[THE CLINICAL INFORMATIVENESS OF AUTOMATED METHODS OF SCREENING DETECTION OF ANTI-NUCLEAR ANTIBODIES USING INDIRECT REACTION OF IMMUNE FLUORESCENCE, ENZYME-LINKED IMMUNOSORBENT ASSAY AND MULTIPLEX XMAP TECHNOLOGY UNDER SYSTEMIC LUPUS ERYTHEMATOSUS].

Thew antinuclear antibodies (ANA) consist heterogeneous group of auto antibodies reacting with various components of nucleus and cytoplasm. The ANA is a main serological marker of systemic lupus erythematosus (SLE). The implementation in clinical practice of new highly productive techniques of immune analysis using automated systems sets up prerequisites for standardization and amelioration of reproducibility of detection of ANA. The study was carried out to compare diagnostic significance of automated techniques of screening detection of ANA (indirect immunofluorescence test on cells HEp-2 (IIFT-HEp-2)), enzyme-linked immunosorbent assay (ELISA) and multi-complex immune analysis (MIA, using suspension technology xMAP) in serum of patients with SLE. The serums from 94 patients with SLE were analyzed. The comparison group included 70 patients with other rheumatic diseases. The control group consisted of 30 healthy donors. The screening detection of ANA using technique IIFT-HEp-2 was implemented on automated platform AKLIDES, ELISA - on automated analyzer ALEGRIA and MIA on automated analyzer BioPlex 2200. The technique IIFT-HEp-2 demonstrated the most high diagnostic sensitivity as compared with ELISA and MIA- BioPlex 2200 (96.8%; 79.8% and 82.9% correspondingly). The general diagnostic specificity of detection of ANA using technique IIFT-HEp-2 was lower than in case of ELISA and MIO-BioPlex 2200 (40%, 70% and 57% correspondingly). In the group of healthy donors the lowest diagnostic specificity was observed in ANA screening analysis using MIA-BioPlex 2200 (80%) while in case of applying IIFT-HEp-2 and ELISA indices of diagnostic specificity made up 93.3% and 96.7% correspondingly. The ANA analysis of mix of 26 nuclear antigens using ELISA technique was a reliable laboratory test for diagnostic of SLE (likelihood ratio of positive result - 2.66). By the level of likelihood ratio of negative result of the IIFT-HEp-2 technique was more informative test for exclusion of diagnosis of SLE than techniques of ELISA and MIA-BioPlex 2200 (0.08; 0.29 and 0.3 correspondingly). The detection of ANA using technique of is the most preferable primary screening test for diagnostic of SLE. The ELISA of antibodies to mix of nuclear antigens and MIA on the basis of xMAP technology are less preferable screening tests for diagnostic of SLE as compared with IIFT-HEp-2 because of false-negative results in 20% and 17% of cases correspondingly. ELISA and MIA are to applied as confirmatory screening tests permitting to detect antigen-specific ANA in patients with SLE with positive results of IIFT-HEp-2.

[The clinical immunologic characteristic and laboratory diagnostic of bronchial asthma under pecilomycosis.]

