[The interferon therapy of patients with chronic viral hepatitis: the factors affecting the treatment results]. / Interferonoterapiia bol'nykh khronicheskim virusnym gepatitom: faktory, vliiaiushchee na rezul'taty lecheniia.

The paper presents clinicoimmunological characterization or therapeutic efficacy of alpha-interferons produced in Russia and criteria of their administration in patients with chronic viral hepatitis. A 6 to 12 months course (single dose 1 x 10(6)-3 x 10(6) IU improves the disease running, hepatic function and corrects immune status in 55.6% of patients with chronic active hepatitis eventuating in liver cirrhosis and in 57.9% of patients in chronic active hepatitis of moderate activity. Alpha-interferons are indicated in chronic active hepatitis and cirrhosis under high activity of cytolytic process, immunodeficiency, weak autoimmune process and protein shifts.

[The problem of the interferon therapy of patients with chronic viral hepatitis]. / Problema interferonoterapii bol'nykh khronicheskim virusnym gepatitom.

In this work the results of the clinico-immunological evaluation of the therapeutic effectiveness of alpha-interferon preparations are presented and criteria suitable for use in screening patients with chronic virus hepatitis, sensitive to interferon therapy, are discussed. The study revealed that the use of alpha-interferon preparations in single doses of 1-3 x 10(6) in a prolonged course of treatment (6-12 months) facilitated essential improvement in the clinical course of the disease and ensures correction of the immune status in 55.6% of patients with chronic active hepatitis (CAH) resulting in cirrhosis of the liver and 57.9% of patients with CAH moderate activity. Indications for the use of alpha-interferon preparations in patients with CAH-induced cirrhosis were high activity of the cytolytic process, the presence of immunodeficiency, faintly pronounced autoimmune process and the presence of protein shifts.

[The treatment of patients with chronic persistent hepatitis B with interferon preparations]. / O lechenii bol'nykh khronicheskim persistiruiushchim gepatitom B preparatami interferona.

Alpha-interferon preparations were injected intramuscularly in a single weekly dose 1.10(6) - 1.5.10(6) IU in courses lasting from 1 to 6 months to 37 patients with chronic persistent hepatitis B (CPHB) who entered a randomized clinicoimmunological trials. Except for moderate hyperfermentemia and HBs-antigenemia CPHB patients responsive to 3-4-month courses, alpha-interferon treatment of CPHB had no advantages over conventional therapy of the disease.

[The epithelial proliferative activity of the mucosa of the large intestine in dysentery patients at the acute period of the disease depending on the expression of morphological changes]. / Proliferativnaia aktivnost' épiteliia slizistoi obolochki tolstoi kishki bol'nykh dizenteriei v ostrom periode bolezni v zavisimosti ot vyrazhennosti morfologicheskikh izmenenii.

The dependence of proliferative activity on the degree of histomorphological changes in colonic mucosa of patients with dysentery was studied histoautoradiographically in colonic biopsies. Morphological changes were evaluated according to N. B. Shalygina's schema (catarrhal, exudative, erosive or ulcerous inflammation) A 2.5-3-fold increase of the labelled nuclei index (LNI) and label intensity (LI) was found in the catarrhal inflammation. LNI was increased 1.2-fold and LI 1.5-fold in cases of other types of inflammation; they were lower than in catarrhal inflammation.

[Immune system indices for the prediction of the course of human immunodeficiency virus infection]. / Nekotorye pokazateli immunnoi sistemy dlia prognozirovaniia techeniia infektsii, vyzyvaemoi virusom immunodefitsita cheloveka.

In 25 persons having HIV infection with different dynamics of the progress of the disease the content of lymphocyte populations was studied (by the methods of rosette formation and with the use of monoclonal antibodies) and the rosette-forming and functional metabolic activity of neutrophils was determined. In comparison with patients with a stable course of HIV, patients with relatively rapid progress infection were found to have a significantly lesser amount of E-rosette-forming cells (E-RFC), active E-RFC, theophylline resistant E-RFC, E-rosette-forming neutrophils (E-RFN) and active E-RFN in combination with a significantly higher neutrophil and phosphatase activity and a significantly higher content of cation proteins. These characteristics may be used as criteria for prognosis of HIV infection progression.

