aspects of proteomics as well as special ones on the basis of models of cardiac diseases and cancer.

[Introduction to preventive and predictive medicine: past experience and future reality].

The active practical introduction of the achievements of genomics, proteomics, metabolomics, and bioinformatics brought about a fundamental change in views on the role and place of medicine in the structure of healthcare at the turn of the 1980s-1990s, by giving impetus to the development of the radically new health care area--preventive, predictive, and personalized medicine (PPPM).

[Aproaches to immunotherapy in different immunophenotypes of cutaneous basal cell carcinoma].

The combination of two immunomodulating agents (genferon derived from exogenous IFN-alpha2b and cycloferon, endogenous IFN inductor) was added to the complex therapy of 60 patients with different cutaneous basal cell carcinoma (CBCC) immunophenotypes. All patients underwent tumor resection, 1-3 days after surgery the patients received immunotropic therapy by focal cycloferon injections (2 ml of 12.5% solution) on days 1, 2, 4, 6, 8 and 10 post-operation with simultaneous genferon therapy via suppositoria (1 000 000 ME) twice a day for 10 days. The therapy was well-tolerated. Essential parameters of immune homeostasis were evaluated before and 3 months after immunotropic therapy. During further observation (for a mean period of 1.8 years) none of the patients displayed any signs of CBCC relapse. The immunological studies results give evidence for correction of immune disturbances characteristic for CBCC patients. This data confirm the effectiveness of immunotropic therapy for relapse prevention and immune disorders correction and allow recommending it for CBCC patients with high relapse risk.

[Autoimmunity and autoimmune syndrome: norm and pathology].

Multicomponent analysis of variations of serum marker antibodies is an efficacious tool for preventive (pre-clinical) diagnosis of immune disorders causing serious diseases. Successful development of this method may lead to revision of the approaches accepted in modern medicine and facilitate practical transition to the prognosis-prevention paradigm. The study of antibody spectra reflecting individual genetic and epigenetic features provides a basis for prognostication of health and pathological conditions. We believe that in most cases early diagnosis of reversible pathologic processes their further development can be arrested which provides a real opportunity to preserve health.

[Comprehensive examination of the female urogenital tract infection by polymerase chain reaction using multiplex test systems].

The results of the polymerase chain reaction studies performed in 2006-2008 were used to make a retrospective analysis of the detection of urogenital herpesvirus infections in reproductive-aged women constituting the urban population of the central region of Russia. The study used both monotarget and mutiplex test systems to detect herpes simplex virus (HSV), cytomegalovirus (CMV), Epstein-Barr virus (EBV), human herpesvirus types 6 and 7. A total of about 7.500 referrals; the detection rate for HSV was about 1%; that for CMV was from 0.3 in 2006 to 1% in 2008; that for EBV was from 0.1% in 2006 to 0.3% in 2008. More than a half of HSV-, CMV-, or EBY-positive samples also contained DNA of other causative agents and some samples did two pathogens or more. Multiplex test systems for herpesviruses considerably enhance the efficiency of diagnostic studies and reduce the material and time costs of diagnosis.

[Diagnostic and pathogenetic implications of the site specificity of antibody proteases in multiple sclerosis].

Disseminated sclerosis is currently regarded as a CNS autoimmune disease. One of the mechanisms behind this pathology is antibody (AB) formation. In this context, recent data on AB with proteolytic activity are of importance because they participate in selective proteolysis of myelin proteins in patients with disseminated sclerosis. This paper focuses on AB-proteases associated with disseminated sclerosis and site-specificity of antibody-mediated proteolysis of myelin basic protein. Protocol of serodiagnostic algorithm to be used in clinical practice is described.

[Current protease-antibody-based serodiagnostic tools and their use in the diagnosis of autoimmune thyroid diseases].

