[The pathogenetic role of the serotonin-histamine-cyclic nucleotide system in ulcerogenesis].

The study was dedicated to the role of serotonin in the development of experimental gastric ulcer in rats, and the role of serotonin, histamine, and purine bases in patients with peptic ulcer. The intensification of serotonin and histamine production was shown to promote the sanogenesis of persistent gastric ulcer.

[Antibodies to Helicobacter pylori in gastric diseases].

AIM: To study the count of antibodies to Helicobacter pylori (ABHP), their role in diagnosis and prognosis in gastric diseases (GD). MATERIAL AND METHODS: Enzyme immunoassay (kits from EcoLab and Vektor-Best, Russia) was used to measure serum levels of ABHP (IgG, IgA, IgM+IgG+IgA) in 46 GD patients. RESULTS: It is shown that GD are characterized by a regular rise of serum ABHP which are serological markers of Helicobacter pylori infection. Percentage and absolute value of IgG-HP were the highest (78%, mean titer 1:604 vs control 1:110) as well as (IgM+IgG+IgA) antibodies to CagA-HP (approximately 82%, mean titer 1:160 vs. control 1:10); the level of IgA-HP was elevated by 39%, mean titer 1:442, control 1:120. Elevated levels of IgG-HP reflect intensity of inflammatory processes, IgA-HP--atrophic processes, IgM+IgG+IgA)-CagA-HP--proliferative processes in GD. CONCLUSION: High concentrations of ABHP are a diagnostic criterion of HP infection, reflect intensity of infectious, inflammatory, atrophic and proliferative processes in GD. Long-term persistence of elevated ABHP concentrations is one of the indications for application of antichelicobacter therapy in GD associated with HP while ABHP fall is an additional criterion of efficacy of the treatment.

[Cytokines and cytokine therapy in gastrointestinal diseases]. / Tsitokiny i tsitokinoterapiia pri zabolevaniiakh organov pishchevareniia.

AIM: To compare cytokine status in gastrointestinal diseases (GID) with reference to etiological factor, course, stage, therapy of the disease. MATERIAL AND METHODS: Enzyme immunoassay was used to examine cytokines in the peripheral blood, tissue homogenates of 560 GID patients. GID were represented by ulcer disease (UD), cholelithiasis, chronic hepatitis (CH), glutenic enteropathy (GE), Crohn's disease (CD), nonspecific ulcer colitis (NUC). RESULTS: In chronic recurrent GID (UD, cholelithiasis, GE) early exacerbation was characterized by elevated concentrations of IL-1 beta, IL-6, IL-8. Concentrations of IL-12, Inf alpha, g, TNF alpha reached maximum on the height of the disease. Intensification of regenerative processes raised concentrations of IL-4, IL-10. An overall level of serum cytokines averaged 190-780 pg/ml, reaching in some patients with active disease 1200-3000 pg/ml, in remission 30-110 pg/ml, in the control 40 pg/ml. In chronic progressive GID the levels of IL-1 beta, IL-2, IL-8, IL-6 reached 30-80 pg/ml, IL-12, Inf gamma, TNF alpha--150-370 pg/ml. A rise in cytokines concentrations in inflammatory viral, bacterial, autoimmune GID was higher than in cancer, alcoholism-related diseases, metabolic disturbances. Basic therapy in patients with chronic recurrent GID led to a significant fall in concentration of serum cytokines. Therapy with monoclonal antibodies to TNF alpha was associated with transitory pronounced favourable changes in peripheral blood cytokine status. CONCLUSION: GID provoke elevation of serum and tissue cytokines, impairment of cytokine balance in correlation with the etiological factor, variants of the course, stage of the disease, on-going therapy.

[Interleukins in chronic diseases of digestive organs]. / Interleikiny pri khronicheskikh zabolevaniiakh organov pishchevareniia.

