[The connection between the decomposition of mature collagen and the level of natural cytotoxicity in patients with focal scleroderma]. / Sviaz' mezhdu raspadom zrelogo kollagena i urovnem estestvennoi tsitotoksichnosti u bol'nykh ochagovoi sklerodermiei.

Increased rate of pyridinoline excretion with urine was detected in patients with focal sclerodermia: the ratio pyridinoline/creatinine was equal to 0.094 +/- 0.049 as compared with that of 0.073 +/- 0.049 in controls. Concentration of mature collagen cross-links involving pyridinoline structure in urine of patients with focal sclerodermia did not depend on the patients age and the disease duration. However, this pattern correlated distinctly with clinical form of the disease (0.073 +/- 0.049 in local form and 0.013 +/- 0.017 in generalized form of sclerodermia) as well as correlated reversely with the rate of activity of natural killer cells (r = -0.977).

[The cyclic nucleotide system of patients with focal scleroderma]. / Sistema tsiklicheskikh nukleotidov u bol'nykh ochagovoi sklerodermiei.

Studies of the function of cyclic nucleotide system in the lymphocytes of patients with focal scleroderma have revealed that this condition is characterized by growth of the intracellular cAMP/cGMP ratio, correlating with the process duration, severity, and dissemination. A correlation between lymphocyte regulatory function defect and the presence of immunodeficiency syndrome was demonstrated. Sensitivity of lymphocytic cyclic nucleotides in focal scleroderma patients to thymoptin, a thymic agent, was examined. Manifest clinical effect of this drug is based on stabilization of the function of lymphocytic cyclic nucleotides system and, consequently, on normalization of the immunologic parameters. Potentialities and prospects of thymic factors immunotherapy of focal scleroderma patients are discussed.

[A clinico-immunological assessment of the efficacy of combined methods of treating patients with different immunopathological forms of focal scleroderma]. / Kliniko-immunologicheskaia otsenka éffektivnosti kompleksnykh metodov lecheniia bol'nykh s razlichnymi immunopatologicheskimi formami ochagovoi sklerodermii.

To help the physicians choose a rational scheme of combined therapy of patients with various immunopathologic forms of focal scleroderma, the authors present a clinical and immunologic assessment of the efficacies of 2 combined therapeutic courses, enzyme immunotherapy and penicillin immunotherapy, as well as of the individual course of tactivin immunotherapy. Inclusion of tactivin in any complex therapeutic scheme appears to be necessary. In patients suffering from the condition for a long time, with multiple foci of involvement, tactivin should be combined with enzymic drugs, like hyaluronidase (lydase). Enzyme immunotherapy promoted a more active resolution of the skin process. Penicillin immunotherapy alone is disputable, and further studies of such treatment are necessary. Enzyme immunotherapy should be considered as the optimal scheme of rational combined treatment for focal scleroderma.

[Clinico-immunological parallels in patients with focal scleroderma]. / Kliniko-immunologicheskie paralleli u bol'nykh ochagovoi sklerodermiei.

Combined immunological examination of patients with focal scleroderma included studies of the humoral and cellular immunity parameters. The findings evidence that mainly immunological disorders underlie the pathogenesis of this disease, whose various combinations form this of that immunopathological pattern. An immunological classification of focal scleroderma is suggested. Clinical and immunological parallels in patients with different immunological variants of focal scleroderma are analyzed. The results permit a conclusion on the two basic mechanisms in the pathogenesis of focal scleroderma: (1) immunodeficiency involving the effector B component and (2) an isolated hyperfunction of natural killer cells.

[Possible role of natural cytotoxicity in impairment of collagen catabolism in focal scleroderma]. / O vozmozhnom uchastii mekhanizmov estestvennoi tsitotoksichnosti v narusheniiakh katabolizma kollagena pri ochagovoi sklerodermii.

Relationship between the state of natural cytotoxicity and collagen catabolism were studied in patients with focal sclerodermia. In the impairment activity of natural killer cells (NK cells) was markedly altered depending on such clinical parameters as duration, severity, activity and distribution of the disease as well as it was related to definite transformations in catabolism of collagen proteins. Low rate of collagen production and intensive collagenolytic processes correlated with the high level of hydrolytic activity of NK cells at the early steps of systemic morphea guttata accompanied by highly progressive course of the disease. Under conditions of subacute forms of focal morphea guttata activity of NK cells was distinctly decreased down to 50% of that of normal state and was accompanied by alterations in the spectrum of collagenolytic enzymes as well as by considerable variations in collagen production and in posttranslational modification of collagen fibrils. During the chronic step of sclerodermia activity of NK cells was normalized and correlated with the lowered rate of collagen production as well as with the subsequent alterations in collagen proteins catabolism. Alterations in the level of natural cytotoxicity appear to correlate with the state of collagen metabolism in focal sclerodermia.