[Fibrinolytic activity of the urine during chronic glomerulonephritis and amyloidosis]. / Fibrinoliticheskaia aktivnost' mochi pri khronicheskom glomerulonefrite i amiloidoze.

Correlative interconnections between plasminogen activator (PA) activity (fibrin plate method) and level of urokinase antigen (Ag UAP) and tissue PA antigen (Ag TAP) in urine and blood (ELISA) were studied in 60 patients with chronic glomerulonephritis (CGN) and 38 patients with amyloidosis. The high degree of positive correlation between blood and urine initial PA activity and Ag UAP content was found. This suggests the possible leading role of UAP in formation of the basal fluctuations of fibrinolytic activity in blood and urine. High degree of correlation--r = +0.84 and p < 0.001--was found between blood Ag UAP and urine Ag TAP in amyloidosis only. The functional protein loading probe revealed great importance of high urine and blood AP activity in realizing of ultrafiltration renal process--in CGN and amyloidosis.

[Urokinase as a blood and urine plasminogen activator in chronic glomerulonephritis and amyloidosis]. / Urokinaza kak aktivator plazminogena krovi i mochi pri khronicheskom glomerulonefrite i amiloidoze.

To estimate the individual role of the plasminogen activators (PA) urokinase (u-PA) and tissue (t-PA) in the development of two renal diseases (the nephrotic forms of chronic glomerulonephritis (CGN) and amyloidosis, the baseline plasma and urine levels of u-PA and t-PA antigens, their functional activity (FPAA), and changes in these parameters were determined after protein loading test (0.7 g/kg). In healthy individuals and patients with amyloidosis, the baseline FPAA changes from 0 to the maximum were caused only by the alterations of u-PA levels, in those with CGN, they were induced by the changes in the content of u-PA and t-AP antigens. The functional loading test revealed PA reserves solely in patients having a high baseline FPAA for both nephropathies: u-PA in amyloidosis and t-PA in CGN. In all the patients, the urine levels of u-PA antigens were 20-40 times more than those of t-PA antigens and 5-6 times less than those plasma u-PA. The findings suggest that urokinase may be regarded as the major plasminogen activator involved in CGN and amyloidosis.

[Activators and inhibitors of fibrinolysis in chronic glomerulonephritis and amyloidosis]. / Aktivatory i ingibitory fibrinoliza pri khonicheskom glomerulonefrite i amiloidoze.

Functional activities of plasminogen activators (FPAA) and their inhibitors and plasminogen activators's (PA), antigen level were determined in 31 patients with chronic glomerulonephritis, 23 patients with amyloidosis and 15 healthy persons. High FPAA correlated with favourable prognosis of diseases, elevated PA antigen level and diminished alpha 1-antitrypsin, alpha 2-macroglobulin and antiactivator activities. There were decreased PA antigen level and increased inhibitor's activities in group with zero FPAA. Protein loaded functional probe demonstrated the presence of PA reserves in high FPAA patients and "pathological proteolysis" in zero FPAA patients. The last phenomenon was likely connected to nonspecific proteases differed from PA.

[The clinical importance of determining the von Willebrand factor in patients with lupus nephritis]. / Klinicheskoe znachenie opredeleniia faktora Villebranda u bol'nykh volchanochnym nefritom.

Venous occlusion test has found out the reserve of vascular and renal endothelium in excretion of Willebrand factor in patients with inactive lupus nephritis and those with active lupus nephritis with urinary syndrome. In severe active lupus nephritis (lupus nephritis with nephrotic syndrome and rapidly progressive lupus nephritis) it was not recorded. This fact evidences intensity of immune inflammation and coagulation in the kidneys in the above forms of lupus nephritis.

[The venous occlusion test in assessing the fibrinolytic activity of the vascular endothelium in lupus nephritis patients]. / Test venoznoi okkliuzii v otsenke fibrinoliticheskoi aktivnosti sosudistogo éndoteliia u bol'nykh volchanochnym nefritom.

A venous occlusion test was used to evaluate the reserves of the kidneys and that of vascular endothelium fibrinolytic activity (VEFA) in patients with lupus nephritis (LN). Prior to and following venous occlusion functional activity of plasminogen activators in plasma and urine (PAPU), plasma activity of antiactivator (PAAA), urokinase urine activity (UUA) were measured by fibrin plate lysis test in 24 patients with active LN, 6 SLE patients with intact kidneys, 10 healthy subjects. Venous occlusion test revealed normal reserve of plasma activator activity in mild LN and depletion of this reserve in LN patients with nephrotic syndrome and rapidly progressive LN. In the latter patients PAPU and PAAA were suppressed. PAPU reserve existed in all the patients, but those with rapidly progressive LN. UUA in LN was close to normal and did not change significantly after venous occlusion. The data obtained suggest that patients with severe LN had reduced reserves of VEFA, while in those with progressive LN there were also diminished reserves of renal fibrinolytic activity reflecting the severity of endothelial lesion.