AIM: To characterize quantitatively and functionally interleukines (IL) in chronic gastrointestinal diseases (CGD) depending on the affected organ, etiology, activity and stage of the disease. MATERIAL AND METHODS: Levels of IL-1 beta, IL-4, IL-6, IL-8, tumor necrosis factor alpha (TNF-alpha), gamma interferon (Inf-gamma) in peripheral blood of 300 patients with chronic hepatitis, gastroduodenal ulcer, cholelithiasis, glutenic enteropathy and other CGD were measured by enzyme immunoassay. RESULTS: CGD are accompanied by cytokine imbalance the severity of which depended on the etiological factor (virus, alcohol, etc.), the disease activity, stage and kind of IL. A maximal IL rise was seen in exacerbations of ulcer, cholelithiasis, chronic viral, autoimmune diseases. At early disease stages higher were the levels of Inf-gamma, IL-1 beta, IL-8, IL-6; at late stages--of TNF-alpha, IL-4. In patients with highly and moderately active CGD content of IL reached 250-750 pg/ml that is 3-5 times higher than in inactive CGD. In alcohol-induced CGD and metabolic disturbances IL level was under 150 pg/ml. CONCLUSION: Assessment of the cytokine spectrum in CGD holds prognostic importance as this spectrum allows conclusion on the disease activity, its progression.

[Frequency of relapse and gigantic stomach ulcers]. / Chasto retsidiviruiushchie i gigantskie iazvy zheludka.

Frequently recurrent stomach ulcers are ulcers that exacerbate 2-3 times per year. Indolent ulcers are ulcers for which there is no healing during three months of continuous treatment.

[Interleukins in stomach and duodenal ulcers]. / Interleikiny pri iazvennoi bolezni zheludka i dvenadtsatiperstnoi kishki.

The results of research have shown, that the ulcer disease is accompanied by the increase of peripheral blood interleukins. The maximal increase of interleukins quality and especially TNFa and interleukine-4 was revealed in the patients with peptic ulcer, that was diagnosed at the first time. Interleukins increase was less expressed in the patients with freguent ulcer relapses. In patients with UDS the level of interleukins at first revealed ulcer was a little bit higher, than at frequently relapsing ulcer, however contents of all investigated interleukins in UDS is rather lower than in ulcer disease of duodenum. The definition of cytokines profile in the patients with stomach and duodenal peptic ulcer has prognostic importance because it allows to receive the additional information about disease activity, its prognosis and efficiency of anti-ulcer's therapy.

[Changes in local humoral immunity during stomach ulcer healing with laser and drug therapy]. / Izmenenie mestnogo gumoral'nogo immuniteta v protsesse zazhivleniia iazv zheludka pod vliianiem lazernoi i medikamentoznoi terapii.

The increase of the contents of serum IgA, IgG, IgM on the edge of long non-cicatrizing gastric ulcer was determined. At the same time the level of SIgA decreased in comparison with unaltered gastric mucosa. It is shown that the immunoglobulin content in the healed ulcer cicatrice depended on treatment method. The medicamentous therapy was accompanied by lowering of the contents of IgG, IgA, SIgA and by some increase of IgM level. The laser therapy is characterized by lowering of IgA, IgG, IgM level on a background of significant increase of SIgA content. The local humoral immunity after laser therapy was the same as in persons with unaltered gastric mucosa.

[Complicated form of chronic stomach ulcer]. / Oslozhnennaia forma khornicheskoi iazvy zheludka.

Stomach ulcer is one of the most important problems of gastroenterology. Complicated, often recurring, giant and refractory stomach ulcers are most complex in the pathogenetic and treatment regard. The chronic and often recurring course of the disease, high percent of complications including such severe ones as perforation and bleeding, malignization, penetration and stenosis quite often result in a partial or complete disability in patients. As is well known, it is generally the most active and capable part of population that suffers from this disease.

[Role of stress in the etiopathogenesis of duodenal ulcer in young patients]. / Rol' stressa v étiopatogeneze iazvennoi bolezni dvenadtsatiperstnoi kishki u bol'nykh molodogo vozrasta.

