[Endotoxin theory of atherosclerosis].

The involvement of bacterial lipopolysaccharides in the induction of atherogenesis is postulated. The excess of bacterial lipopolysaccharides (endotoxin aggression) is observed in the general blood circulation of volunteers with the presence of atherosclerotic risk factors (obesity, diabetes, stress, pathology of haemostasis, kidney, intestines, etc.). The results allow to be optimistic about the prospects for preventing the development and progression of atherosclerotic pathology.

[Endotoxin aggression in pathogenesis of acute myocardial infarction and its origin].

Endotoxin aggression of intestinal origin occurs in 89% of patients with acute myocardial infarction and may be a factor of the induction and/or progression of the disease. Sources of the development of endotoxin aggression often are Escherichia coli, Bacteroicles, Klebsiella, Proteus and Pseudomonas.

[The biotropic weather conditions and changing the clocks as the extraneous risk factors of weather-dependent exacerbations of chronic diseases].

This paper reports the results of medico-meteorological investigations suggesting the influence of biotropic (unfavourabe) weather conditions characteristic of transient seasons in combination with the abolition of on the frequency of application for emergency medical aid. It was shown that the abolition of during the period from 2009 to 2013 resulted in a significant rise in the frequency of application for the emergency treatment of exacerbation of cardiovascular diseases. The sociological studies involving the responders of various social and age groups carried out parallel to the medical ones demonstrated that most of them (77%) considered the abolition of to be the main cause of the deteriorated of the sense of wellbeing and emphasized the necessity of winter time reversal.

[Features of nutritive correction in swimmers during their training in conditions of midlands].

The efficiency of the correction of diet using dietary supplements and special foods for athletes has been evaluated in 21 highly qualified swimmers, aged 17 to 26 years, during training cycle in midlands (altitude 1792 m above sea level). A personalized approach, consisting of the timely correction of individual programs of biomedical support, especially nutritional correction is directly linked to the performance of the functional state of an athlete in the most important period of training in midlands. At the end of training gathering the increase in AcT, ALT blood plasma activity by 18-42% and the reduction in the activity of creatine kinase by 26% in the normal ranges (p < 0.05), as well as increased cortisol level by 35% was noted, indicating an adequate voltage of the body systems in response to the load presented in conjunction with the use of pharmacological correction. Hemoglobin concentration in blood increased by 5.6% (p < 0.05). Assessment of body composition showed that by the end of the training cycle in midlands there was an increase of active cell mass by 3.5% (p < 0.05). Significant (p < 0.05) increase in oxygen consumption (by 7%) along with the improvement of swimming in the 200 m in the zone of anaerobic threshold (ANSP) (by 5%) at the end of the training cycle demonstrate the effectiveness of the training process conditions and effective use of nutritional support.

[The endotoxine aggression in the pathogenesis of postoperative complications in children with Hirsprung disease].

Signs of disseminated intravascular clotting (DIC), which were considered the laboratory sign of the subcompensated endotoxine aggression, were detected in 20 children with the Hirsprung disease, aged 3 months - 11 years. Under the influence of the operation stress the subcompensated DIC transformed to the acute decompensated reaction, which led to early complications, such as anastomosistis with tendency to the insufficiency or stenosis, enterocolitis, etc. The study revealed not only the straight connection between the postoperative complications and endotoxine aggression, but the necessity of preoperative preparation, directed on the decrease of the intestinal endotoxin level and normalization of antiendotoxin immunity.

[Nutritional factors of inflammation induction or lipid mechanism of intestinal endotoxin transport].

