[Neutrophil bactericidal and absorptive function in gout].

AIM: To study neutrophil bacterial and absorptive functions and the specific features of their impairments in gout. SUBJECTS AND METHODS: The study included 48 male patients with a valid diagnosis of gout (mean age, 59.7 +/- 10.3 years; duration of the disease, 9.2 +/- 2.1 years; blood uric acid (UA), 520 +/- 80 micromol) (Group 1); 25 apparently healthy volunteers (mean age 55.1 +/- 6.2 years; blood UA, 350 micromol/l) (Group 2). Neutrophil functional activity was estimated from the phagocytic-nitroblue tetrazolium reduction (NBT test) and myeloperoxidase (MPO) activity, the determination of non-enzyme cationic proteins (CP) and their spontaneous and induced indices. Neutrophil phagocytic function was also studied. RESULTS: In Group 1, the content of active oxygen forms (AOF) was increased, on average, to 113.3 +/- 8.65 conventional units (CI) versus 88.22 +/- 5.23 CI in Group 2; p < 0.05). In 34 (70.8%) of the 48 male patients with gout, spontaneous MPO activity was significantly reduced as compared with that in Group 2: 348.4 +/- 13.6 and 509.2 +/- 12.2 CI, respectively (p < 0.01). In Group 1, the level of CP was noticeably decreased to 60.1 +/- 2.06 CI whereas in Group 2, it was 84.91 +/- 5.36 CI (p < 0.05). In gouty patients, the CP stimulation index averaged 0.70 +/- 0.13; in Group 2, it was significantly higher--1.2 +/- 0.05 (p < 0.05). CONCLUSION: In the majority of gouty patients, neutrophil functional activity suffers due to its lower phagocytic function, which suppresses the body's antioxidant defense and contributes to the chronic pattern of an inflammatory process.

Pathogenetic aspects of severe course of herpetic infection.

We studied the state of antiviral defense in patients with severe course of herpetic infection of anogenital and labial localization and the frequency of its combination with other herpes virus infections. It was found that severe course of herpetic infection caused by herpes simplex virus occurs against the background of combined secondary immunodeficiency and its complication. We first demonstrated that severe course of the disease is associated with mixed viral infection.

[Severe herpetic infection].

AIM: To study antiviral defense in patients with severe anogenital and labial herpetic infection, prevalence of herpetic infection and possible combination with other strains. MATERIAL AND METHODS: The immune status (basic lymphocyte subpopulations, IgA, IgM, IgG, circulating immune complexes in blood serum, cytokines, interferon status, functional activity of neutrophils) was investigated in 102 patients with severe Herpex simplex infection (HSI). RESULTS: Marked deficiency and hyporeactivity of natural and/or specific cytotoxicity were found in 70% HSI patients with severe disease. CONCLUSION: Severe HSI runs in serious combined secondary immunodeficiency, its complications and is an active mixed viral infection.

[Individual changes of gene expression in the interferon system in human blood cells due to amixin and cycloferon].

The action of amixin and cycloferon on the expression of genes in the systems of interferon (IF) and cell apoptosis (CA) was studied by semi-quantitative RT-PCR in human blood microsamples before and after the administration of the drugs. Individual changes were determined in the transcription activity of genes of IF (alpha, beta, gamma), enzymes 2',5' oligoadenylatesynthetase (OAS), RNSase L, dsRNA-dependent proteinkinase (dsPK) and of CA effectors (FasAg, bcl-2, gamma-actin) registered dynamically in 24 h and 48 h. The activity parameters of IF genes were compared with the results of biological titration of IF activity in blood samples in vivo and in vitro. A pronounced ability of cycloferon to stimulate selectively the activity of genes of human IF, type I (beta IF--by 100 times and alpha IF--by 10 times), without affecting essentially the activity of other genes in blood cells, was detected. Amixin was found to inhibit the titration of genes with high activity levels. (alpha-, beta-IF, RNAases L, bcl-2 and gamma-actin). The antiviral and IF-induced properties of the drug are explained to a great extent by the apoptotic effect (activation of genes Fas, gamma-IF, OAS and affected transcription of gene bcl-2). A positive correlation was observed between the processes of activation of IF-genes transcription and the production of the total circulating IF. Antagonistic relations between type I and II IFs in human blood cells were shown.

[Drug intolerance]. / K voprosu o neperenosimosti lekarstvennykh sredstv.

The authors present experimental data on luminol-dependent neutrophil chemiluminescence of blood from patients with drug intolerance. A decrease in intensity of neutrophil and whole blood chemiluminescence was registered in the presence of intolerated drugs. In acute phase of generalized intolerance reaction the chemiluminescence test showed readiness of the blood cells to react inadequately to the contact with different drugs leading to variations in generation of active oxygen forms. Improvement in patients' condition was followed by narrowing spectrum of drugs causing a decrease in the intensity of the chemiluminescence. Later, the chemiluminescence ratio remained low in testing only those drugs causing intolerance reaction.

[The clinical efficacy and pharmacokinetic characteristics of theopek and theobiolong in bronchial asthma patients]. / Klinicheskaia éffektivnost' i osobennosti farmakokinetiki teopéka i teobiolonga u bol'nykh bronkhial'noi astmoi.

