[The humoral immunity against diphtheria].

Results of the conducted study showed that naturally acquired antibacterial and postvaccinal antitoxic antibodies against diphtheria were found in human blood sera. Challenge of ADT-M toxoid to adults resulted in production of antitoxic as well as antibacterial antibodies in high concentrations. In response to challenge of ADT-M toxoid simultaneously with bacterial vaccine against diphtheria Codivac both antibacterial and antitoxic antibodies were synthesized in blood on optimal physiologic levels. This study revealed dynamics of some specific characteristics of humoral immune response after challenge of two different vaccines against diphtheria--ADT-M toxoid and Codivac vaccine.

[Specific antibodies and their role in the formation of antidiphtheria immunity].

In human sera, studied with the use of the enzyme immunoassay, antidiphtheria postvaccinal antitoxic IgG and naturally acquired antibacterial IgG, IgM and IgA were detected. In the blood of children and adults aged up to 50 years antitoxic IgG were present at normal and high concentrations. In 50% of children antibacterial IgA were absent, while specific antibacterial IgM could be found at high concentrations. Changes in the content of antibacterial antibodies of different classes in sera were observed with age. More than 90% of adults had antibacterial IgA and IgG at normal and hig concentrations, while the level of IgM decreased. Under the influence of ecological, social, anthropogenic and other environmental factors the optimum levels of specific antibodies were replaced by anomalous ones, which led to an increased number of persons susceptible to diphtheria infection and in the intensity of the circulation of the infective agent. The deficiency of antidiphtheria antibacterial antibodies in the blood determined the necessity of correcting immunity by means of not only toxoid, but also bacterial antigens.

[A large-scale epidemic of diphtheria in Moscow in recent years: patterns of development]. / Krupnaia pidemiia difterii v Moskve v poslednie gody: zakonomernosti razvitiia.

Data on the dynamics of diphtheria morbidity in Moscow in 1958-1999 are presented. The last epidemic which started at the end of the 1980s and reached its peak in 1994, giving a 59-fold rise in morbidity in comparison with the pre-epidemic period, is characterized in detail. During the epidemic 12,267 persons fell ill, 454 of them died (mortality rate was 4%). Having started in Moscow, the epidemic gradually spread not only over the territory of Russia, but also over some other republics of the former Soviet Union (Ukraine, Belarus, etc.). Possible causes of this epidemic emergency are considered. The ever increasing share of adult population among persons affected by the epidemic (75%) is noted. The infection adults is characterized by severity of clinical manifestations and increased morbidity among adults, is shown. Under complicated social and economic conditions (crisis situation) the increase of groups of high risk which included unemployed adults of working age, retirees as well as socially non-adapted persons, was registered. Mainly these groups determined tense epidemiological situation in diphtheria in Moscow.

[The antidiphtheria activity of the pre-EGF fragment]. / Antidifteriinaia aktivnost' fragmenta pre-EGF.

The DNA fragment, coding a part of the protein molecule--the precursor of the epidermal growth factor (pre-EGF76-208)--and containing the sequence of 133 N-end amino acid residues, was obtained with the use of gene engineering and molecular biological techniques. For this purpose a fraction of poly(A+) = RNA was isolated from the kidney of a newborn infant; on this fraction the "library" of cDNA fragments whose coding capacity corresponded to the required sequence of mRNA in the pre-EGF gene was obtained in the reaction of reverse transcription, conjugated with the polymerase chain reaction (PCR). After the determination of the nucleotide sequences in 11 fragments only 1 fragment which contained practically no mutations appearing in PCR as the result of amplifications was chosen. This fragment was used for the construction of a hybrid plasmid controlling the synthesis of hybrid fusion protein with the sequence of pre-EGF76-208. Fusion protein was synthesized with very low effectiveness, but the use of metallo-affinity chromatography permitted to isolate and purify it, its purity reaching 98%. Then its antitoxic activity was determined in the skin test on guinea pigs and found to be not less then 10(6) I.U./mg of protein.

[Clinical aspects of diphtheria in infants]. / Klinicheskie osobennosti difterii u detei rannego vozrasta.

The symptomatology of different forms of diphtheria was analyzed in 49 patients under 3 year of age. It has been established that in infants, diphtheria is marked by the diversity of localizations and a fairly high portion of associated toxic diphtheria of the stomatopharynx and disseminated croup. These gravest forms are fairly difficult to recognize them clinically. Their early diagnosis should rest on the presence of the pronounced signs of intoxication, edema of the lonsils and stomatopharyngeal mucosa, and pannicular patches spreading beyond the tonsils. In the presence of toxic diphtheria, the stages of croup become shorter while the recognition of its symptoms is embarrassing.

[Clinico-laboratory analysis of the diarrhea syndrome in young children excreting rotaviruses with feces]. / Kliniko-laboratornyi analiz diareinogo sindroma u detei rannego vozrasta, vydeliaiushchikh rotavirus s fekaliiami.

