[POSITIVE EFFECTS OF MODERN IMMUNOCORRECTION ACCORDING TO THE ANALYSIS OF CYTOKINES AND SLPI IN PATIENTS WITH PYELONEPHRITIS].

The peculiarities of cytokines as compounds of immunogenesis are shown in the patients having acute (A) and chronic (Ch) pyelonephritis (PN). The combination of antibacterial therapy with Nukleinat and Galavit promotes the positive changes of cytokin-producing ability of immunocompetent cells and decrease in the level of proinflammation cytokines in blood and urine, secretory leucocyte protease inhibitor (SLPI) in urine. In children with PN and adult patients with diagnostically elevated titres of antibodies (IgG) to Herpes simplex virus, Cytomegalovirus are shown the positive effects of Kanephron® H and Proteflazidum, accordingly. Clinico-immunological effects of immunomodulators testify to the expediency of this usage in complex therapy with the aim to modulate the cytokine link of immunity for improvement of the effective treatment in APN and the protection against aggravation of kidney functioning in ChPN.

[Proinflammatory cytokines in patients with pyelonephritis].

The antiinflammatory cytokines participate in antiinfective immunity, that is why it is advisable to study their peculiarities in determination of the role in immunologic pathogenesis of pyelonephritis. Of the work is to study the levels of pro-inflammatory blood cytokines in the patients with pyelonephritis (PN), to determine the peculiarities in acute and chronic its course in children and adults. The immuno-enzymic method ELISA and the corresponding test-systems were used to study the levels of cytokines in blood. There were studied the levels of pro-inflammatory cytokines (TNF, MCP and IL-23) in blood serum of patients with acute (APN) and chronic (CPN) pyelonephritis. The analysis showed the reliable increase in levels of all studied findings in both forms of PN--both in all 173 patients and in every group--children (87) and adults (86). The MCP-1 levels in APN are reliably higher than in CPN, while in TNF-b and IL-23--do not differ. The levels of all three cytokines in blood of adults were higher than in children in APN, but TNF--in CPN as well. The high level of TNF, MCP-1 and IL-23 in blood of adults and children confirm their important role both in APN and CPN, but MCP-1 can be considered as a predictor of acute/exacerbation of chronic pyelonephritis. By the findings of the studied cytokines, more expressed immune response was noted in the adults.

[The role of immunological mechanisms in the development of the late sequelae of nuclear disasters]. / O roli immunologicheskikh mekhanizmov v razvitii otdalennykh posledstvii iadernykh katastrof.

Effects, both specific and non-specific, were analysed of ionizing radiation in a comparative evaluation of medical sequels of the Chernobyl disaster and of the Semipalatinsk Range nuclear test. A hypothesis is advanced assuming that development of all major bodily morbid conditions is directly related to the dysfunction of certain complex of organs, the thyroid gland in the first place, the thymus gland known to be a central organ of systemic immunogenesis. A breach in the thymus link triggers harmful cascade reactions of neuroimmunoendocrinological regulation, appeared to be responsible for the pathogenesis of practically all pathologies disclosed.

[The level of interleukins (IL-1 and IL-2) and of IL-2R+ cells in patients with acute and chronic pyelonephritis]. / Uroven' interleikinov (IL-1 i IL-2) i IL-2R+ kletok u bol'nykh ostrym i khronicheskim pielonefritom.

It has been shown that in patients with acute pyelonephritis a spontaneous production of the interleukin IL-1 remains unchanged, while that stimulated with the aid of LPS is significantly below the norm. A spontaneous secretion of IL-2 in patients with chronic pyelonephritis has also been found unchanged, whereas in acute pyelonephritis this same parameter tends to rise above the level recordable in healthy donors. The production of this lymphokine stimulated with the aid of PhHA is significantly lower both in acute and chronic pyelonephritis. The level of cells carrying receptors to IL-2 is appreciably above the norm in patients with acute pyelonephritis, whereas in those presenting with the chronic process this parameter does not differ from that in the control group. The data obtained suggest distinctive features in the interleukin link of immunity (IL-1, IL-1, IL-2P) in patients with pyelonephritis.

[Intravascular laser radiation of blood in the multimodality treatment of patients with urogenital tuberculosis]. / Vnutrisosudistoe lazernoe obluchenie krovi v kompleksnom lechenii bol'nykh tuberkulezom mochepolovykh organov.