[Acute Campylobacter colitis]. / Ostryi kampilobakterioznyi kolit.

Biopsies of colon mucous membrane obtained at colonofibroscopy of 16 adult patients with colon campylobacteriosis were studied. Acute diffuse colitis was found in all cases. Exudative inflammation with hemorrhagic component and microerosion formation was found up to day 10 of the disease. Catarrhal inflammation was observed from day 10-16 during the period of convalescence. Abundant infiltration of tunica propria with eosinophylic leucocytes is a peculiar feature of colon campylobacteriosis. This, together with a diffuse character of inflammation, makes a difference with Shigella colitis. Complete normalization of the mucosa does not occur within 16 days.

[The clinico-morphological characteristics and efficacy of interferon therapy in patients with chronic delta hepatitis]. / Kliniko-morfologicheskaia kharakteristika i éffektivnost' interferonoterapii u bol'nykh khronicheskim gepatitom del'ta.

The results of the examination of 20 patients having chronic hepatitis delta (CHD) with the disease lasting 1-2 years (8 patients) and 3-6 years (12 patients) are presented. In most of the patients of both groups, irrespective of the duration of the disease, the development of severe hepatic lesions has been established. The morphological study has revealed in 45% of the examined patients the presence of chronic active hepatitis leading to the cirrhosis if the liver. A prolonged course of treatment (8-12 months) with reaferon (recombinant interferon alpha 2, obtained by gene engineering technique), injected intramuscularly in a dose of 1 x 10(6) I.U. once or twice a week, has proved to be effective in 47% of CHD patients aged 15-30 years with a weak expression of autoimmune process. It is recommended that interferon therapy in patients with CHD requires individual indications.

[The comparative characteristics of the indices of lymphocyte and neutrophil functional activity in patients with HIV infection and chronic viral hepatitis B]. / Sravnitel'naia kharakteristika nekotorykh pokazatelei funktsional'noi aktivnosti limfotsitov i neitrofilov u bol'nykh s infektsiei VICh i khronicheskim virusnym gepatitom B.

In 34 patients with human immunodeficiency virus (HIV) infection at the asymptomatic stage and 29 patients with chronic viral hepatitis B at the period of exacerbation (of these 14 patients had chronic persistent hepatitis and 15 patients had chronic active hepatitis) the complex study of the functional activity of lymphocytes and neutrophils was carried out by cytochemical methods with the simultaneous determination of the content of immunoregulating lymphocyte subpopulations. In patients with chronic active hepatitis a decrease in the percentage and the absolute number of helper T-lymphocytes and the ratio of CD4/8 in comparison with those in patients with HIV infection were revealed. At the same time patients with HIV infection exhibited more pronounced decrease in the activity of all lymphocytic enzymes under study (neutrophil esterase, acidic phosphatase and succinate dehydrogenase in lymphocytes), as well as in the activity of myeloperoxidase and the content of cation proteins and glycogen in neutrophils in comparison with patients having chronic active hepatitis.

[The prostaglandin and cyclic nucleotide levels in the organs of mice with experimental anthrax intoxication]. / Uroven' prostaglandinov i tsiklicheskikh nukleotidov v organakh myshei pri éksperimental'noi sibireiazvennoi intoksikatsii.

In this work the influence of Bacillus anthracis toxin, introduced intraperitoneally in a dose of LD100, on the content of prostaglandins E and F2 alpha, 6-ketoprostaglandin F1 alpha, thromboxane, cAMP and cGMP in the lungs, heart, liver and spleen of BALB/c mice in the time course of experimental intoxication has been studied. The concentration and proportion of prostaglandins and cyclic nucleotides have been shown to undergo-sharp changes in all organs under study in the process of intoxication. The level and proportion of prostaglandins in the lungs ensures the development of vaso- and bronchodilatation processes even at early stages of the action of the toxin. B. anthracis toxin sharply increases the content of cGMP in the organs under study and cAMP in the liver. The activating effect on the adenylate cyclase system of tissue cells is not linked with the action of the edematous factor of the toxin. The role of cyclic nucleotides and prostaglandins in the development of pulmonary edema in intoxication with B. anthracis toxin is discussed.

