Phenotypic shift of small intestinal intra-epithelial type 1 innate lymphoid cells in celiac disease is associated with enhanced cytotoxic potential.

The small intestinal (SI) epithelium harbors a heterogeneous population of lymphocytes that mediate mucosal damage and repair in celiac disease (CD). The composition and roles of human proximal SI intra-epithelial innate lymphoid cells (ILCs), and their alterations in CD, are not well understood. We report that duodenal intra-epithelial ILCs predominantly consist of natural killer (NK)p44+ CD127- cytotoxic ILC1s and NKp44- CD127+ helper ILC1s, while ILC3s only represent a minor population. In patients with newly diagnosed or active CD (ACD) and refractory CD type 1 (RCD I), the frequency of SI NKp44+ ILCs is decreased, with restoration of NKp44+ ILC frequency observed in patients adhering to a gluten-free diet who show evidence of mucosal healing. Moreover, the frequency of SI NKp44- ILCs is increased in ACD and RCD I patients and correlates with the severity of villous atrophy and epithelial damage, as assessed by serum levels of fatty acid binding protein 2 (FABP2). We show that the ILC alterations in CD represent a phenotypic shift of cytotoxic ILC1s rather than an increase in helper ILC1s or transdifferentiation of ILC1s to ILC3s, and activation-induced loss of NKp44 by cytotoxic ILC1s is associated with increased interferon (IFN)-γ expression and release of lytic granules. These findings suggest that intra-epithelial NKp44- CD127- cytotoxic ILC1s may contribute to mucosal damage in CD.

[Pathomorphology of spiral uterine arteries, umbilical vessels and placenta in disorders of maternal-fetal circulation]. / Patomorfologiia spiral'nykh arterii matki, pupochnykh sosudov i platsenty pri narusheniiakh materinsko-plodnogo krovotoka.

The comparison of the spiral uterine arteries structure, umbilical vessels and placenta is performed in 16 women with normal haemodynamics and in 31 women with disturbances of mother-foetus circulation, and the data obtained were compared with results of dopplerometry made before the delivery. Three clinical groups are distinguished according to the predominant localization of the resistance to the blood flow: the first--with the domination of the spiral arteries obliteration (lack of gestational changes, hyperplastic arteriosclerosis) with a characteristic ultrastructural pathology of the syncytiotrophoblast microvilli, rheological disturbances in the intervillous space and large necroses of villi; the second--with a predominance of early immaturity of the stroma and capillaries or sclerosis and compression of foetal villous capillaries, i. e. with a reduction of a capillary bed and increase of the resistance to the blood flow; the third--with a predominance of the umbilical arteries narrowing and supporting villi and signs of a blood stasis in the foetal veins. Morphologic heterogeneity of the mother--foetus circulation disturbances should be taken into consideration when choosing obstetric tactics.

[Pathogenetic factors of destructive process in trabecular tissues in primary open-angle glaucoma]. / Patogeneticheskie faktory destruktivnogo protsessa v trabekuliarnykh tkaniakh pri pervichnoi otkrytougol'noi glaukome.

Trabecular endothelium and collagen fibers of the posterior wall of Schlemm's channel, obtained in sinusotrabeculectomy from patients with various stages of primary open-angle glaucoma were examined by electron microscopic and biochemical methods. Endothelial cell destruction, damage, rejection, and dissociation in intertrabecular space, progressing in severity, were observed. "Denudation" and degradation of collagen fibers and fibrils were observed. The content of lipid peroxides in aqueous humor and blocks of Schlemm's channel trabecular wall increased from stage to stage, while the level of biogenic antioxidant glutathione decreased.

[Perfusion pressure in ocular vessels of patients with open-angle glaucoma]. / Perfuzionnoe davlenie v sosudakh glaz u bol'nykh otkrytougol'noi glaukomoi.

Perfusion pressure in ophthalmic vessels was measured by computer-aided ophthalmodynamography in health, stenoses of the internal carotid artery, and open-angle glaucoma. A total of 70 subjects were examined. Stenoses of the internal carotid artery are associated with a noticeable reduction of perfusion pressure on the side of stenosis. Some patients develop optic nerve atrophy (without excavation). Secondary neovascular glaucoma was diagnosed in 1 patient. Primary open-angle glaucoma was revealed in none of the patients. Increase of intraocular pressure in patients with open-angle glaucoma was associated with a reduction of perfusion pressure. However, in more than 50% of patients a higher pressure was observed in the orbital artery corresponding to the eye with a higher ophthalmic tone than in the contralateral eye. This was conducive to a certain leveling of perfusion pressure. Such a reaction is regarded as a manifestation of autoregulation of ocular vessels, important for blood delivery to the eyes.

[A glutathione deficiency in open-angle glaucoma and the approaches to its correction]. / Defitsit glutationa pri otkrytougol'noi glaukome i podkhody k ego korrektsii.