Laser therapy was performed in 45 patients with tuberculosis of the urinary system and male genitals. The radiation was found to have a positive action on the patients' general condition and short-term immunomodulating effect. Following a month, immunological parameters became baseline or near-baseline. In the course of 5 years there was an exacerbation of tuberculosis in 2 (4 +/- 3%) patients who had received laser therapy and in 8-18% routinely treated without laser therapy.

[The clinico-immunological effects of leukinferon in the treatment of patients with acute suppurative pyelonephritis]. / Kliniko-immunologicheskie éffekty leikinferona pri lechenii bol'nykh s ostrym gnoinym pielonefritom.

A many as 20 patients with acute purulent pyelonephritis were studied for clinical and immunological effects of leukinferone. The above patients were convalescent earlier than control subjects. There were instances where clinical status was not accompanied by shifts in immunity. However, on an average in the group, such parameters as level of lymphocytes, amounts of B-cells, Igs G, A, T-helpers, and Tx/Tc ratio were found to be increased as was activity of EK-cells. Stimulating effects of leukinferone were particularly pronounced in those patients with decreased values for immunological status. A conclusion is reached to the effect that patients with acute pyelonephritis may benefit from those treatments involving the use of the above drug preparation.

[The clinico-immunological effects of T-activin in the combined treatment of patients with acute suppurative pyelonephritis]. / Kliniko-immunologicheskie éffekty T-aktivina v kompleksnom lechenii bol'nykh ostrym gnoinym pielonefritom.

Results were studied of use of T-activin in those clinical settings related to acute inflammatory diseases of the kidneys. There was a positive clinical effect from this preparation in all twenty-eight patients with acute purulent pyelonephritis, accompanied by readjustments in the patients' immune system. A rise to the norm was found to occur in T-helper counts, and accordingly, immunoregulatory index, NK-cell activity, blood microbocydic activity. The in vitro investigations done suggested the need for individual testing of immunocompetent cells of the patient to optimize the therapy.

[The effect of different types of recombinant interferon on the induction of 2,5-oligoadenylate synthetase in natural killers and the tumor cells in bladder cancer patients]. / Vliianie razlichnykh tipov rekombinantnogo interferona na induktsiiu 2,5-oligoadenilatsintetazy v estestvennykh killerakh i kletkakh opukholi u bol'nykh rakom mochevogo puzyria.

Recombinant interferon treatment of donors' and bladder cancer patients' lymphocytes results in activation of natural killer cells which is in correlation with enhanced activity of 2,5-oligoadenylate synthetase in them. The study of sensitivity of bladder cancer cell primary cultures showed that the cells are sensitive to various interferons virtually in all the cases observed as indicated by high synthetase activity. The baseline level of 2,5-oligoadenylate synthetase in tumor cells surpassed that in natural killers from healthy donors which may be related to elevated levels of serum gamma-interferon in the above patients.

[Fibronectin and its significance in pyelonephritis]. / Fibronektin i ego znachenie pri pielonefrite.

Fibronectin levels were measured by enzyme immunoassay in 68 patients with pyelonephritis and 10 patients with chronic cystitis. The patients with chronic cystitis, acute and chronic non-obstructive pyelonephritis exhibited significantly high average blood fibronectin levels, whereas those with chronic obstructive pyelonephritis displayed the levels slightly different from those observed in healthy individuals. Hypofibronectinemia was detected in 23.3% of patients with chronic pyelonephritis. Preincubation of the neutrophils isolated from pyelonephritis patients with fibronectin increased the initially low phagocytic capacity without enhancing their metabolic activity. In experimental pyelonephritis, administration of exogenous fibronectin was demonstrated to contribute to a rapid bacterial elimination from the kidneys, to decrease the intensity of an inflammatory response, to prevent renal histostructural lesions, to enhance the functional activity of immunocompetent cells and to stabilize their membranes. The findings may serve the basis for using fibronectin in clinical practice as a promising agent to treat pyelonephritis.

[Cross-reacting HLA antigens as a factor increasing the risk of childlessness in a family]. / Perekrestnoreagiruiushchie antigeny sistemy HLA kak fator, povyshaiushchii risk bezdetnosti v sem'e.