Food behavior disorderes (high fat diet) and systematic strong drinks use could be the most important causes of excess intake of intestinal endotoxin (ET) in circulation (endotoxin aggression development) and induction of inflammation. In this work we investigated antiendotoxin immunity activity, ET level and some biochemical parameters in two group of patients, which were treated with orlistat or medical starvation. We suggest that lipid component of food takes a part in mechanism of ET delivery in bloodstream and its recycling in hydrophobic form. High serum ET level in obesity patients could be direct corollary of excess fat intake and strong drinks use. It provides increased lipid absorption in circulation. Fatty tissue could be depot of ET hydrophobic form in organism. We also suggest that lipid mechanism takes a part in ET deposition in bloodstream. Prolonged starvation and anorexia leads to development inflammatory changing like systematic inflammatory response syndrome (SIRS).

[Using diagnostic software module for monitoring the functional reserves of the organism for the estimation of the efficacy of health-improving and rehabilitative programs].

The social implications of the estimation of health reserves and their monitoring becomes increasingly important for early diagnostics of dysfunctional problems associated with the social and occupational activities as well as for the prevention of the development of pathological processes. Taking this fact into consideration, we have designed a diagnostic technology called "health reserves" for the identification of subjects with risk factors of the development of the most widespread diseases that enables the users to perform qualitative assessment of the risks, evaluate functional reserves of the organism, and prognosticate the efficacy of application of non-medicamental technologies for the improvement of the patients' health status. We studied 79 patients aged from 18 to 73 years including 33 (42.8%) men and 44 (57.2%) women at their admittance to the clinic and within 2-3 days after discharge. The patients were treated using non-medicamental rehabilitative techniques, such as remedial gymnastics, massage, iodine-bromine baths. The results of the treatment were subjected to the mathematical analysis. The study permitted to determine predictors of efficacy of the non-medicamental treatment and individualized rehabilitation programs.

[Intestinal endotoxin in induction of type 1 diabetes].

We studied serum level of intestinal flora endotoxin (LPS) in 45 children and adolescents aged 3-17 years old with diabetes mellitus type 1. Levels of endotoxin, were significantly elevated in type 1 diabetic patients (2.89 +/- 0.33 Eu/ml) compared with control (0.4 +/- 0.03 Eu/ml). There was significant difference in serum LPS levels in patients with type 1 diabetes onset (3.93 +/- 0.79 Eu/ml) compared with children and adolescent with old time diabetes (2.37 +/- 0.27 Eu/ml). These results have a major implication on our understanding of the role of gut flora endotoxin in pathogenesis of type 1 diabetes.

[Estimation of the functional reserves of the organism and identification of the subjects at risk of common diseases].

The existing system of preventive medical examination of the population engaged in economic activities with the purpose of early diagnostics of a variety of disorders and pathological conditions practically does not use the technologies for the assessment of health reserves and identification of the groups at risk of developing common diseases and premorbid conditions. We examined a total of 67 subjects (32 men and 35 women) and treated the data obtained by using the mathematical methods of statistics. The results were used to develop the "Health Reserves" hardware and software complex whose diagnostic potential and informational content permit to identify individuals at high risk of developing common diseases, quantitatively evaluate functional reserves of the human organism, and predict the efficacy of application of non-medicamental technologies for their enhancement.

[Intestinal endotoxin in the pathogenesis of ocular inflammatory diseases and the antiendoxin constituent of its treatment].

Blood was studied in 119 patients with ocular inflammatory lesions: endophthalmitis (n = 10), iridocyclitis of viral (n = 47) and unknown (n = 62) genesis, by using the procedures developed by the authors to determine the integral values of the concentration of endotoxin in systemic blood flow and the activity of antiendotoxin immunity. Intestinal endotoxin aggression was found to be involved in the pathogenesis of ocular inflammatory diseases. The use of drugs and procedures, which could diminish the entry of intestinal endotoxin into the blood stream and intensify the processes of its binding and release from systemic blood circulation, substantially enhanced the efficiency of a therapeutic process.

[Endotoxin aggression as a universal factor of pathogenesis of hemostatic disorders in children with urological pathology].

