[Antihypertensive therapy optimization and endothelial function in patients with gout and chronic urate tubulointerstitial nephritis].

AIM: to characterize the markers of endothelial dysfunction and the effect of antihypertensive drugs on them in patients with chronic urate tubulointestinal nephritis (UTIN) and articular gout. SUBJECTS AND METHODS: The study enrolled 81 patients aged 39 to 59 years with gout and urate nephropathy. All the patients were diagnosed as having grade 1-2 arterial hypertension. A lower glomerular filtration rate (GFR) was noted in 49.9%; microalbuminuria (MAU) and elevated serum endothelin-1 (ET-1) levels were recorded in all the patients. Combination antihypertensive therapy based on the use of angiotensin-converting enzyme (ACE) inhibitors and/or an angiotensin II receptor blocker (ARB) in combination with calcium channel blockers was performed during 12 months. The time course of changes in blood pressure, the parameters of target organ lesion, and the markers of endothelial dysfunction were monitored. RESULTS: Before the study, all the examinees were found to have MAU and increased serum ET-1, which are regarded simultaneously as signs of renal lesion and as markers of endothelial function. A combination of an ACE inhibitor or an ARB could diminish albuminuria and reduce ET-1 concentrations, lower systolic and diastolic blood pressure significantly, and increase GFR. CONCLUSION: The patients with articular gout and chronic UTIN are observed to have signs of endothelial dysfunction eliminated by combination antihypertensive therapy.

[Endothelial function in patients with arterial hypertension and impaired uric acid metabolism].

The aim of the study was to investigate endothelial function in patients with arterial hypertension and impaired uric acid metabolism in comparison with patients having arterial hypertension and normal uric acid metabolism. 46 patients aged 32-56 yr with grade I-II AH were included in the study. A group of 36 patients (27 male, 9 female) presented with AH and impaired uric acid metabolism (hyperuricemia), the control group included 10 patients with AH and unaffected uric acid metabolism. Inclusion criteria in the two groups were identical. Endothelial dysfunction was documented in all patients and confirmed by increased levels of serum endothelin-1 and microalbuminuria, qualitative and quantitative changes in the intima-media complex and its thickening. These changes were much more pronounced in patients with hyperuricemia It is concluded that impaired uric acid metabolism in patients with AH leads to rapid onset and progression of endothelial dysfunction. This fact should be taken into consideration by doctors practicing antihypertensive treatment and for the evaluation of cardiovascular risks.

[Use of laws of interelement interactions for understanding of mechanisms of various human diseases].

The review considers the basic laws of interaction of elements in real physiological conditions of metabolism. The law of replacement and two it consequences have been formulated taking into account a major principle of cybernetics, the feedback principle. A rule of a fractional threshold and the law of toxicity based on the Mertz's rules have been formulated. These laws have been used here for consideration of mechanisms of occurrence and development of apoptosis and also side-effects of statins. Study of bioinorganic mechanisms of different diseases is a erspective way for search of complex connections of metals and ligands, capable to interaction with initiators of chain reactions, and for a finding of substances--inhibitors these reactions.

[Distribution of chemical elements in whole blood and plasma]. / Raspredelenie khimicheskikh élementov v tsel'noi krovi i plazme.

The distribution factor (Fd) of 35 elements of plasma and whole blood in 26 healthy men and women was detected by ICP-OES. Usilig this parameter the elements were subdivided in 3 pools. 9 of them have Fd higher than 1.5 ("elements of plasma"-Ag, Ca, Cu, In, Li, Na, Se, Si, Sr); 6 have lower than 0.5 ("elements of blood cells"-Fe, K, Mn, Ni, V, Zn), other 20-about 1 ("blood elements"). Fd of all elements depends on ionic radius. Elements of 2nd sub-groups of all groups of Mendeleev's periodic table ("heavy metals") depend on the similar law: "with growing of ionic radius the concentration of elements in plasma enhances". In alkaline metals Fd depends on the opposite law:" with growing of ionic radius of alkaline metal the quantity of elements in blood cells enhance". Dependence of Fd on the value of atomic mass in periods or in exterior electronic cloud (s-, p-, d-, f-) was not established. The table of distribution of all detected elements in whole blood in relation to 8 macroelements (Ca, Mg, K, Na, S, P, Fe, Zn,) is presented, as a basic diagnostic criteria in metal-ligand homeostasis disturbance.

[R proteins as a reflection of disorders in the cellular reception mechanisms in kidney diseases]. / R-belki kak otrazhenie narushenii mekhanizmov kletochnoi retseptsii pri zabolevaniiakh pochek.

As many as 47 patients with amyloidosis and 31 with chronic glomerulonephritis (CGN) were examined for the blood serum content of R proteins, chemotactic activity of blood leukocytes and the degree of the inhibitory influence of the autologous serum on chemotaxis. Amyloidosis and CGN were marked by an increase of the level of receptor proteins. A reverse correlation was established between the rise of the content of R proteins and the chemotactic properties of leukocytes. In CGN, the rate of demonstration of the high titers of R proteins and the magnitude of the chemotaxis decline depended on the disease phase (the degree of activity) whereas in amyloidosis, these reactions differed insignificantly in patients with various clinical patterns and stages of renal amyloidosis.

[The level of R proteins in reactive arthritis]. / Uroven' R-belkov pri reaktivnykh artritakh.

A total of 46 patients with reactive arthritides and 20 patients with rheumatoid arthritis (RA) were examined, as compared with 20 normal persons, for the blood serum content of the products of catabolic breakdown of cell receptors--R proteins (according to inhibition of the hemagglutination reaction between human red blood cells and anti-R-serum) and for conventional parameters of phagocyte function of leukocytes. The content of R proteins in patients with reactive arthritis and RA was found to be increased, and the phagocytic activity was discovered to be lowered. The changes in the parameters indicated depended on the disease entity and the disease course. The possible pathophysiological importance of changes in the level of R proteins in arthritides is discussed.

[Value of cytochemical tests in nephrology]. / Znachenie tsitokhimicheskikh testov v nefrologii.

The activity of peripheral blood leukocyte enzymes (neutrophils and lymphocytes) was assessed by cytochemical methods in 166 patients with chronic glomerulonephritis, lupus nephritis and amyloidosis (primary, secondary, hereditary in periodical disease) to determine their importance for differential diagnosis and to assess the activity and prognosis of these nephropathies. Correlation of the nature of enzymatic shifts with nephropathy type, activity of inflammation and prognosis of nephritides was shown. The effectiveness of the use of cytochemical tests in examination of nephrological patients was substantiated.