[Development and use of a domestic test system for diagnosis of tuberculous infection on the basis of quantitative analysis of interferon-gamma induction in whole blood samples in vitro, by using specific recombinant antigens].

A test system was developed to detect tuberculous infection by qualitative analysis of interferon-gamma (IFN-gamma) in the plasma samples after 20-24-hour incubation of whole blood samples in the presence of Mycobacterium tuberculosis (MBT) antigens: tuberculin PPD and a mixture of the MBT-specific recombinant antigens ESAT-6 and CFP-10. The analysis used 3 test tubes each containing 1 ml of heparinized venous blood, one of which served as a control; the other two test tubes were employed to measure antigen-induced IFN-gamma production. Whether this test system might be used to determine primary tuberculous infection was studied in 277 children and adolescents. The threshold diagnostic IFN-gamma induction level determined in the test tube containing a mixture of the antigens ESAT-6 and CFP-10 was ascertained. Postvaccine allergy was detectable if there was IFN-gamma induction in the test tube containing tuberculin and if there was no diagnostic IFN-gamma level in that containing the antigens ESAT-6 and CFP-10. The diagnostic sensitivity of detection of primary tuberculous infection was 97.6% with 94.4% specificity, which enabled this condition to be differentiated from postvaccine allergy. The level of antigen-induced IFN-gamma may be lower in relatively disseminated forms of pulmonary tuberculosis.

[Significance of determination of gamma-interferon in the diagnosis of tuberculous exudative pleurisy].

The pleural fluid concentration of gamma-interferon (gamma-IFN) was studied in 44 patients with exudative pleurisy. The tuberculous nature of exudative pleurisy was established in 25 patients on the basis of X-ray study, a follow-up, microbiological study of pleural exudate specimens, and morphological studies of biopsy specimens obtained at video-assisted thoracoscopy or surgery. The the pleural exudate concentrations of gamma-IFN were over 300 pg/ml (mean 1019 +/- 161 pg/ml) in 19 out of 21 patients with exudative pleuritis in a phase of active inflammation. The patients with the fibrous outcome of pleurisy of tuberculous etiology and those with exudative pleurisy of non-tuberculous etiology, including that in malignancies and papapneumonic pleurisy, were observed to have lower concentrations of gamma-IFN (mean 118 +/- 16 pg/ml). With the discriminating level of above 300 pg/ml, the sensitivity and specificity of the test were 90.5 and 100%, respectively.

[Circulating complexes of plasma fibronectin (fibronectin-fibrin) in human diseases]. / Tsirkuliruiushchie kompleksy plazmennogo fibronektina--fibronektin-fibrin pri nekotorykh zabolevaniiakh cheloveka.

The study of circulating complexes fibronectin-fibrin in 21 patients with immunocomplex affections revealed their high levels which occurred in inverse relationships with fibronectin concentrations in the blood, but in direct correlation with indicators of inflammation (fibrinogen, cialic acid). It is suggested that the complexes are involved in the development of fibrosis at the sites of chronic inflammation in immune disorders.

[Unstable angina: tissue plasminogen activator, tissue plasminogen activator inhibitors, protein C and other factors of the blood fibrinolytic system]. / Nestabil'naia stenokardiia: tkanevyi aktivator plazminogena, ingibitor tkanevogo aktivatora plazminogena, protein C i drugie faktory fibrinolitecheskoi sistemy krovi.

The authors examined the activities of plasminogen activator, its inhibitor, the levels of C protein, antithrombin III, alpha 2-antiplasmin, plasminogen, fibrinogen, fibrinogen/fibrin degradation products in 22 patients with unstable angina by using the vein occlusive test. No significant differences were found in the examined parameters while comparing the group of stable angina patients and healthy subjects. It was concluded that thrombogenesis disturbances in unstable angina were regional and the recording of peripheral blood fibrinolytic parameters failed to detect any changes characteristic of unstable angina.

[Signs of thrombin formation in venous occlusion in patients with ischemic heart disease and the role of the protein C activation system in its utilization]. / Priznaki obrazovaniia trombina pri venoznoi okkliuzii u bol'nykh ishemicheskoi bolezn'iu serdtsa i rol' sistemy aktivatsii proteina C v ego utilizatsii.

Elevated levels of fibrin peptide A were found in venous occlusion only in the patients unconsuming C protein, which indicates that there is a relationship between the thrombin production processes during venous occlusion and the C protein system functioning, the anticoagulant function of the endothelium in particular. Moreover, this makes it possible to employ the standard venous occlusion test to make an integral assessment of endothelial function.

[Newly developed stenocardia: fibrinolysis and hemostasis at rest and during physical exercise after myocardial infarction]. / Vpervye voznikshaia stenokardiia: fibrinoliz i gemostaz v pokoe i pri fizicheskoi nagruzke u bo'lnykh, perenesshikh v étot period infarkt miokarda.

Postmyocardial infarction patients with angina of new onset showed increased blood levels of fibrinogens, soluble fibrin and fibrinogen-fibrin degradation products one month after the acute onset of MI, while their baseline fibrinolysis had been normal. A variety of fibrinolytic disorders were revealed in response to physical stress.

[Initial-onset stenocardia: characteristics of the blood coagulation system and fibrinolysis as reaction to physical exertion]. / Vpervye voznikshaia stenokardiia: nekotorye osobennosti svertyvaiushchei sistemy krovi i fibrinoliza, reaktsiia na fizicheskuiu nagruzku.