The analysis of the acid-forming function of the stomach, both basal and stimulated with insulin, atropine test, tests for the content of the adrenocorticotropic hormone, somatotropic hormone, thyrotropic hormone, triiodothyronine, thyroxin, cortisol in the blood and the content of gastrin in the blood and gastric juice, activity of the processes of lipid peroxidation, content of ceruloplasmin in the blood, content of Helicobacter pylori (Hp) in the gastric mucosa were conducted in 68 men and 64 women at the age from 18 to 40 years suffering from gastroduodenal ulcer in order to examine the role of stress in ulcer formation. 38 patients with duodenal ulcer took proton pump blockers and antioxidants for 3 years whenever they were in a stress situation. The research revealed that young patients with duodenal ulcer show enhanced sensitivity of parietal cells and sympathoadrenal system to stressful situations, and stimulation of the acid-forming stomach function takes place under the effect of both catecholamines and gastrin. Men can have both Hp-dependent and Hp-independent duodenal ulcers, while women have mostly Hp-dependent duodenal ulcers. Prescription of proton pump blockers of and antioxidants for patients with duodenal ulcer, who are in a stressful situation, reduces the frequency of duodenal ulcer recurrences.

[Biogenic amines and cyclic nucleotides in the laser therapy of long-term nonhealing stomach ulcers]. / Biogennye aminy i tsiklicheskie nukleotidy pri lazeroterapii dlitel'no ne zazhivaiushchikh iazv zheludka.

A study is presented of the effect of copper vapors laser therapy on the content of biogenic amines--serotonin and histamine and the state of adenylcyclase (AC) system (content of cAMP, cGMP and AC activity) at the edge of the gastric ulcer. Direct effect of laser radiation (single dose 10--15 J.) produced a significant increase of serotonin, histamine, cAMP, AC activity and an insignificant increase of cGMP. Healing of the ulcerative defect after 5--6 laser therapy sessions was followed by a reduction of the content of serotonin, increase of histamine, cAMP and AC activity. The authors discuss the biostimulating effect of laser radiation by influencing the inflammatory-proliferative processes in the epitheliocytes in prolonged nonhealing gastric ulcers.

[Effect of laser irradiation of different intensities on the processes of healing of stomach ulcers]. / Vliianie lazernogo izlucheniia razlichnoi moshchnosti na protsessy zazhivleniia iazv zheludka.

Patients with stubborn peptic ulcers were exposed to copper vapor laser of various intensities with similar irradiation energy. The best therapeutic effect (more rapid ulcer healing) was achieved when ulcer bottom and edges were exposed to laser of higher intensity; the effect is explained by a higher stimulation of inflammation and a more rapid and clear-cut restructuring of connective-tissue stroma on ulcer bottom.

[The content of biologically active substances in the margin of a stomach ulcer being treated with a copper-vapor laser]. / Soderzhanie biologicheski aktivnykh veshchestv v krae iazvy zheludka pri lechenii lazerom na parakh medi.

A study was made of the effect of laser therapy on the content of she biologically active substances serotonin, histamine, PGE2 and PGF2 alpha as well as on the adenylate cyclase system--adenylate cyclase activity and cGMP content. Direct exposure to laser produced an appreciable increase of the content of serotonin and histamine, PGE2 and PGF2 alpha, cAMP and of adenylate cyclase activity. On the healing of ulcerous defect after 5-6 sessions of laser therapy a decrease of the content of serotonin, a rise of histamine, PGE2, PGF2 alpha, cAMP accumulation and adenylate cyclase activation were recorded.

[The effect of laser therapy on the mechanisms for generating healing in long-term nonhealing stomach ulcers]. / Vliianie lazeroterapii na nekotorye mekhanizmy sanogeneza dlitel'no nezazhivaiushchikh iazv zheludka.

A study was made of the effect of copper laser therapy on the content of PGE and PGF2 alpha and on the adenylate cyclase system (cAMP, cGMP and adenylate cyclase content) in patients with gastric ulcer. Seventy patients with indolent (from 3 months to 2 years) gastric ulcers were examined. The patients were assigned into 2 groups: group I received drug therapy combined with the influence of laser on copper vapours on the ulcerous surface (a single radiation dose 10 to 15 J). As compared to group I, the patients of group II manifested a considerable rise of the content of cAMP and prostaglandins, as well as adenylate cyclase activation in the gastric mucosa. Nonspecific biostimulating action of laser radiation exercised via the influence on the dysregenerative processes in the epitheliocytes of long nonhealing ulcer edges is under discussion.