[Role of biological defects in formation and development of bronchial asthma and potentialities of premorbid diagnosis]. / Rol' biologicheskikh defektov v formirovanii i razvitii bronkhial'noi atmy i vozmozhnosti premorbidnoi diagnostiki.

The paper considers bronchial asthma as a polygenic disease. It presents some data available in the literature on the role of genetic disorders in the development of atopic states and the authors' own findings of various biological defects detected in apparently healthy blood relatives of patients with bronchial asthma. It is concluded that premorbid diagnosis is of importance in high risk persons.

[The effect of adequate therapy on the indices of external respiratory function in patients with arterial hypertension combined with obstructive lung diseases]. / Vliianie adekvatnoi terapii na pokazateli funktsii vneshnego dykhaniia u bol'nykh arterial'noi gipertoniei v sochetanii s obstruktivnymi zabolevaniiami legkikh.

In patients with associated arterial hypertension and obstructive lung diseases, external respiratory function was established to return to normal thanks to adequate hypotensive therapy and administration of the cholinolytic agents combined with antibacterial and antiinflammatory treatment.

[The clinico-functional effectiveness of calcium antagonists in correcting the bronchial hyperreactivity of bronchial asthma patients]. / Kliniko-funktsional'naia éffektivnost' antagonistov kal'tsiia pri korrektsii giperreaktivnosti bronkhov u bol'nykh bronkhial'noi astmoi.

In 46 bronchial asthma (BA) patients, a study was made of the effects of calcium antagonists (CA) (corinfar, perdipine) on bronchial sensitivity and reactivity determined on bronchospasm induction with the increasing doses of acetylcholine. A single intake of 20 mg of a CA in BA patients significantly improved bronchial sensitivity and reactivity (the rise of the PD25 and the decline of the alpha angle). 20 patients were treated with corinfar for two weeks after administration of the basic therapy. As a result, the clinical status as well as bronchial sensitivity and reactivity improved in the majority of BA patients. While assessing the efficacy of the treatment with corinfar after half a year it was established that in 9 out of 13 BA patients, the PD25 increased and the alpha angle diminished. Thus, CA reduce bronchial hypersensitivity and hyperreactivity to acetylcholine in BA patients.

[The efficacy of the magnesium sulfate aerosol treatment of bronchial asthma patients]. / Effektivnost' lecheniia aérozolom sul'fata magniia bol'nykh bronkhial'noi astmoi.

Action of magnesium sulphate (MS) aerosol (solution osmolality 260 mmol/l, pH 6.6) on bronchial sensitivity and reactivity to acetylcholine(AC) and graded exercise as well as bronchial permeability assessed by general plethysmography and pneumotaxography were studied in 49 patients with mild and moderate bronchial asthma. It is shown that when compared to placebo, MS inhalations conducted in the time of attenuating asthma exacerbation improved immediate and long-term responses in atopic and effort asthma. Both in single doses and course administration MS reduced non-specific bronchial hyperreactivity and secretory activity of mast cells. Positive dynamics of bronchoprovocative AC test suggested response to treatment in most BA patients.

[Influence of berotec inhalations on pulmonary gas exchange in patients with bronchial asthma]. / Nekotorye aspekty vliianiia ingaliatsii beroteka na legochnyi gazoobmen u bol'nykh bronkhial'noi astmoi.

AIM: To determine mechanisms inducing changes in lung gas exchange after berotec inhalation in patients with bronchial asthma (BA). MATERIALS AND METHODS: A study was made of external respiration function including estimation of lung transfer factor (TLCO sbh.) and its components--transfer coefficient (KCO), membrane diffusion capacity (DM), pulmonary capillary blood volume (Vc)--by the single breath holding method on CO in 14 healthy persons and 39 patients with BA before and after berotec inhalation. The data were obtained in the absolute values and their changes after berotec inhalation were measured in percent to initial ones. RESULTS: In healthy subjects we did not observe changes of TLCO sbh. and its components after berotec inhalation, only an insignificant decrease of VA eff. was registered (p < 0.01). After berotec inhalation a considerable improvement in Sgaw, FEV1, RPV and a decrease of TLCO sbh., KCO were observed. Changes in TLCO sbh. were caused by a decrease in DM without changes in VA eff. in BA patients with initial normal values of KCO. In patients with smaller initial values of KCO moderate improvement of bronchial permeability without changes in KCO, PaO2 were observed. These changes occurred due to a decrease of VA eff. CONCLUSION: Changes of the transfer factor and its components in patients with BA reflect two types of adaptation reactions in response to berotec inhalation and their role in mechanisms of compensation of gas exchange in the lungs.