[The functional activity of plasminogen activators in the blood plasma and urine of patients with lupus nephritis]. / Funktsional'naia aktivnost' aktivatorov plazminogena v plazme krovi i v moche bol'nykh volchanochnym nefritom.

A fibrin plate technique was employed to study functional activity of plasminogen activators in plasma and urine (FAAP, FAAU), activity of antiactivator in plasma (AAAP), urokinase urine activity (UUA) in 35 lupus nephritis (LN) patients. The latter comprise 3 groups by the disease severity: 22 patients with active LN attended by urinary syndrome (group 1), 7 patients with LN associated with nephrotic syndrome (group 2), 6 patients with rapidly progressing LN (group 3). Control groups included 5 SLE patients with unaffected kidneys and 25 healthy subjects. FAAP proved heterogeneous both in SLE and healthy subjects. SLE patients with progressive LN had diminishing FAAP which was accompanied by growing AAAP. The latter reached maximal values in groups 2 and 3. UUA declined with LN aggravation. The relation of low FAAP in LN patients to affection of vascular endothelium and binding of plasminogen activators with the inhibitors to form inactive complexes is considered.

[The effect of a protein loading test on the fibrinolytic system in patients with chronic glomerulonephritis and amyloidosis]. / Vliianie belkovoi nagruzochnoi proby na fibrinoliticheskuiu sistemu u bol'nykh khronicheskim glomerulonefritom i amiloidozom.

Investigation of the reserves of the fibrinolytic system with the aid of protein stimulation was carried out in 10 patients with chronic glomerulonephritis and in 10 patients suffering from amyloidosis. All the patients manifested proteinuria exceeding 3.5 g/day and other symptoms of nephrotic syndrome of varying intensity. Renal function was preserved in all the patients. The reserves of the fibrinolytic system were measured by analyzing blood plasma and urine before and after beef protein stimulation. The data revealed reciprocal responses of activator activity in blood plasma and urine in patients suffering from chronic glomerulonephritis and amyloidosis. In patients with amyloidosis, the test revealed complete depletion of activator activity in urine while its considerable reserves were preserved in blood plasma of the systemic channel.

[Antistreptococcal antibodies in the blood serum of glomerulonephritis patients]. / Protivostreptokokkovye antitela v syvorotke krovi u bol'nkyh glomerulonefritom.

To study humoral antistreptococcal immunity, 29 patients with acute glomerulonephritis (AGN), 211 patients with chronic glomerulonephritis (CGN) and 30 healthy donors were examined. According to EIA, blood sera of the indicated groups demonstrated antibodies (AB) to structural components of Streptococcus--A-polysaccharide (A-ps) and hyaluronic acid (HA) and to its extracellular products--streptokinase (SK) and streptolysin-O (ASLO). It has been shown that in the blood of AGN patients, the levels of AB to A-ps, SK and ASLO were high. The highest level of AB and SK was detected in 55% of the patients with the disease standing of up to half a year. In patients of all the clinical groups of CGN, the levels of AB to A-ps, SK and HA were elevated. The degree of the rise of the levels of all AB depended on the disease activity. Of prognostic importance in the chronicity of AGN and progression of CGN are high titers of AB and SK. The etiological role of streptococcus in glomerulonephritis and its importance in CGN exacerbation and prognosis are under discussion.

[Laser treatment of patients with chronic glomerulonephritis]. / Lazernaia terapiia bol'nykh khronicheskim glomerulonephritis.

Helium-neon laser therapy of patients suffering from mixed and nephrotic glomerulonephritis demonstrated hypotensive, diuretic and fibrinolytic activity boosting clinical effects. The use of the new treatment method seems to be justified, since all the patients given laser therapy manifested pronounced resistance to the pathogenetic therapy carried out previously (glucocorticoids, cytostatics, hypotensive and diuretic drugs). The presence of diverse effects and lack of complications suggest a broader-scale use of laser therapy in nephrology. At present the authors are analyzing the ++patho-chemical bases of the therapeutic efficacy of laser therapy of patients suffering from chronic glomerulonephritis. The results will be reported in the next paper.

[A substrate inhibitor analysis of the urinary excretion of tissue and plasma kallikreins in patients with chronic glomerulonephritis]. / Substratno-ingibitornyi analiz mochevoi ékskretsii tkanevogo i plazmennogo kallikreinov u bol'nykh khronicheskim glomerulonefritom.