The actuality of the problem is is conditioned by detection of infection of patients' blood with fungi genus paecilomyces in the form of carriage or activation of pecilomycosis infection with clinical manifestation of allergic diseases and bronchial asthma. The purpose of study is to analyze clinical and immunologic characteristics of bronchial asthma under pecilomycosis and to develop new approaches to its laboratory diagnostic in conditions of the primary health care unit. The complex examination of patients that included collection of allergy anamnesis, physical examination, application of laboratory, cytology, immunology and microbiology analysis was carried out. The diagnosis of pecilomycosis was established at the basis of express-diagnostic using direct count of mature spherules and yeast-like cells of fungi genus Paecilomyces in blood sample, detection of specific IgE- and IgG antibodies to allergen of fungus Paecilomyces spp. in blood of patients and cultural analysis. The clinical immunological characteristics of atopic and endogenous (non-atopic) forms of bronchial asthma in 143 patients were examined. The activation of pecilomycosis was established in 120 (83.9%) patients: the content of mature spherules of fungus genus Paecilomyces in blood varied from 8 000 to 55 000 (in average 17 500±755) in 1 mkl at the standard 1000-6000 (in average 3417±433) in 1 mkl. The specific IgE- and IgG antibodies to allergen of fungus Paecilomyces spр. were detected (57% and 81% correspondingly). The development of bronchial asthma is induced by activation of pecilomycosis in blood: it occurred against the background of acute respiratory viral infection in 74 patients (62%), seasonal and age fluctuations of immune status in 34 patients (28%), under stress impact in 12 patients (10%). The immune response to infection with fungus genus Paecilomyces is conditioned by mechanisms of non-specific resistance and specific immunity. The eosinophils and natural killers are involved into sanation of blood from fungal cells of non-phagocyting sizes using antibodies-mediators of specific IgE and IgG antibodies to allergen of fungus Paecilomyces as effector cells in reaction of antibody-dpendent and cell mediated cytotoxicity. The phagocytosis of small fungal forms was detected: endospores by monocytes, neutrophils, eosinophils and cytolysis of fungal cells by erythrocytes. The obtained data permits to differentiate carriage or activation of pecilomycosis in blood of patients with bronchial asthma, to mark out individuals with atopic or non-atopic profile of immune reaction determining specificity of their immune defense from agent of fungal infection and clinical picture of disease. The algorithm is proposed concerning diagnostic of bronchial asthma of pecilomycosis etiology in conditions of primary health care unit.

[Mechanisms of the development of immunodependent inflammation in silicosis]. / Mekhanizmy razvitiia immunozavisimogo vospaleniia pri silikoze.

Patients with uncomplicated silicosis were found to develop chronic immunodependent inflammation caused by an adjuvant effect of silica and characterized by autoimmune, histamine- and complement-dependent components. Reduced specific and non-specific antimicrobial defence underlies frequent complication of silicosis by tuberculosis and nonspecific infectious diseases of the bronchopulmonary system. A diagram showing the development of immunodependent inflammation in silicosis is presented.

[Histamine-related reactions in patients with byssinosis]. / Gistaminzavisimnye reaktsii u bol'nykh bissinozom.

The purpose of the study was to analyze the mechanism of histamine action in histamine-dependent reactions of neutrophils and lymphocytes in patients with byssinosis and chronic asthmatic bronchitis under cotton and flax dust effect. The appraisal of histamine content in blood serum, receptor/histamine distribution of lymphocyte and neutrophil subpopulations (rosette-forming double and triple reactions), determination of histamine modeling effect on lymphocyte-neutrophil cooperation in the inhibition reaction of leukocyte migration revealed that under cotton dust effect neutrophils and the complement system were involved into the histamine liberation process in byssinosis patients, lymphocytes were most likely not involved into the process. Flax dust-affected histamine reactions were not so distinct: lymphocyte and neutrophil reactivity in byssinosis patients did not exceed the standards. Patients with chronic asthmatic bronchitis had high blood concentration of histamine and experienced some changes in cells' migration characteristics. It was assumed that primarily nonimmune mechanisms of histamine liberation and activation of the complement system were involved into byssinosis pathological process in patients exposed to cotton and flax dust effect. In patients with chronic asthmatic bronchitis there occurred all 3 activation mechanisms of biologically active substances, i.e., allergic and nonantigenic ways of histamine liberation and activation of the complement system.

[Transplacental passage of the antiviral agent, bonafton]. / Issledovanie transplatsentarnogo perekhoda protivovirusnogo preparata bonaftona.

The ability of 14C-bonafton to penetrate the placental bar was studied in female Wistar rats. The drug was shown to penetrate through the placenta in insignificant amounts. The maximal quantities of the drug which entered the fetuses proper during the last third of pregnancy do not exceed 0.55% of 14C-bonafton content in the mother's blood. It was revealed that bonafton transplacental penetration is barred by fetal envelopes.