[The effect of exercise on the content of biogenic amines and acetylcholine of the blood in bronchial asthma patients]. / Vliianie fizicheskoi nagruzki na soderzhanie biogennykh aminov i atsetilkholina v krovi u bol'nykh bronkhial'noi astmoi.

The content of acetylcholine, histamine and the total amount of catecholamines were measured in blood of 33 patients with bronchial asthma, in 6 patients with preasthma and in 10 practically normal subjects before and after the use of graded exercise (bicycle ergometry). Subgroups of the patients with asthma of effort were singled out. In such patients, exercises resulted in a significant rise of histamine (p less than 0.05) or acetylcholine level (p less than 0.05). Histaminemia was mostly accompanied by an immediate obstructive response of the bronchi to exercise in the distal parts. In patients with a high acetylcholine content, obstruction of the large bronchi was mainly observed, with a slightly delayed response to exercise.

[Chronoprevention and chronotherapy of bronchial asthma]. / Khronoprofilaktika i khronoterapiia bronkhial'noi astmy.

Chronobiological investigation of external respiratory function parameters was conducted in 93 patients with preasthma and bronchial asthma and in 13 healthy persons. The peculiarities of circadian organization of external respiratory parameters which were used for administration of chronotherapy were revealed in the patients. Some time before the appearance of maximum deterioration of indices under study, mostly indices of bronchial permeability, drugs (broncholytics, inhalation steroids and intal) were administered. Objective and subjective methods of assessment of bronchial permeability using a diary of self-evaluation were compared. The substitution of laboratory investigation for self-evaluation will make it possible to widely use chrono-diagnosis and chronotherapy for patients with bronchial asthma, and chronotherapy was found to be more effective than commonly used therapeutic schemes.

[The role of disorders in the homeostasis of divalent cations in the pathogenesis and clinical picture of bronchial asthma]. / Rol' narushenii gomeostaza dvukhvalentnykh kationov v patogeneze i klinicheskoi kartine bronkhial'noi astmy.

Mg and Ca concentrations in the serum, red cells, lymphocytes and 24-h urine were examined in 13 preasthma (PA) patients, 26 atopic asthma patients and 23 bacterial asthma (BA) patients. The patients' age ranged from 15 to 65 years. The measurements were made on AAC-508 absorption spectrophotometer (Hitachi, Japan) and Microlyte selective ionometer (Kone, Finland). Lack of Mg and excess of Ca in blood cells and low Mg values in circadian urine were recorded in all the patients irrespective of the disease variant, phase, course, broncho-obstruction. Changes in cell electrolyte composition in asthma and PA patients seem to disturb cAMP metabolism and to enhance lipid peroxidation, thus being responsible for bronchial hyperreactivity. Superactivation of free-radical lipid peroxidation in cellular membranes is suggested to underlie, among other factors, defective intracellular homeostasis of bivalent cations in the above patients.

[Peculiarities of cell reception in bronchial asthma patients with bronchial hyperreactivity to hyperosmolar provocation]. / Osobennosti kletochnoi retseptsii u bol'nykh bronkhial'noi astmoi s giperrektivnost'iu bronkhov na giperosmoliarnuiu provokatsiiu.

AIM: To investigate characteristics of the cell receptor systems in bronchial asthma (BA) patients with bronchial hyperreactivity (BHR) induced by hyperosmolar provocation. MATERIALS AND METHODS: 15 patients with BA, in most cases atopic, in remission were studied. The bronchoprovocative test (BPT) with ultrasonically nebulized 3.6% hypertonic NaCl solution (UNHS) FEV1-control was performed. Cell receptors reactivity was analysed on the model of erythrocyte resistance (ER) to hyperosmolar provocation (HP) under the modulation by adrenergic and histaminergic agents. RESULTS: It was revealed that ER was significantly higher (p < 0.05) in BA patients with BHR to UNHS under histaminergic modulation, but ER did not differ in BA patients with or without BHR to UNHS under the adrenergic modulation. The correlation was found between DFEV1 on BPT and magnitude of ER to HP under the blockade of H1-histaminergic receptors (r = 0.72; p < 0.02). CONCLUSION: The development of BHR to hyperosmolar stimulus may be due primarily to disturbance of histaminergic receptor system.

[The therapeutic potentials of Ditec in bronchial asthma patients]. / Terapevticheskie vozmozhnosti ditéka u bol'nykh bronkhial'noi astmoi.