[The role of microbial toxic substances in the pathogenesis of acute intestinal infections]. / O roli mikrobnykh toksicheskikh substantsii v patogeneze ostrykh kishechnykh infektsii.

The authors suggest a syndromal approach to the acute intestinal infection pathogenesis provoked by gram-negative bacteria. A brief review of the achievements in the field of pathogenicity of infectious agents is given on the basis of which a conclusion is drawn about the main role of toxins in the clinical manifestation determining the principal syndromes in acute intestinal infections, i. e. diarrhea and inflammation. A pathogenetic syndromal classification of acute intestinal infections is forwarded which allows a practitioner to choose a pathogenetic therapy. The classification is useful for the pharmacologists as well searching for the methods of detoxification.

[Lymphocyte and neutrophil cytochemistry in the dynamics of different forms of diphtheria in adults]. / Tsitokhimiia limfotsitov i neitrofilov v dinamike razlichnykh form difterii u vzroslykh.

The cytochemical study of lymphocytes and neutrophils isolated from fractionated blood of diphtheria patients and carriers has revealed that a decrease in the activity of lymphocyte succinic dehydrogenase and myeloperoxidase can be observed at all periods of the disease and in all its forms. A decrease in the activity of lymphocyte nonspecific esterase has been noted only in patients with toxic and subtoxic diphtheria and a decrease in the activity of neutrophil alkaline phosphatase, in carriers. The analysis of correlations between the parameters of five enzymes under study (lymphocyte succinic dehydrogenase, lymphocyte acid phosphatase, lymphocyte non-specific esterase, myeloperoxidase, neutrophil alkaline phosphatase) and enzymatic rosette parameters has been made. The analysis has revealed an essential increase in the number of correlations in comparison with donors, changes in the qualitative nature of these correlations and sometimes the reversion of the correlations. Carriers have shown the greatest number of correlations. By the end of the terms of observations no restoration of normal correlations has been observed.

[The cellular immune response in different forms of diphtheria in adults]. / Kletochnyi immunnyi otvet pri razlichnykh formakh difterii u vzroslykh.

In 109 adult diphtheria patients with different forms of the disease (toxic, subtoxic, localized) and carriers, the latter including 6 persons having had the localized form of diphtheria, 12 different subpopulations of T and B lymphocytes and neutrophils were studied by the methods of rosette formation with sheep, mouse and bovine red blood cells. The study showed that, starting from week 2 of the disease, an increase in the content of the subpopulations under study was registered in all forms of diphtheria; the disease, as well as in patients with the localized form of the disease accompanied by complications and in long-term carriers. In all forms of diphtheria a decrease in the content of neutrophil rosette-forming cells was shown. The marker tests for prognostication of the complicated course of the disease, viz. the elevated content of M-rosette-forming cell and T gamma-rosette-forming cells during the first week of then disease, were established.

[The lymphocyte populations at different stages in the infection caused by the human immunodeficiency virus]. / Populiatsii limfotsitov na razlichnykh stadiiakh infektsii, vyzvannoi virusom immunodefitsita cheloveka.

In 58 persons infected with HIV the comparative study of the content of immunocompetent cells was carried out by the methods of rosette formation and immunofluorescence with the use of monoclonal antibodies. An increase in the content of rosette-forming cells (RFC), such as active E-RFC, E-RFC, theophylline-resistant E-RFC and M-FRC, in asymptomatic seropositive persons was established. At this stage of the disease the amount of lymphocytes T4 and T8 and their ratio underwent no essential changes. At the stage of lymphoadenopathy an increase in the content of lymphocytes T8, more pronounced in patients with secondary infectious lesions, was noted. At this stage a decrease in T4/T8 ratio appeared for the first time. A high level of rosette-forming lymphocytes was still observed both at this period and at the period of clinically developed AIDS, while the level of lymphocytes T4 sharply dropped in such patients.

