[Particular features of erythropoiesis in high altitude and possibilities of applying of hypoxic hypoxia methodology for the patients with hemopoietic suppression].

Conditions of hypoxic hypoxia at 3200 m height exert significant positive changes in hemopoiesis, normalizing erythropoiesis and coagulation system. Hypoxic climate therapy can be regarded as an additional efficient method to the pathogenetic treatment for patient with unpainful aplastic anemia and idiopathic thrombocytopenic purpura. It should be emphasized that patients must be out of immunosuppressive therapy when getting high altitude stationary.

[Regulation of erythropoiesis in patients with suppressed hematopoiesis during mountain climatic treatment].

AIM: to estimate the regulation of erythropoiesis and the coagulation system in patients with suppressed hematopoiesis in a mountain hospital (3200 m above sea level). SUBJECTS AND METHODS: The investigation included 12 patients with aplastic anemia (AA) and 10 with idiopathic thrombocytopenic purpura (ITP). Blood was received at a Bishkek hospital, then on days 20 and 40 of stay in the mountains. The authors studied erythropoietin (EPO) by enzyme immunoassay (Protein Contour kit, Russia), serum ferritin (SF) by immunoradioassay (Immunotech kit, Czech Republic), hypoxia-inducible factor-1alpha (HIF-1alpha), homocysteine (HC), hepcidin, endothelin (ET), and thrombomodulin (TM) by sandwich enzyme immunoassay, by applying monospecific antisera and monoclonal antibodies against relevant antigens (IDG Int Inc, USA). RESULTS: On staying in the mountains, there was a gradual increase in the content of hemoglobin in patients with AA and ITP. On day 40, in keeping with higher hemoglobin (Hb) levels, both groups showed a decrease in HIF-1alpha concentrations to the normal values (from 8.2 to 4.5 pg/ml). Due to the anemic syndrome, baseline EPO was increased by 5-7 times in the patients from both groups. On days 20-40, the content of EPO showed a 1.3-2.5-fold increase. In AA, HC was almost 3 times greater than the normal values; in ITP, it was 1.5-fold increased. On day 20 and during the patients'stay in the mountains, the level of HC remained in the normal range in both groups. CONCLUSION: Hypoxic hypoxia positively affects a number of hematological parameters, by normalizing erythropoiesis (Hb, EPO, and HIF-1alpha), iron metabolism (SF), and the coagulation system (HC, ET, and TM).

[Characteristics of erythropoiesis regulation in population living at high altitude]. / Osobennosti reguliatsii éritropoéza u zhitelei vysokogor'ia.

AIM: To study characteristics of iron deficiency anemia (IDA) in native population of high altitude territories. MATERIAL AND METHODS: 1300 women living in Tien-Shan areas were examined for serum and erythrocytic ferritins (SF and EF), general iron-binding capacity of the serum, transferrin saturation with iron, transferrin, soluble transferrin receptor (TR), erythropoietin (EP), Hb, erythrocytes, erythrocytic indices. RESULTS: Regulation of erythropoiesis in women living at high altitude is specific, i.e. disagreement between complete depletion of iron (by SF and EF) and normal level of Hb, erythrocytes, EP and TR. CONCLUSION: It is suggested that in population living at high altitudes (3000 m above the sea level and higher) long-term adaptation to hypoxia gave rise to an original mechanism of erythropoiesis regulation when all coming iron participates in hemoglobin synthesis without iron deposition. Under hypoxic hypoxia regulation of erythropoiesis is directed to prevention of tissue hypoxia.

[Hemopoiesis regulation in healthy subjects and in patients with aplastic anemia at high altitudes]. / Reguliatsiia gemopoéza u zdorovykh liudei i u bol'nykh aplasticheskoi anemiei v usloviiakh vysokogor'ia.

The paper deals with effects of high-altitude (3200 m) adaptation on the clinical presentation, hemopoiesis, proliferation and differentiation of erythroid bone-marrow cells, growth of cultured bone-marrow fibroblasts, iron metabolism, function of the adrenal cortex and T lymphocytes of aplastic anemia patients. The high-altitude adaptation improves the clinical picture, facilitates hemopoiesis and proliferation and maturation of erythroid bone marrow cells, increases the efficacy of the colony-formation of bone marrow cells, intensifies the glucocorticoid function of the adrenal cortex, and produces positive immunological changes in the organism. Repeated courses of mountain-climatic therapy produce a more stable clinicohematological remission and increase the survival and working capacity of patients. Indications of mountain-climatic therapy are presented.

[Effect of high mountain altitude on the growth of bone marrow fibroblasts in patients with cytolytic syndromes]. / Vliianie vysokogor'ia na rost v kul'ture fibroblastov kostnogo mozga u bol'nykh s tsitoliticheskimi sindromami.

The efficacy of colony-formation of bone marrow fibroblasts was examined in 18 patients with pancytopenia and partial cytopenia, 5 patients with intravascular hemolysis and in 4 patients with iron deficiency anemia before and after staying in mountains at an altitude of 3,200 m. It was shown that during staying in mountains, the efficacy of colony-formation was 2 to 4 times as increased. A difference was noted in the pattern of the growth of fibroblasts in patients with intracellular cytolytic syndromes and intravascular hemolysis and iron deficiency anemia.