Ditec effects on clinicofunctional status were investigated in 15 patients with mild and moderate atopic bronchial asthma (ABA) aged 20-50 (5 males and 10 females). A single ditec dose had a broncholytic effect along the entire bronchial tree and reduced sensitivity to acetylcholine. Magnesium sulfate (a single dose 3 mmol Mg2+, pH 6.6, the solution osmolality 260 mmol/l) potentiated ditec action on nonspecific hyperreactivity of the bronchial tree. Four-week ditec course induced no considerable changes in bronchial permeability, but increased reversibility of bronchial obstruction, inhibited sensitivity and response of the bronchial tree to acetylcholine. Course administration of ditec lowered endobronchial concentration of histamine and lipid peroxidation intensity showing antiallergic and antiinflammatory properties of the drug. Ditec is recommended for ABA and other asthma forms treatment as a safe and effective modality.

[The results of the dynamic observation of bronchial hyperreactivity in risk-group subjects and in bronchial asthma patients. Some corrective procedures]. / Rezul'taty dinamicheskogo nabliudeniia za giperreaktivnost'iu bronkhov u lits grupp riska i bol'nykh bronkhial'noi astmoi, nekotorye sposoby ee korrektsii.

The following bronchial provocation tests were carried out: 310 with acetylcholine, 216 with submaximal physical exercise, 246 with cold air inhalation, and 103 with aspirin in healthy subjects, relatives of bronchial asthma patients, in patients with preasthma and asthma in a stage of exacerbation abatement or remission. Based on the data obtained the authors show nonspecific hyperreactivity of the bronchi in healthy relatives of bronchial asthma patients, heterogeneity and a high incidence of responses to acetylcholine, cold air and physical exercise, augmentation of the reaction intensity to different stimuli in all asthma patients. The follow-up of bronchial hyperreactivity discovered its progression in the absence of the treatment and the lowering of its intensity as a result of the treatment with calcium antagonists, magnesium sulfate, punctate massage, sublaminal physical exercise, ultraviolet radiation of autologous blood, specific desensitization with aspirin.

[The therapeutic potentials of magnesium sulfate in bronchial asthma]. / Terapevticheskie vozmozhnosti sul'fata magniia pri bronkhial'noi astme.

Twelve patients with preasthma (PA) and 27 bronchial asthma (BA) patients were examined for the effect of magnesium sulphate aerosol on bronchial sensitivity and reactivity to acetylcholine (ACC) and graded physical exercise (GPE) as well as on bronchial patency recorded by general plethysmography and pneumotachography. Inhalation of the drug was established to exert no bronchodilatory action but reduced, as compared with placebo, nonspecific hyperreactivity of the bronchial tree and blocked the ACC induced increment of histamine in the exhaled air condensate. The data obtained allow bronchial smooth muscles and mast cells to be regarded as targets for magnesium sulphate. The drug properties discovered may serve a prerequisite for its use in the combined treatment of BA patients and those with PA.

[Quality of life and characteristics of the external respiration function in patients with bronchial asthma]. / Kachestvo zhizni i pokazateli funktsii vneshnego dykhaniia u bol'nykh s bronkhial'noi astmoi.

AIM: To investigate correlations between quality of life, bronchial obstruction, nonspecific bronchial hyperreactivity (NSBH) and response of these parameters to treatment with inhalation steroids in patients with bronchial asthma (BA). MATERIAL AND METHODS: The study included 67 BA patients (47 women and 20 men) aged 18 to 62 years (mean age 43 years). 59 of them had the diagnosis of atopic BA, 8 had bacterial BA. Quality of life was assessed with the questionnaire AQLQ, bronchial obstruction was judged by forced expiratory volume per a second (FEV1). Bronchial hyperreactivity was studied with acetylcholine and histamine tests. RESULTS: Quality of life strongly correlated with FEV1 and NSBH. Positive changes in the latter due to treatment with inhalation glucocorticoid budesonide (400 mcg/day) entailed improvement of life quality. CONCLUSION: Bronchial obstruction and NSBH have a significant effect on BA patients' life quality which should be considered in monitoring of BA patients' condition.

[Bronchial nonspecific reactivity in patients with bronchial asthma and in the preasthmatic state and its alteration under the influence of acupuncture]. / Nespetsificheskaia reaktivnost' bronkhov u bol'nykh bronkhial'noi astmoi i v sostoianii predastmy i ee izmenenie pod vliianiem akupunktury.

The development of nonspecific bronchial hypersensitivity and hyperreactivity in bronchial asthma and effectiveness of its correction with acupuncture were investigated in 152 patients with asthma and preasthma. 94 of them were subjected to acupuncture. The authors employed a complex of diagnostic methods with determination of 241 parameters processed later with the use of systemic modelling. Bronchial hypersensitivity as indicated by the response to acetylcholine was related to impaired coordination of bronchomotor tone regulating systems: parasympathetic part of the autonomic nervous system, eosinophilic and monocytic bronchial inflammation, glucocorticoid homeostatic alterations. The corrective role of acupuncture consists in reduction of nonspecific bronchial hyperreactivity, normalization of blood acetylcholine, resensitization of cell beta-adrenergic receptors, elevation of mean concentrations of 11-OCS and T-lymphocytes.