A comparative analysis of HLA phenotypes of fertile and infertile spouses revealed that among the infertile the sum of spouses showed compatibility in two or three HLA antigens. A detailed analysis also showed that 10 infertile couples exhibited identical and 2 antigens with a similar structure and function with so-called cross-reactions increasing the histocompatibility index to 75%. The significance of these facts for infertility risk factors is discussed.

[The use of prostatilen in treating patients with prostatic diseases]. / Primenenie prostatilena pri lechenii bol'nykh s zabolevaniiami predstatel'noi zhelezy.

A clinical trial of polypeptide prostatic preparation prostatilen has been performed in 37 and 15 patients with chronic prostatitis and prostatic adenoma, respectively. The treatment resulted in attenuation of algetic and dysuria symptoms. Copulative function and spermatogenesis improved. The uroflowmetric index rose, while residual urine and leukocyte count in prostatic secretion reduced. The drug demonstrated antibacterial and immunomodulation effects in the absence of adverse reactions. Prostatilen is indicated in: chronic prostatitis, prostatic adenoma stage I, normospermatogenic and toxic sterility, interoceptive copulative dysfunction, dysuria. The drug in recommended for clinical application.

[Immunity disorders and the increased fatigability syndrome in the residents of the city of Kiev]. / Narusheniia immuniteta i sindrom povyshennoi utomliaemosti u zhitelei g. Kieva.

A clinical and immunological study is presented of 1030 practically healthy persons inhabiting Kiev from the moment of the Chernobyl accident. It was established clinically that during the last 5 years more frequent became acute respiratory viral infections, exacerbation of existing infection foci, appearance of complaints of reduced working capacity, somnolence apathy, increased fatiguability, worsening of memory, periodic subfebrility and oth. This symptom complex was determined as the "increased fatiguability syndrome". It was characterized immunologically by different changes showing most frequently a reduction of the functional activity of natural killers. The authors analyze different variants of immunological disorders in this group of subjects and give practical recommendations on using immunotropic drugs. They emphasize the importance of a service of clinical immunology in Ukraine able to organize special services to the population.

[Immunity and the possibilities for immunomodulation in acute pyelonephritis]. / Sostoianie immuniteta i vozmozhnosti immunomoduliatsii pri ostrom pielonefrite.

The paper presents evidence on dysfunction of natural killer cells and abnormal proliferative response of peripheral blood mononuclears to T- and B-cell mitogens (PHA, Phytolacca) in patients at varying stages of acute pyelonephritis. A number of immunomodulators (recombinant alpha 2-interferon, IL-2 and tactivin) produce different effects on natural killer activity and lymphocyte blast transformation in healthy donors and pyelonephritis patients. Immunotropic effects of immunopeptides depend on the drug dose, the response of various subpopulations of the immunocompetent cells being individual. It is suggested that immune system, natural killer activity in particular, plays an important part in pathogenesis of acute pyelonephritis. In vitro experiments demonstrate that there can be a positive clinical response to tactivin and recombinant alpha 2-interferon administered in doses activating the function of certain immunocompetent cells.

[Acute pyelonephritis and the immunity status]. / Ostryi pielonefrit i sostoianie immuniteta.

The quantitative and functional state of different populations of immunocompetent cells was studied in 45 patients with acute serous and 46 patients with acute purulent pyelonephritis. An imbalance has been found in the system of regulatory cells, activation of phagocytosis with reduction of its reserve capacities, disorders of IL-producing capacity of mononuclears and suppression of the functional activity of NK cells.

Pemphigus and pemphigoid epidermocytes interfere with interleukin cascade reactions.

The aim of this study was to reveal the origin of interleukin cascade reaction disturbances in pemphigus vulgaris (PV) and bullous pemphigoid (BP). We investigated the influence of culture supernatant of epidermal keratinocytes from the skin of PV and BP patients on functional activity of donor peripheral blood mononuclears. It was found that epidermal keratinocyte culture supernatant in the acute phase of PV and BP decreased the ability of mononuclears to proliferate in response to PHA and Con A, secrete interleukin-1 and interleukin-2, and absorb an exogenous interleukin-2. Such inhibitory effect was far less pronounced in epidermal keratinocytes obtained from PV and BP patients at the remission stage. Epidermocytes from healthy subjects stimulated the immunocompetent cell activity. The results obtained indicate that epidermal keratinocytes in the acute phase of pemphigus and pemphigoid produce a putative soluble factor(s), which may be the origin of the immunodeficiency in PV and BP patients.