Lambda interferon (IFN-lambda) in serum is decreased in hantavirus-infected patients, and in vitro-established infection is insensitive to treatment with all IFNs and inhibits IFN-gamma-induced nitric oxide production.

Hantaviruses, causing hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), are known to be sensitive to nitric oxide (NO) and to pretreatment with type I and II interferons (alpha interferon [IFN-alpha]/IFN-beta and IFN-gamma, respectively). Elevated serum levels of NO and IFN-gamma have been observed in HFRS patients, but little is known regarding the systemic levels of other IFNs and the possible effects of hantaviruses on innate antiviral immune responses. In Puumala virus-infected HFRS patients (n = 18), we report that the levels of IFN-alpha and IFN-beta are similar, whereas the level of IFN-lambda (type III IFN) is significantly decreased, during acute (day of hospitalization) compared to the convalescent phase. The possible antiviral effects of IFN-lambda on the prototypic hantavirus Hantaan virus (HTNV) replication was then investigated. Pretreatment of A549 cells with IFN-lambda alone inhibited HTNV replication, and IFN-lambda combined with IFN-gamma induced additive antiviral effects. We then studied the effect of postinfection treatment with IFNs. Interestingly, an already-established HTNV infection was insensitive to subsequent IFN-alpha, -beta, -gamma, and -lambda stimulation, and HTNV-infected cells produced less NO compared to noninfected cells when stimulated with IFN-gamma and IL-1beta. Furthermore, less phosphorylated STAT1 after IFN treatment was observed in the nuclei of infected cells than in those of noninfected cells. The results suggest that hantavirus can interfere with the activation of antiviral innate immune responses in patients and inhibit the antiviral effects of all IFNs. We believe that future studies addressing the mechanisms by which hantaviruses interfere with the activation and shaping of immune responses may bring more knowledge regarding HFRS and HCPS pathogenesis.

[Study of the function of leukocyte adhesion molecules in chronic respiratory diseases].

OBJECTIVE: To study the function of leukocyte adhesion molecules in the pathogenesis of Chronic Obstructive Pulmonary Diseases (COPD) and cor pulmonale, and to evaluate the effect of anti-leukocyte-adhesion therapy for cor pulmonale. METHODS: The positive expression rates of CD(11a), CD(11b), CD(18), CD(54) in peripheral blood were quantitatively analyzed by flow cytometry using monoclonal antibodies in 42 cases of COPD (stable stage), 41 cases of cor pulmonale (stable stage), 24 healthy controls as well as 20 cases of cor pulmonale who had taken huobahua. RESULTS: The expression rates of CD(11a), CD(11b), CD(18), CD(54) in monocytes and CD(11a) in lymphocytes from the COPD group were much higher than those in the control group (P < 0.05). CD(11a), CD(11b), CD(18), CD(54) in neutrophils and CD(11a), CD(18), CD(54) in monocytes, and CD(18) in lymphocytes in the cor pulmonale group were significantly stronger than those in the control group (P < 0.05); whereas the positive expression of CDs was greatly reduced in the cor pulmonale patients who had taken huobahua (P < 0.05). No differences were found in other groups. CONCLUSIONS: Upregulation of CD(11a)/CD(18), CD(11b)/CD(18), CD(54) in monocytes, CD(11a)/CD(18), CD(11b)/CD(18), CD(54) in neutrophils and CD(11a)/CD(18), CD(54) in monocytes in cor pulmonale may promote adhesion of leukocytes with endothelial cells, which may play an important role in the pathogenic process. Huobahua may prevent the development of cor pulmonale by down regulating the expression of CDs.

[Influence of MP infection on immunologic function in patients with chronic obstructive pulmonary disease].