[The correction of biological defects in bronchial asthma patients by the methods of Chinese medicine]. / Korrektsiia biologicheskikh defektov u bol'nykh bronkhial'noi astmoi metodami kitaiskoi meditsiny.

42 patients with bronchial asthma underwent combined treatment according to 8 methods of classical Chinese medicine. Partial and complete immediate and long-term responses were achieved in 81% of the patients with asthma diagnosed by Chinese criteria as cold and mixed. Satisfactory results were recorded in 19% of hot bronchial asthma cases.

[The potentials of a unified polyclinic-hospital system in raising the quality of the diagnosis and the efficacy of the differentiated therapy of bronchial asthma patients]. / Vozmozhnosti edinoi sistemy poliklinika--statsionar v povyshenii kachestva diagnostiki i éffektivnosti differentsirovannoi terapii bol'nykh bronkhial'noi astmoi.

The authors review potential approaches to the upgrading of the diagnosis at the out- and inpatient stages of the rendering medical assistance to patients suffering from bronchial asthma (BA). Show the necessity of the counselling specialized aid, additional studies of the signs of atopy, wise combination of non- and medicamentous treatment methods to enhance the efficacy of the treatment of BA patients. Provide evidence for the advisability of solving the organizational problems concerned with a closer interaction of the polyclinic and hospital with the leading medical institutions on the problem "Pathology of the Respiratory Organs".

[Magnesium sulfate in management of bronchial asthma]. / Opyt primeneniia sul'fata magniia v lechenii bol'nykh bronkhial'noi astmoi.

The effect of magnesium sulfate aerosol (osmolality of the solution 260 mmol/l, pH 6.6) on bronchial sensitivity and reactivity to acetylcholine (AC) and graded exercise as well as bronchial permeability measured by general plethysmography and pneumotaxography were evaluated in 49 patients with mild and moderate bronchial asthma (BA). When compared to placebo, magnesium sulfate (MS) inhalations performed at the stage of attenuating exacerbation, improved immediate and long-term response of patients with atopic and effort BA. In this disease, both single and course doses of MS reduced nonspecific bronchial hyperreactivity and secretory activity of mast cells. A positive trend in the parameters of AC provocative test predicted efficacy of MS treatment in the majority of BA sufferers.

[Bronchial reactivity characteristics in EEG variants in bronchial asthma patients]. / Osobennosti reaktivnosti bronkhov pri nekotorykh variantakh EEG u bol'nykh bronkhial'noi astmoi.

The authors' investigations show that those asthmatics who have EEG-recorded lowered convulsion threshold of the cortical neurones exhibit higher hypersensitivity and hyperreactivity of the bronchi than those in patients with intact cortical-subcortical relationships. The interaction of the above parameters demonstrates stable relations between bronchial reactivity and bioelectrical cerebral activity.

[Effects of magnesium sulfate aerosol on indices of external respiration in patients with bronchial asthma]. / Vliianie aérozolia sul'fata magniia na pokazateli funktsii vneshnego dykhaniia u bol'nykh bronkhial'noi astmoi.

Plethysmography and pneumotachography were applied to measure bronchial permeability, and reactivity of the bronchi in 10 patients with pre-asthma and 17 with asthma upon administration of magnesium sulfate aerosol (solution osmolality 260 mmol/l, pH-6.6). Though the drug inhalation did not induce bronchial dilatation, it diminished both hypersensitivity and hyperreactivity of the bronchial tree to acetylcholine. These properties of magnesium sulfate in the absence of unwanted sequelae when introduced endobronchially allow its advocating in combined treatment of asthma and pre-asthma.

[Role of magnesium and calcium ions in the pathogenesis of bronchial asthma]. / Rol' ionov magniia i kal'tsiia v patogeneze bronkhial'noi astmy.

Nuclear absorption spectrophotometry (ACC-508, Hitachi, Japan) and selective ionometry (Microlyte, Kone, Finland) were used to measure Mg and Ca concentrations in the serum, red cells, lymphocytes and 24-h urine of 26 patients with atopic and 23 patients with bacterial bronchial asthma (BA) aged 15-65. Irrespective of BA variant, phase, severity and bronchial obstruction, the blood of the examinees contained insufficient quantities of Mg and excessive ones of Ca. 24-h urinary excretion of Mg was subnormal. BA-specific changes in cell electrolyte composition impair cAMP metabolism and activate lipid peroxidation. This results in emergence of bronchial hyperreactivity. It is suggested that abnormal intracellular homeostasis of bivalent cations in BA patients may be due to hyperactivation of free-radical oxidation of cell membrane lipids.