A total of 151 patients with open-angle glaucoma, 23 ones with closed angle glaucoma, and 57 ones with age-associated cataracts were examined. The reference group consisted of 21 subjects with posttraumatic cataracts (1.5 years after the injury) and normal subjects. Nonprotein sulfhydryl groups (glutathione) were measured in the peripheral blood, aqueous humor, and in tissue samples from the scleral drainage sites, obtained in antiglaucoma surgery and in surgery for cataract extraction. Aqueous humor of patients with posttraumatic cataracts, blood samples of these patients and normal subjects were examined for control. The level of sulfhydryl groups was found significantly lowered in the anterior chamber humor of patients with open-angle glaucoma, particularly in those with disease Stages II and III as against the controls. The content of sulfhydryl groups was lowered in the tissue samples from the scleral drainage area of patients with open-angle glaucoma Stages II and III vs. that in the patients with Stage I condition. Similar changes were found in the red cells of patients with Stages II and III open-angle glaucoma. Glutathione is an important component of the cellular antioxidant system. The findings point to a reduction of the processes of antioxidant defense of ocular tissues, developing as early as in the first stage of open-angle glaucoma. Lipoic acid administration for 2 months was associated with a rise of glutathione level in the red cells of patients with Stages II and III open-angle glaucoma.

[New directions in the hypotensive therapy of open-angle glaucoma (experimental and clinical research)]. / Novye napravleniia gipotenzivnoi terapii otkrytougol'noi glaukomy (éksperimental'no-klinicheskie issledovaniia).

Clinical use of eye drops of a hybrid beta-alpha-adrenoblocker OF-4680 to reduce intraocular pressure has shown a high efficacy of the drug, not inferior to thymolol, for local hypotensive therapy of open-angle glaucoma. A combination of thymolol with taurin helped reduce the inhibiting effect of the beta-blocker on chamber humor secretion and simultaneously enhanced its discharge. The results evidence the desirability of correcting glutathion deficiency, detected in the patients with narrow-angle glaucoma, by lipoic acid.

[Results of combined use of taufon and timolol in the treatment of patients with open-angle glaucoma]. / Rezul'taty sochetannogo primeneniia taufona i timolola pri lechenii bol'nykh otkrytougol'noi glaukomoi.

The effect of taufon and timolol maleate combination on intraocular pressure and ocular hemodynamics was studied in 44 patients (63 eyes) with primary open-angle glaucoma. Combined administration of these agents elevated almost twofold the fluid discharge efficacy coefficient and normalized Becker's coefficient in 68.6 percent of patients. The patients were followed up for 8 weeks. Taufon addition to timolol modified the action of this latter drug, normalizing the ocular hemodynamics.

[Effects of activated autoplasma on platelet aggregation in patients with vascular diseases of the fundus oculi]. / Vliianie aktivirovannoi autoplazmy na agregatsiiu trombotsitov u bol'nykh s sosudistymi zabolevaniiami glaznogo dna.

Activated autoplasma (AAP) was used in the treatment of patients with central chorioretinal dystrophy and diabetic retinopathy. The therapeutic effect of AAP injected intrabulbarly and its effect on platelet aggregation in the peripheral blood after intramuscular and intravenous injections were assessed. Intravenous AAP was found to exert a manifest disaggregating effect, whereas intramuscular injections did not affect platelet aggregation.

[Treatment of peritonitis of appendicular etiology]. / Lechenie peritonita appendikuliarnogo proiskhozhdeniia.

The authors had 475 patients with appendicular peritonitis under observation. All of them underwent emergency operation and were given antibacterial therapy with metronidazole and agents of the aminoglycoside series. Among 223 patients, the operation on whom was completed by traditional drainage of the abdominal cavity and complete closure of the operative wound, 148 patients developed postoperative complications. Five patients died. In 252 patients, primarily delayed sutures were applied to the wound and drainage of the abdominal cavity was limited. The abdominal cavity was inspected repeatedly in 24 patients with generalized peritonitis and clinical signs of anaerobic nonclostridial infection. Postoperative complications occurred in 87 patients and were limited to suppuration of the wound. One patient died.

[Thrombocytopathies and their role in the development of hemorrhagic syndrome in vascular diseases of the fundus oculi]. / Trombotsitopatii i ikh rol' v razvitii gemorragicheskogo sindroma pri sosudistykh zabolevaniiakh glaznogo dna.

Examinations of 407 patients with angiological disorders of the fundus oculi (diabetic retinopathy, retinal vein thrombosis, central chorioretinal dystrophy, retinal angiitis) revealed relapsing hemorrhagic syndrome in 40% (170) patients. No thrombocytopenia was revealed in any of the patients, which suggests qualitative impairment of platelets in such patients. Evaluation of the platelet aggregation coefficient (PAC) using thrombin aggregation inducers and adenosine diphosphate disodium revealed a statistically significant decrease of PAC for one or both aggregants in all 170 patients with the hemorrhagic syndrome, which indicated platelet dysfunction. A course of intramuscular injections of 1% adenosine triphosphate sodium normalized platelet function and stimulated resorption of hemorrhages.

[Pathogenetic factors in thrombosis of the central retinal vein]. / Patogeneticheskie faktory tromboza tsentral'noi veny setchatki.

Studies of the hemorheologic parameters and the hemostasis system components in the blood and lacrimal fluid of 130 patients with thrombosis of a branch of the central retinal vein (CRV) and calibrometry of the CRV have lead the authors to a conclusion that the major factors contributing to the pathogenesis of CRV thrombosis are (1) disordered blood rheology; (2) changes in the local hemostatic potential; (3) impaired blood stream in the corresponding CRV branches. Rationale for the use of drugs normalizing the blood rheology in CRV thrombosis is given.