The usage of substrate inhibitor analysis made it possible to estimate the levels of excretion of plasma proteinases, including plasma kallikrein in the urinary DValLeuArgpNA (S-2266)- and DProPheArgpNA (S-2302)-amidase activity in patients with latent and nephrotic types of chronic glomerulonephritis (CGN). The soya bean trypsin inhibitor, an inhibitor of plasma kallikrein and other plasma proteinases, such as that of the blood coagulative factors XIa and XIIa, and the high selective plasma kallikrein inhibitor DPhePheArgCH2Cl were used as those differentiating kallikreins of tissue and plasma origin. The S-2266 and S-2302-amidase activity of the urine from healthy subjects was shown to be determined by only tissue (renal) kallikrein. The urine from the patients with a latent CGN type displayed the activity of plasma proteinases, but plasma kallikrein made no significant contribution to the urine amidase activity in these patients. With a nephrotic CGN type, great quantities of trypsin-like proteinases were secreted from the plasma through the glomerular filter into the urine, the proportion of plasma kallikrein in the urinary S-2266 and S-2302-amidase activities being approximately 27%. The compensatory and pathogenetic role of plasma kallikrein is discussed if there is lower excretion of tissue (renal) kallikrein in CGN with the nephrotic syndrome.

[Components of kallikrein-kinin system in the urine of patients with glomerulonephritis]. / Komponenty kallikrein-kininovoi sistemy v moche bol'nykh glomerulonefritom.

Activities of main components of the kallikrein-kinin system: tissue (renal) and blood plasma kallikreins, kininases I and II, bradykinin-activating activity as well as free kinins, were estimated in urine of patients with latent and nephrotic forms of glomerulonephritis as compared with those parameters in urine of healthy persons. Content of tissue kallikrein was decreased in urine of patients with nephrotic form of glomerulonephritis as distinct from the disease latent form and healthy persons. At the same time, urine of these patients with nephrotic form contained elevated amount of blood plasma kallikrein and other proteinases of blood plasma origin. Bradykinin-inactivating activity as well as activities of kininase I and II were increased in urine of patients with the disease latent form 2-, 7- and 2.5-fold, respectively, and in urine of patients with nephrotic form--40-, 45- and 40-fold, respectively as compared with normal state. Daily excretion of free kinins with urine of healthy persons constituted 6.6 +/- 0.9 micrograms-eqv of bradykinin (BK), in patients with latent and nephrotic forms of glomerulonephritis--1.7 +/- 0.3 and 2.8 +/- microgram-eqv BK, respectively. Three kinins were found in all the examined persons when urine was collected in acid medium: BK, lysyl-BK and Met-Lys-BK; content of BK was minimal in urine of healthy persons and maximal--in urine of patients with nephrotic form of the disease. Clinical importance of the patterns studied and their role in correction of treatment course of patients with nephrotic form of glomerulonephritis are discussed.

[The clinico-morphological characteristics of psoriatic nephropathy]. / Kliniko-morfologicheskie osobennosti psoriaticheskoi nefropatii.

Based on studying the data obtained during examination of patients with psoriasis combined with the urinary syndrome possible varieties of psoriatic nephropathy, namely chronic glomerulonephritis (CGN) and amyloidosis were distinguished. CGN combined with psoriasis was mainly represented by latent glomerulonephritis (GN) and morphologically, it was mostly represented by the mesangio-proliferative variant, with IgA and C3 being fixed on the basal membrane of the capillaries and in the mesangium. The clinicomorphological feature of that form of psoriatic GN is combination of the signs of both associated CGN and hyperuricemia and IgA-nephritis. Special emphasis is laid on the diagnosis of rapid-progressing GN which is of paramount importance for institution of early etiopathogenetic therapy. Amyloidosis associated with psoriasis is characterized by the signs of acquired disease (AA-amyloidosis) and does not differ in its course from amyloidosis coupled with other diseases.

[Clinical value of the study of hemostasis in nephrology]. / Klinicheskoe znachenie issledovaniia gemostaza v nefrologii.

The results of many-year studies on the humoral and platelet links of hemostasis in chronic glomerulonephritis (CGN) and amyloidosis were analyzed with relation to a stage of disease and prognosis of its course. Activation of the blood coagulation system (BCS), platelet hyperaggregation and suppression of the fibrinolytic system were revealed in CGN. Hypercoagulation was most noticeable in patients with active and prognostically unfavorable GGN types correlating with the frequency of local (in the kidney) intravascular coagulation, the frequency of peripheral thromboses and DIC-syndrome. In amyloidosis hypercoagulation shifts of BCS were combined with the activation of fibrinolysis and thrombocytopenia. Pathogenetic, adaptive and compensatory significance of changes of system of hemostasis revealed in CGN and amyloidosis was discussed.