The role of the kidneys in development of endotoxin aggression and participation of the latter in impaired regulation of hemostasis was demonstrated basing on examination of 30 children with congenital urological pathology. In progressive decline of accumulative-excretory function of the kidneys, compensated chronic endotoxin aggression in children with urological diseases transforms into a subcompensated or uncompensated one with definite clinical manifestation: fever, aggravation of chronic pyelonephritis, marked DIC syndrome, macrohematuria.

[Endotoxin aggression in the development of hemostatic disorders in children with surgical diseases].

The role of endotoxin aggression in the development of hemostatic disorders was analyzed in 62 children who had undergone urgent and elective surgeries. It is demonstrated that indices of endotoxin-antiendotoxin system and hemostasis before surgery may be regarded as prognostic criteria for development of complications during and after surgery.

[The functional activity of anti-endotoxin factors in viral hepatitis A and B]. / Funktsional'naia aktivnost' antiéndotoksinovykh faktorov pri virusnykh gepatitakh A i B.

Bacterial endotoxins (BE) that are lipopolysaccharide complexes (LPS) are a structural component of the external membrane of gram-negative bacteria. In normalcy, BE interact with many types of cells in the mammals. In terms of the concentration, BE may cause cell damage or stimulate the production of many biological mediators, such as interleukins, prostaglandinds, alpha-TNF. Many gastrointestinal bacteria in humans are gram-negative and BE constantly enter the blood. In health, the absence of a toxic response to BE is explained by the presence of natural humoral and cellular antiendotoxic systems and the hepatic absorption of LPS. In patients with hepatitis A and B, the following indices of the blood antiendotoxic systems were determined: the level of antiendotoxic antibodies to Re-chemotype glycolipids was assessed by the passive hemagglutination reaction in the "Antiendotox-1-test"; the count of polymorphonuclear leukocyte (PMNL) fixating LPS on their own surface and endotoxin binding function of PMNL was in vitro measured by the strain ELISA and sandwich ELISA with Re-glycolipids, respectively (LPS-test); the endotoxin fixation function of serum high density lipoproteins (HDL) was also assessed. The humoral and cellular antiendotoxic systems in patients with mild advanced hepatitis A and B was studied when the disease was most clinically significant, at an early convalescence, and at convalescence itself. Finally, the findings indicate that there is a significant decrease in Re-antibody levels and there is a greater absorption ability of HDL than that in the control. Six different types of an antiendotoxic fixation reaction of PMNL were identified in patients with viral hepatitis in the different periods of the disease. The alterations observed may play an important role in the pathogenesis of toxemia in patients with viral hepatitis.

[Myocardial morphology in endotoxic shock]. / Morfologiia miokarda pri éndotoksicheskom shoke.

The myocardium of rabbits with endotoxin shock produced by two intravenous injections (0.1 and 0.3 mg/kg) of the typhoid fever bacillus antigen was studied histologically, histochemically, histoenzymatically and by polarization microscopy. Animals were killed by decapitation 0,5-1,5, 5-10, 24-30, 48-80, 120-194 hours after the 2nd injection; animals dying in the course of experiment were also examined. Morphological substrate of heart insufficiency, morphofunctional heterogeneity of cardiomyocytes of both inner and external myocardial layers were revealed. Hypoxia of a complex origin is the main cause of the above alterations.

[Pathology of the digestive organs and systemic endotoxinemia]. / Patologiia organov pishchevareniia i sistemnaia éndotoksinemiia.

The intestine being a natural depot of the gram-negative bacteria, may be the source of the systemic endotoxinemia in various pathologic processes followed by the increase of bacteria death, mucous membrane damage, pancreas endocrine function deficiency, liver barrier function depression, decrease of the portal circulation speed or its shunting. At the same time, the systemic endotoxinemia in itself may be one of the most important etiological factors of the various digestive organs injury. The authors observations and the literature suggest an important role of the endotoxin-positive granulocytes in the pathogenesis of the haemorrhagic infarct of the intestine, mesenteric vein thrombosis, destructive appendicitis and cholecystitis.