The aim of this study was to detect Mycoplasma pneumoniae(MP) in sputum with chronic obstructive pulmonary disease(COPD) by using polymerase chain reaction and measured the level of sIL-2R in chronic pulmonary heart disease(CPHD) patients by Enzyme Linked Immnosorbert Assay(ELISA). At the same time, we also measured the level of the serum total IgE in CPHD patients. We determine the relationship between the sIL-2R and lymphocytes. The results showed that rate of MP infection in COPD patients was 34.59%. The rate of MP infection in CPHD patients and asthmatic patients were significantly higher than that in patients with chronic bronchitis. The level of sIL-2R in patients with CPHD who had MP infection increased significantly higher than that in CPHD patients which didn't have MP infection. There was a linear negative correlation between the level of sIL-2R and lymphocytes. The level of serum total IgE in CPHD patients with MP infection was higher than that in patients with other infection. These data suggest that MP is a common agent in COPD patients, particularly in CPHD and asthma. MP infection can impair the cellular immunity and immunotherapy combined with antibiotics may be more effective.

[Hemosorption in the treatment of chronic pulmonary heart in patients with tuberculosis]. / Hemosorbtsiia v lechenii khronicheskogo legochnogo serdtsa u bolnykh tuberkulëzom.

Hemosorption was tried in 32 patients with pulmonary tuberculosis complicated with chronic cor pulmonale. Hemosorption is shown to regulate hemodynamics and immunological condition of the above patients. Thus, CIC levels lowered to normal, while IgM tended to elevation, systolic pressure in the pulmonary artery decreased, hemodynamic shifts got corrected.

[Development of chronic cor pulmonale in restrictive and obstructive pulmonary dysfunctions]. / Razvitie khronicheskogo lëgochnogo serdtsa pri restriktivnom i obstruktivnom tipakh narusheniia funktsii lëgkikh.

A total of 2840 patients with pulmonary tuberculosis and bronchial asthma were studied. Antigens are shown to induce a systemic vascular response with elevated systolic pressure in the pulmonary artery, peripheral venous spasms. There is activation of the sympathoadrenal system and desensitization of beta-adrenoreceptors with lower levels of cyclic adenosine monophosphate (CAMP). There is a direct correlation between the CAMP levels and the cardiac output, between those and the pulmonary systolic pressure (PSP). This determines hyperkinetic hemodynamics in tuberculosis with the volume- and pressure-loaded heart. Paresis of pulmonary circulation, as well as hypokinetic hemodynamics occur as a result of an allergic immunological reaction in severe fibrocavernous processes in the area of tuberculosis. There is a direct correlation between the circulating immune complexes and CAMP. In bronchial asthma microcirculation is impaired due to antigenic exposures and elevated intrathoracic pressure. Pulmonary capillary reduction in restrictive processes results in higher levels of CAMP and right-to-left shunt, leading to hypoxemia. In obstructive pulmonary diseases, hypoxemia is caused by hypoventilation and impaired ventilation-perfusion ratios.

[Changes of immunologic function in patients with COPD induced chronic cor pulmonale].

We determined the counts of lymphocyte subpopulation CD3+, CD4+, CD8+ and CD16+ in PBL by using APAAP method and some humoral immunological parameters (HIP) in patients with COPD induced chronic cor pulmonale. The results showed: (1) In cases during exacerbation stage, the counts of CD3+, CD4+, CD16+ and the CD4+:CD8+ ratio decreased remarkably (P < 0.001). There was significant correlation between the counts of CD3+, CD4+, the CD4+:CD8+ ratio and PaO2 (P < 0.01). No marked change in serum IgG, IgA and IgM level was observed. Serum IgE and CIC level was significantly higher and C3 level lower than those in controls (P < 0.01). After treatment the counts of CD3+, CD4+, CD16+ and the CD4+:CD8= ratio went up notably (P < 0.01), but no significant change was found in the HIP. (2) In cases during remission stage only the CD4+ level was low (P < 0.05) and no remarkable difference was observed in the HIP. After treatment with thymopeptide the counts of CD4+ increased (P < 0.05), CD8+ decreased (P < 0.01) and the CD4+:CD8+ ratio increased (P < 0.01). The serum IgA and CIC level also went up significantly (P < 0.05). This indicated that thymopeptide played a role in regulating the immunologic function.