The pharmacokinetics of theopec (TP) and theobiolong (TB) was studied and compared to theotard and durophylline in 24 bronchial asthma patients. The efficacy of the continuous use of TP and TB was examined in 64 patients. Theophylline (TPh) was absorbed from TP tablets according to the laws of the kinetics of the first order, i. e. one-third of the dose was absorbed rapidly whereas the remaining two-thirds 7.5 times were slowly. The kinetics of TPh absorption from TW was marked by the zero order at a constant rate of 45 mg/h. The volume of distribution, the elimination rate constant, the total clearance, and bioavailability of the drugs under comparison did not differ significantly. During continuous treatment with TP and TB, equiponderant concentrations of TPh were attained by the 4th day, the mean maximum concentration of TPh for TP was 10.6 +/- 1.8, that for TB 9.6 +/- 0.9 micrograms/ml. By the 7th day of the treatment with TP and TB a beneficial clinical effect was reached in 79 and 81% of the patients, respectively, in spite of the fact that there was no well-defined correlation with the changes in the volume of forced expiration per second. During TP and TB intake, the side effects common to TPh occurred equally often (in 19 and 23% of cases, respectively), but they were short-lived and disappeared by themselves or after correction of the dosage. As for TP, the side effects were mostly recorded on the part of the gastrointestinal tract whereas TB provoked tachycardia, cardialgia which should be taken into account in cases where the drug is prescribed to patients with concomitant diseases.

[Bronchoconstrictive and bronchodilating effects of acetylsalicylic acid in patients with bronchial asthma]. / Bronkhokonstriktornoe i bronkhodilatiruiushchee deistvie atsetil- salitsilovoi kisloty u bol'nykh bronkhial'noi astmoi.

An aspirin test has been performed in 100 asthma patients. The response of the bronchi appeared contradictory: aspirin asthma on the one hand, and bronchodilatation on the other occurred in 31 and 28 patients, respectively; 41 patients appeared nonresponders. Maximum effect of the drug was noted in the small bronchi. Desensitization to aspirin and hemosorption reduced asthma patients sensitivity to nonsteroid antiinflammatory drugs.

[The effect of the plasma of patients with asthma of physical effort on the energy state of the lymphocytes]. / Vliianie plazmy bol'nykh astmoi fizicheskogo napriazheniia na énergeticheskoe sostoianie limfotsitov.

The effect of the plasma obtained before and after graded submaximal exercise was examined in 10 bronchial asthma patients with the syndrome of asthma of physical effort (APE) by means of fluorescent exploration using the cation probe 4-(p-demethylaminostyryl)-1-methylpyridinum and rat thymocytes as a test system. Four normal donors and five bronchial asthma patients without the APE syndrome were used as control. The plasma of patients with the APE syndrome, obtained after physical exercise, brought about a decrease of the number of fluorescent cells. In APE patients, the coefficient of the drop of thymocyte fluorescence amounted to 0.65 +/- 0.04, that in the control group to 1.1 +/- 0.08 (p less than 0.01). It is assumed that after physical exercise in the plasma of APE patients, there may occur factor depolarizing the membrane of thymocytes, which is likely to play a substantial role in the pathogenesis of the afterload bronchospasm.

[Hemosorption in the treatment of aspirin-induced bronchial asthma]. / Gemosorbtsiia v lechenii bol'nykh aspirinovoi bronkhial'noi astmoi.

Oral aspirin test was performed in 50 asthma patients. Of them 18 patients exhibited idiosyncrasy to the drug. All the patients were subjected to hemosorption. Subsequently, 16 patients achieved remission. The hemosorption resulted in reduction of tracheobronchial hypersensitivity, especially to PGE2 alpha. Phagocytosis and T-cell immunity returned to normal. Sixteen patients underwent aspirin desensitization which had a more potent action on the function of beta-adrenergic receptors of the smooth muscles of the bronchi. Complete desensitization in 3 patients was recorded only after 1-3 hemosorption sessions.

[A case of hereditary angioneurotic edema provoked by functional insufficiency of C1-inactivator]. / Sluchai nasledstvennogo angionevroticheskkogo oteka, obuslovlennogo funktsional'noi nedostatochnost'iu C1- inaktivatora.

The hemolytic activity of complement, the concentration of C1-inactivator, of C1q and C4 components of complement as well as the activity of contact-activated kallikrein and the functional activity of C1-inactivator were studied in the plasma of a female patient with hereditary angioneurotic edema (HAE), of her mother, sister and normal donors. The hemolytic activity of complement, the concentration of C1-inactivator and C1q in the blood plasma of the persons examined turned out unchanged as compared with the same parameters in donors. Meanwhile in the patient with HAE and her mother with symptoms similar to HAE, the concentration of C4 appeared lower than that in the patient's sister not suffering from the disease and in donors. The activity of contact-activated kallikrein in the plasma of the patient's sister and mother exceeded the activity of the enzyme in donors. The least activity of plasma kallikrein was recorded in the proband. The functional activity of C1-inactivator in the proband constituted 50-60% of the activity of that parameter in her sister and donors. The magnitude of the functional activity of C1-inactivator in the patient's mother approximated its magnitude in the proband. Therefore, the development of HAE in the given case was mainly provoked by functional insufficiency of C1-inactivator. The magnitude of the spontaneous TAME-esterase kallikrein-like activity in the blood plasma of the patient with HAE remained within normal.