The purpose of the investigation was to comparatively study the possible clinicodiagnostic and clinicoprognostic value of thyroglobulin (TG) autoantibodies (anti-TG autoAB) and thyroid peroxidase (TPO) (anti-TPO autoAB) with proteolytic activity (protease-AB) and to develop additional clinicoimmunological criteria for working out a protease-AB-based laboratory serodiagnosis protocol. Sera from 240 patients with autoimmune thyroiditis (AIT), 124 with diffuse toxic goiter (DTG), and 172 with other thyroid diseases were studied. Serum from 40 clinically healthy donors served as a control. Sera were screened for anti-TG and anti-TPO autoAB by enzyme immunoassay and/or radioimmunoassay. Nonspecific proteolytic activity was determined, by incubating a highly purified AB IgG-isotype solution with nonspecific substrate (such as BSA-FITS or thyoredoxine/Trx), followed by the measurement of relative fluorescence shifts at a wavelength of 470 nm. The blood samples taken from patients with AIT or DTG and the highly purified anti-TG or anti-TRO autoAB of IgG isotype were incubated with appropriate human substrates to determine AG-specific proteolytic activity. Proteolysis products were detected by PAAG electrophoresis. An association was found between the rise in the frequency of protease AB, their catalytic activity, a tendency toward autoAB between themselves, and the degree of thyroid tissue degradation in AIT and DTG; some specific features of a serological pattern were noted in diferent dorms of AIT and DTG. For example, the prevailing autoABs have been shown to be TG-specific in AIT and TPO-specific proteases in DTG; also, the detectable catalytic activity of both autoAB in AIT is an order of magnitude higher than that in DTG. No protease ABs have been recorded in other forms of thyroid diseases in which antithyroid autoABs are also frequently detected. The screening procedure for protease AB may be considered as a highly sensitive and specific indicator test in the diagnosis and prediction of AIT and DTG, which allows one to diagnose not only within the framework of major thyroid nosological entities, but much broader, by covering a great variety of syndromal forms of pathology.

[Cytokines and their role in pathogenesis of diabetic retinopathy].

The role of cytokines is estimated in development of diabetic retinopathy. Titer of cytokines is compared in healthy subjects and patients with impaired glucose metabolism. Fundus examination and specific cytokines level assessment allowed us to conclude that cytokines directly take part in pathogenesis of retinopathy before clinical manifestation. It provides rational to use cytokine level as a predictor of early manifestation of diabetic retinopathy, its timely treatment and prevention of progressing till end stages.

[Post-infection clinico-immunologic syndrome: fundamentals of etiopathogenesis and immunogenodiagnostic strategy].

Professor Yu.M. Lopukhin, an ardent advocate of translation of scientific achievements into clinical medicine, is a founder of new scientific disciplines including clinical immunology that evolved from the fusion of new knowledge, original clinical thought, high-tech diagnostic and therapeutic modalities. Highly promising investigations into molecular pathogenetic mechanisms of various diseases, their diagnosis, and prevention make up a most important aspect of his scientific work. The progress of chronic recurring infectious diseases (CRID) is closely related to the associated immune disorders, e.g. post-infection clinico-immunologic syndrome (PIKIS) that reflects the character and severity of disturbances of immune homeostasis. This syndrome associated with CRID is as a rule provoked by infectious agents of different nature, immunopathologic processes inherent in individual patients, specific clinical course ofCRID or inadequate application of antimicrobial medicines. Three forms of PIKIS are described in this paper: (1) post-infection secondary immunodeficiency syndrome:, (2) post-infection autoimmune syndrome, (3) combination of the two.

[Antithyroid antibodies of varying specificity in the pathogenesis and diagnosis of autoimmune thyroid diseases].

AIM: To compare the possible pathogenetic and clinicodiagnostic value of antithyroid autoantibodies (autoAB) different in specificity, such as monospecific ones to thyroglobulin and thyroid peroxidase (anti-TG and anti-TPO autoAB) and bispecific ones to thyroglobulin and thyroid peroxidase simultaneously (anti-TGPO autoAB), in patients with autoimmune thyroid diseases. MATERIALS AND METHODS: The sera from 240 patients with autoimmune thyroiditis (AIT) and from 124 with diffuse toxic goiter (DTG) were examined. The sera from 40 healthy donors served as a control. The sera were screened for anti-TG and anti-TPO autoAB, anti-TGPO autoAB, by employing enzyme immunoassay and/or radioimmunoassay. The results were statistically processed using the variation statistics-based programs. RESULTS: The specific features of an autoantigenic component to thyroid tissues were found in the sera of patients with AIT and DTG. An association was established between the progression of disease and the phasic change of autoAB populations or their combinations. CONCLUSION: The procedure for evaluating seropositivity for antithyroid autoAB, which is referred to as non-invasive studies, can be considered as a criterion test in the diagnosis and prediction of the course of AIT and DTG.

[Post-infectious clinical-immunological syndrome and its place in clinical practice].