[Study on the T cell functions induced by anti-CD3mAb in chronic pulmonary heart disease].

We studied the T lymphocyte transformation and IL-2's functions induced by anti-CD3 mAb in 42 cases of CPHD. The T lymphocyte transformation, activity of IL-2 and expression of IL-2R were determined by 3H-TDR incorporation, bioassay and immunoabsorption methods. The results showed that PBL transformation and activity of IL-2 were decreased in the patients of acute exacerbation stage more than those in controls and remission stage (P < 0.05 or P < 0.01); activity of IL-2 in the patients of remission stage was close to that in controls (P > 0.05), but PBL transformation was still less than that in controls (P < 0.01); Expression of IL-1R were increased in the patients more than in controls (P < 0.01). G.I of anti-CD3mAb and PHA stimulating PBL proliferation showed positive correlation (P < 0.01), activity of IL-2 and expression of IL-2R were not correlated (P > 0.05). The results showed that extrinsic IL-2 could enhance PBL proliferations induced by anti-CD3mAb, especially in CPHD patients.

Successful pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension associated with anticardiolipin antibodies: report of a case.

Chronic pulmonary thromboembolism with pulmonary hypertension is a rare but most unique syndrome in the broad spectrum of pulmonary embolism. This report describes a successful pulmonary thromboendarterectomy performed for a totally occluded right pulmonary artery on a 43 year old man who presented with positive cardiolipin antibodies. The surgery was performed through a median sternotomy with cardiopulmonary bypass and intermittent periods of deep hypothermic circulatory arrest. We are convinced that this method allows for complete removal of the thrombotic obstruction and should be the procedure of choice for patients with very proximal obstruction of a pulmonary artery.

[Immunological disorders in chronic bronchitis]. / Immunologicheskie narusheniia pri khronicheskom bronkhite.

The paper considers changes of cellular and humoral immunity in 181 chronic sufferers with bronchitis. The disease forms and severity were suggested to be evolutionary stages. There was suppression of immunological reactivity most evident in T-cell system and interleukin-1 in progressive chronic bronchitis. Immunological shifts proved more severe in obstructive chronic bronchitis complicated by pulmonary emphysema and chronic cor pulmonale. Alterations in immunological status may contribute to progression of chronic bronchitis.

[Prophylactic medical examination of patients with chronic pulmonary heart]. / Dispansernoe nabliudenie za bol'nymi khronicheskim legochnym serdtsem.

Results are analysed of the efficiency of complex treatment of patients with chronic cor pulmonale including cardiac glycosides, agents stimulating metabolism processes in the myocardium, immunoactive drugs and antiaggregants. The efficacy was evaluated of cardiotonic therapy with different glycosides in hospital and outpatient treatment. The necessity is substantiated of including into complex treatment drugs of metabolic action, immunoactive and antiaggregant agents with the purpose of reducing the threshold of sensitivity of the myocardium to the toxic effect of cardiac glycosides.

[Immunological reactivity of patients with chronic obstructive bronchitis]. / Immunologicheskaia reaktivnost' bol'nykh khronicheskim obstruktivnym bronkhitom.

The paper is concerned with the results of a study of the immune status in 14 COB patients and 53 patients with COB aggravated by pulmonary emphysema and chronic cor pulmonale. The immunologic reactivity of patients was compared with that of healthy persons and persons suffering from frequent repeated bronchitides (35). Variations in the indices of humoral and cellular immunity and the phagocytic system were noted in the COB patients as compared to the normal values. The most noticeable shifts in the mean values as well as in disorders of interrelationships of immunological indices were noted in the patients with COB aggravated by pulmonary emphysema and chronic cor pulmonale. A decision rule was proposed for determination of imbalance of indices of the patients' immune system.