[The role of endotoxin of gram negative bacteria in the pathogenesis of atherosclerosis]. / Rol' éndotoksina gramotritsatel'nykh bakterii v patogeneze ateroskleroza.

Literature data and the results of own research on the role played by lipopolysaccharide (endotoxin) of Gram negative bacteria in the initiation and progressing of atherosclerosis are summarized. Endotoxin promotes activation of all cells taking part in the formation of atherosclerotic plaques, induces the transformation of macrophages of arterial intima into foam cells as well as endothelial lesions and hyperlipidemia, reduces the ratio of cholesterol in lipoproteins of high specific density to total blood cholesterol. With chlamydiae and enterobacteria used as examples, the role of Gram negative bacteria and their endotoxin in the etiology and pathogenesis of atherosclerosis is discussed.

[Role of gram-negative bacterial endotoxins in infectious and non-infectious diseases]. / Rol' éndotoksina gramotritsatel'nykh bakterii v infektsionnoi i neinfektsionnoi patologii.

The role of gram-negative bacteria endotoxin in infectious and non-infectious pathology is reviewed. It is shown that endotoxin may induce some injuries to the lungs, liver, kidney and blood vessels. It is suggested that intestinal microflora endotoxin may take part in the development of many pathological processes. The basis of the endotoxin effect is its capacity to interact with cell membrane. Intravascular blood coagulation and endotoxin shock resulting in the patient's death may occur at high doses of endotoxin.

[Endotoxin of intestinal microflora in liver pathology]. / Endotoksin kishechnoi mikroflory v patologii pecheni.

An important role in the endotoxin immobilization and transport from the intestine into the portal circulation belongs to the granulocytes which are likely able to transfer lipopolysaccharide to Kupffer cells. If the endotoxin diffusion into the mesenterial microvessels increases and (or) the portal circulation speed decreases, the interaction of lipopolysaccharide with granulocytes may become irreversible and facilitate the development of the systemic endotoxemia and the leucocyte-mediated liver damage. Intestinal flora endotoxin takes part in the liver damage pathogenesis in various forms of hepatitis, cirrhosis in various forms of hepatitis, cirrhosis and conditions followed by the circulation deficiency.

[Endotoxin and the polymorphonuclear leukocyte system]. / Endotoksin i sistema polimorfonoiadernogo leikotsita.

Due to its cell pool autoturnover, gram-negative intestinal microflora releasing the biologically active agent lipopolysaccharide may cause portal and systemic endotoxemias. Lipopolysaccharide may function in the activation of the polymorphonuclear leukocyte system and in complex antibacterial homeostatic processes, and, in some situations be the initiating factor in the development of various organ pathology, which is mediated by hyperactivated granulocytes.

[Detection of the endotoxin of Gram-negative bacteria in human blood]. / Opredelenie éndotoksina gramotritsatel'nykh bakterii v krovi cheloveka.

Recent new data on the important role played by lipopolysaccharides (endotoxin) of Gram negative bacteria in physiology and pathogenesis of the most important human infectious and noninfectious diseases testify to the necessity of wide clinical trials of different methods for LPS detection in blood and other physiological fluids. Among presently available diagnostic methods for endotoxinemia detection, the highly sensitive LAL (Limulus Amebocyte Lysate) test in various modifications is most widely used. The LAL test is known to be non-specific, however many drawbacks of this test have been successfully overcome. The results of clinical studies on the determination of the LPS activity in the systemic blood stream and antibody titers to its most common determinants, as well as the reserves of endotoxin binding with granulocytes give grounds for optimistic evaluation of the future studies on the role of LPS in human physiology and pathology. In clinical practice both positive sides and drawbacks of the presently known methods for LPS detection, including the LAL test, must be borne in mind for the complex evaluation of endotoxinemia levels.