The progression of chronic-relapsing infectious disease (CRID) depends on a combination of cumulative immune-mediated responses of the human body, which, in turn, are united by a number of the common mechanisms. The mechanisms are called as the post-infectious clinical-immunological syndrome (PICIS) to demonstrate the features and scale of imbalances of immune homeostasis. PICIS usually accompanies most of the known CRID to define the type of the disease, to predict the progression of and risks for the complications to be risen as well. PIFIS is generally provoked by either infectious pathogens of various nature or by the atypical immune responses from the infected patient, or by the onset of the disease itself, or by the inadequate antimicrobial therapy. Three forms of PICIS which depend on two key factors have been described. These included: (i) the spectrum of a microbial colonization landscape; (ii) the antimicrobial immunity itself to generate, for instance, either of three alternative PICIS, namely, (1) postinfectious secondary immunodeficiency syndrome (PISIS); (2) postinfectious autoimmune syndrome (PIAIS), and (3) PISIS combined with PIAIS, i.e. PISIDAS. The dominant monosyndrome-like form of associated immune imbalances in CRID patients is PISIS. PISIS occurs in more than a third of the clinical cases to stress the autoaggression (PIFAS), or combininative form of the immune-mediated imbalances, i.e. PISIDAS. In the process of the development of CRID, PISIS can give a way to either PIAIS or PISIDAS. Besides the immune-mediated imbalances, an essential role in the pathogenesis of CRID and PICIS is also attributed to the infectious factors capable of forming microbial associates in the pathogenesis of PICIS. Therefore, treatment of such patients should be directed not only at the elimination of the infectious pathogen(s), but also at the restoration of the physiological level of the immune homeostasis impaired by PICIS.

[Architectonics of cell subpopulations of peripheral blood in patients with autoimmune myocarditis: clinical and pathogenetic aspects].

AIM: To compare the most significant architectonic parameters of peripheral blood cell subpopulations in patients with different variants of an autoimmune myocarditis (AIM) course and their clinical value in therapeutic practice. MATERIAL AND METHODS: Blood cell subpopulations were studied with flow cytometry in 99 blood samples from patients having different AIM variants and myocardiosclerosis as well as in 40 healthy donors. RESULTS: Severe (malignant) AIM was characterized by growing indices of T-/B lymphocyte activation, expression of activation markers on the cells of both differentiation lines, disproportions in composition of subpopulations of the immunoregulatory cells, parallel rise in specific weight of dendritic cells, reduced intensity of apoptosis of autoreactive T-lymphocytes. In benign AIM marked immunopathology was not found. This group can be considered as a separate variant of AIM course necessitating an individual approach to planning pathogenetically sound therapeutic and rehabilitation measures. CONCLUSION: The study of activation markers expression on peripheral blood cells is superior to the study of endomyocardial biopsies providing a non-invasive method of immunodiagnosis.

[The current concept of immunological disorders in the case of basal-cell carcinoma].

Imbalance in the interaction of mechanisms of innate and adaptive immunity rather than selective defect of each of the links is a determinant of the development of basal-cell carcinoma of this or that form of immunopathology or that of transformation of one to another form. The lecture gives notions on immunological phenotypes and the parameters of innate and adaptive immunity and on the association of two links of immunity. The major tumor-associated immunological phenotypes are pathogenetically and clinically different, but have signs of two-link immunodeficiency in each case. Tumor-associated secondary immunodeficiency is characterized by defects encompassing both the innate and adaptive links of immunity. Predominant are autoimmune disorders involving mainly the adaptive link of immunological responsiveness in case of tumor-associated autoimmune syndrome concurrent with immunodeficiency.

[Antibody-mediated proteolysis of myelin-associated proteins as a new mechanism of control over demyelinization processes in multiple sclerosis].

Natural antibodies possessing catalytic activity present a new group of biologically active substances that are found in various autoimmune diseases such as autoimmune thyroiditis, myocarditis, multiple sclerosis, and system lupus erythematosus. Presently, an interconnection between the activity of these antibodies and the extent of organic and tissue lesion in autoaggression have been revealed. Clinical use of catalytic antibodies as a diagnostic criterion to evaluate the severity of disease, a prognostic criterion of the risk of invalidization, and as a pathogenetic basis for medicamentous treatment of autoimmune process is a promising directions of study of the role of catalytic antibodies.

[Glial tumors of the brain: current aspects of the immunopathogenesis and immunogenodiagnosis].

Glioblastoma growth is a genetically regulated process. Loss or inactivation of genes - tumor suppressors may give rise to tumors and their progression. Glioblastoma multiforme is followed by a number of genetic breakages. Expression of a number of genes may affect the prognosis of the disease and tumor sensitivity to chemotherapy. Comprehensive studies of glioblastomas showed that there were at least two immunologic phenotypes: 1) that with a picture of pronounced immunodeficiency and 2) that without obvious immunodeficiency. This should be considered when elaborating present-day programs of geno- and immunodiagnosis, as well as clinicoimmunological criteria for the treatment of these tumors.