[The use of hyperbaric oxygenation in treating viral hepatitis B and the reaction of the blood leukocytes]. / Primenenie giperbaricheskoi oksigenatsii v lechenii virusnogo gepatita B i reaktsiia leikotsitov krovi.

A total of 75 patients with virus hepatitis B of medium gravity were examined for the effect of HBO on the clinical course of the disease and blood leukocyte reaction. This reaction was tested on the basis of a complex of rosette-forming and cytochemical tests. HBO was found to produce a favourable effect if used at the early stages of the treatment (the first week of hospitalization). The effect consisted in significant reduction of the rate of exacerbations and residual phenomena. HBO provoked a decrease in the content of T and B lymphocytes by the 10th session of the treatment. A close relationship was revealed between HBO efficacy and the initial level of functional metabolic activity of leukocytes. The use of HBO was always accompanied by the rise of that activity during the treatment. The use of HBO at later times of the treatment (weeks 4-5) did not produce any well-defined clinical effect. Thus, HBO (8-10 sessions, pressure 1.5 absolute atmosphere, exposure 45 min) may be indicated as a prophylactic measure in respect of an unfavourable disease course with regard to the patients' selection on the basis of a complex of cytochemical tests.

[Functional-metabolic activity of the mononuclear phagocyte system of the blood, liver, spleen and skin in children with hepatitis B]. / Funktsional'no-metabolicheskaia aktivnost' sistemy mononuklearnykh fagotsitov krovi, pecheni i selezenki, dermy pri virusnom gepatite B u dete'i.

A total of 102 children aged 5 to 14 years with virus hepatitis B were examined for the status of the mononuclear phagocytic system in accordance with the absolute monocyte count in the circulating blood, esterase and acid phosphatase activity in the monocytes, for function of organ macrophages of the liver and spleen using dynamic scintigraphy with TC-colloid and for macrophages of the skin by the "skin window" method. The rise of the absolute count and lowering of the functional and metabolic activity of blood monocytes were directly proportional to the gravity of virus hepatitis B. The changes persisted for a long time, namely up to 1.5 to 3 months since the disease onset. There was a progressive drop of the functional activity of Kupffer cells in the liver with a maximum decrease seen within 4 to 6 weeks since the disease onset, followed by returning to normal in cyclic disease and preservation of the changes in lingering and chronic virus hepatitis B. Spleen macrophages play an active compensatory role, maintaining normal "purifying" function of the mononuclear phagocytic system. That compensatory response tension appeared high in lingering and especially in chronic virus hepatitis and may serve as a criterion for process chronicity. The changes in the mononuclear phagocytic system observed in cyclic course of mild and medium-gravity virus hepatitis B may be regarded as normal adaptive reaction and do not require any drug correction. The latter one may only be indicated in patients with grave, lingering or chronic disease patterns associated with break down or depletion of the adaptive mechanisms of the system in question.

[A comparison of the dynamics of changes in large intestinal mucosa of acute dysentery patients with detection of a specific antigen in urine]. / Sopostavlenie dinamiki izmenenií v slizistoi tolstoi kishki bol'nykh ostroi dizenteriei s byiavleniem spetsificheskogo antigena v moche.

The relationship between the elimination of shigellae from the body with urine and the dynamics of morphological changes in the mucous membrane of the large intestine of acute dysentery patients at the early convalescence period has been studied. The persistence of Shigella antigen in acute dysentery patients and its elimination with urine is, as a rule, accompanied by local immune cell reaction in the mucous membrane of the large intestine. The antigen circulating in the body is a factor contributing to the inflammatory process in the intestine, the amount of the eliminated antigen being higher in pronounced inflammations of the intestinal mucosa than in residual inflammatory phenomena. A group of patients (3 persons) releasing Shigella O-antigen with urine and having the inflammatory process in the large intestine, but showing no signs of local immune reaction in the lymphoid tissue of the large intestine, has been found. The reactivity of the lymphoid tissue of the intestine in such patients is a risk factor contributing to the development of prolonged dysentery or chronic postdysenteric colitis.