Blood coagulation and fibrinolysis were studied at rest and during bicycle ergometry in 45 patients with angina of new onset (ANO). Fourteen chronic coronary patients and 20 subjects, free of coronary heart disease or coronary atherosclerosis, were taken as controls. Fibrinolysis tended to be depressed in resting ANO patients. Potential fibrinolysis depended on the clinical pattern of the disease and was particularly depressed in patients with severe ANO. Stress did not activate fibrinolysis in patients with vasospastic angina and high basal plasminogen activator level at rest.

[Fibrinogen and fibrin degradation products in the blood of acute myocardial infarct patients at the hospital rehabilitation stage]. / Produkty degradatsii fibrinogena i fibrina v krovi bol'nykh ostrym infarktom miokarda na étape bol'nichnoi reabilitatsii.

An enzyme immunoassay was used for a study of the time course of the content of fibrinogen degradation products (FDP) and free hemoglobin (fHg) in the blood of patients with acute myocardial infarction (AMI) during uncomplicated hospital rehabilitation. A considerable increase in the levels of FDP in the blood serum and fHg in the blood plasma of the AMI patients were noted. These levels were particularly high on the 6-12th day of rehabilitation with further fluctuations on the 22-24th day from the beginning of disease resulting from an increase of the patients' motor activity during rehabilitation which might cause the depletion of endothelial reserves of fibrinolysis activators and an increase in thrombinemia, however changes in the content of FDP and fHg in the blood were more likely associated with DIC-syndrome inherent fluctuations in the system of hemostasis. The content of FDP and fHg in the blood of AMI patients was recommended to be used as a marker of DIC-syndrome and assessment of corrective therapy.

[Immunoenzyme determination of fibrin-fibrinogen degradation product levels in acute myocardial infarct patients]. / Immunofermentnoe opredelenie kontsentratsii produktov degradatsii fibrin-fibrinogena u bol'nykh ostrym infarktom miokarda.

The changes in the blood level of fibrin-fibrinogen degradation products (FDP) have been studied in 62 patients with myocardial infarction. 30 healthy donors served as the control. FDP was determined using solid-phase immunoenzyme assay. Acute and subacute phases of myocardial infarction were characterized by an increase in FDP blood level. However, in severe cases a possible low FDP blood level in conditions of fibrinolysis depression may be associated with an increased risk of severe thromboembolic complications.

[Decreased effectiveness of cold-induced heparin precipitation of plasma fibronectin in infection]. / Snizhenie éffektivnosti kholodovoi geparinopretsipitatsii plazmennogo fibronektina pri sepsuse.

Plasma fibronectin (FN) is one of the major blood opsonins. The content of the glycoprotein reduces in sepsis which in turn may aggravate the course of the infection. FN is detectable in the content of cryoglobulins and cryofibrinogen. The formation of the heparin precipitate following plasma incubation in the cold in the presence of heparin is determined by FN involvement. Fibrinogen (FG) is another main component of the heparin precipitate. To determine the functional activity of plasma FN in sepsis and other pathological conditions, a study was made of the ability of FN and FG to go into the precipitate formed in blood plasma in the cold after its incubation with heparin. Unlike normal subjects in whom over 80% of FN on the average and about 20% of FG went into the heparin precipitate, in patients with hemoblastoses and aplastic anemia complicated by sepsis, less than 40% of FN on the average and about 7% of FG went into the precipitate. In some patients with sepsis, the heparin precipitate did not form. The reduction of FN ability to go into the heparin precipitate correlated with the gravity of the patients' condition. In uncomplicated hemoblastoses, cryoglobulinemia and cryofibrinogenemia and in immunocomplex pathology, the consumption of FN and FG during heparin precipitate formation did not significantly differ from the control. The data indicate that sepsis patients with blood system pathology may develop not only quantitative FN deficiency in the blood but also disorder of the functional activity of the opsonin.

[Fibrinolytic action of an enzyme preparation conjugated with specific antibodies]. / Fibrinoliticheskoe deistvie fermentnogo preparata, kon"iugirovannogo so spetsificheskimi antitelami.

The authors have modified alpha-chymotrypsin covalently bound via aldehyde dextran with polyclonal antibodies to fibrinogen. Modification does not lead to any substantial changes in the catalytic properties of the enzymes or to appreciable losses in specific activity of antibodies. At the same time in experimental thrombolysis in vitro, the derivatives obtained exhibit a higher fibrinolytic action as compared with control preparations. It is assumed that the effect observed is accounted for by an increase in tropism of the conjugate obtained to the fibrin clot.

[Fibronectin level in coronary sinus blood in myocardial ischemia caused by atrial stimulation]. / Soderzhanie fibnonektina v krovi koronarnogo sinusa pri ishemii miokarda, vyzvannoi stimuliatsiei predserdii.

Patients with coronary heart disease and angina pectoris were examined. The blood outflowing from the myocardium at the height of ischemia induced by atrial stimulation was found to have lower levels of fibronectin. Ten minutes after the stimulation discontinuation the concentration of fibronectin returned to baseline. A reduction in the fibronectin content during myocardial ischemia seems to be related to its consumption as a result of maintaining antithrombotic function.