A total of 404 children admitted to the infectious hospital of the non-intestinal type were examined with the aid of counter immunoelectroosmophoresis. Rotavirus antigen was detected in feces in 46.8% of 126 children admitted with a diagnosis of diarrhea, in 10.8% of 278 without diarrhea, and also in 32.9% of 149 children with diarrhea that occurred at the hospital. The clinical course of acute rotavirus gastroenteritis appeared to be materially influenced by acute respiratory viral infection, particularly influenza, and by certain types of opportunistic bacteria contained in high concentrations by the intestine.

[Circulation of the causative agent of diphtheria in immune collectives]. / Tsirkuliatsiia vozbuditelia difterii v immunnykh kollektivakh.

Prolonged observations on the spread of toxigenic C. diphtheriae carriership, made during a school year in 12 groups of immune children (3809 children), showed that the penetration of diphtherial infection could give rise to the outbreak of bacterial carriership, its level being as high as 20.9-35.1% of the total number of children in the group. The spread of bacterial carriership occurred during the first months after the penetration of the infection, achieving its peak, then followed the subsidence of the infection in the focus. Though some children in the group persistently released C. diphtheriae, almost no new cases of carriership were registered in spring. The highest spread of carriership (55.6-73%) was revealed in the first forms of boarding schools despite a higher level of antitoxic immunity in these children. Cases of the spontaneous cessation of carriership were observed. The spread and subsidence of carriership were determined by the presence or absence of a susceptible contingent. Tests on guinea pigs, carried out in the course of this study to determine the toxigenicity of C. diphtheriae, showed its variability.

[Data from different Moscow polyclinics on the utilization of vaccination against diphtheria, pertussis, tetanus, and measles in children of first 3 years of life]. / Dannye ob okhvate privivkami protiv difterii, kokliusha, stolbniaka i kori detei pervykh trekhlet zhizni po materialam otdel'nykh poliklinik Moskvy.

The coverage of children by immunization against diphtheria, pertussis and tetanus during the first 3 years of life as indicated in forms No. 112 and No. 63 in 4 districts of Moscow was studied on the basis of the analysis of 1688 children's development histories. The coverage of children by immunization was found to be on the average 71.7%, fluctuating in individual districts from 58.6% to 85.9%. Immunization against measles covered 41.8% of children with fluctuations 24.2-51.2%. The most frequent reasons for the absence of prophylactic immunization in children during the first 3 years of life, or belated immunization in comparison with the specified terms, were contraindications due to neurological diseases (40.4%), exudative diathesis (15.9%) and recurrent viral infections (16.2%). Medical objections to immunization without sufficient grounds constituted 12.1% of all contraindications; among such objections those given by neuropathologists (9.8%) and pediatricians (2.3%) prevailed. To increase the coverage of children by immunization in the specified terms, the use of such measures as improving work with parents (explaining to them the importance of timely prophylactic immunization) and strict observance of instructions on medical contraindications may be considered most effective.

[Cytochemical study of granulocyte enzymes in germ-free animals with adenovirus infections]. / Tsitokhimicheskoe izuchenie fermentov granulotsitov u gnotobiotikov pri adenovirusnoi infektsii.

The activity of some dehydrogenases and hydrolases was studied by cytochemical methods in the peripheral blood neutrophils of germ-free guinea pigs infected with adenoviruses. The gnotobiotic animals were obtained by hysterotomy in an operation isolation room after which they were transferred into manipulation isolation room and infected with human adenovirus type 1. A depression of enzymes of alpha-glycerophosphate shunt and NADP-H2-diaphorase in neutrophils two days after infection and activation of lactate dehydrogenase and acid phosphatase at 4 days were demonstrated. The pattern of changes in the enzymatic status of intact and infected gnotobiotic animals allowed a diagnosis of adenovirus infection in most cases.

[Enzymatic activity of the lymphocytes in gnotobionts in adenovirus infection]. / Izuchenie énzimaticheskoi aktivnosti limfotsitov u gnotobiotov pri adenovirusnoi infektsii.

The cytochemical activity of succinate dehydrogenases, alpha-glycerophosphate (mitochondrial and hyaloplasmic), lactate, glycose-6-phosphate, glutamate, beta-oxibutyrate, NADP-H2- and NAD-H2 diaphorases and acid phosphatase was studied in lymphocytes of gnotobiotic guinea-pigs infected with human adenovirus type 1. The analysis of transgression of distribution of the values in the experimental and control groups revealed a high informative diagnostic value of acid phosphatase and lactate dehydrogenase of lymphocytes.

[Patterns of antimicrobial immunity in carriers of toxigenic diphtheria bacteria]. / Zakonomernosti antimikrobnogo immuniteta u nositelei toksigennykh difteriinykh bakterii

It was shown in the passive hemagglutination test (PHAT) with a type-specific somatic antigen on 147 carriers of toxigenic diphtheria bacilli that the PHAT titres of 1/80 and over were determined in 64% of bacteria. In the process of carrier state of toxigenic bacteria antimicrobial antibodies were detected in 79% of the children; after the release from the carrier state, the percentage was from 57 to 26, depending on the time lapse after it. Among the carriers of nontoxigenic diphtheria bacilli the PHAT titre of 1/80 and over was established in up to 20% of children, and only in those which were in the focus of toxigenic bacilli carriers. The applied test could be used for epidemiological purpose to determine the spread of the carrier state of toxigenic bacteria in a collective body.