Dysregulatory processes of the cellular link of the immune system in the dynamics of common variable immunodeficiency.

Common variable immunodeficiency (CVID) is a variant of primary immunodeficiency in which inhibition of antibody production is formed due to disorders of intercellular interaction affecting cellular elements of both innate and adaptive immune responses. A feature of CVID is the late start and variability of clinical minifestation. These arguments determine the purpose of the study: to identify the dynamics of changes in the cellular parameters of the adaptive and innate immune response depending on the duration and severity of the infectious manifestation of CVID. In this regard, a retrospective analysis of medical histories and dynamic observation of fifteen patients with CVID were carried out. Selection of specific parameters of cellular indices of factors of innate resistance and adaptive immunity was carried out on the basis of systemic-functional approach of immunodiagnostics. It is shown that in patients with CVID -mediated hypogammaglobulinemia and infectious phenotype of clinical manifestation, enhancement of quantitative and functional potentials of T-link effector cells of adaptive immunity is recorded against the background of reduction of number of regulatory T-helpers. With a more severe clinical course of the disease, the number of CD3+HLA DR + limphocytes is lower than with a more favorable version, there is a tendency to decrease the number of these cells, as well as the number of peripheral Treg with an increase in the length of the disease. Cellular components of innate immunity are characterized by a decrease in neutrophil activity, inhibition of antigen-presenting monocyte activity, the number and cytotoxicity of natural killers. At the same time, the tendency to decrease the cytolytic potential of NK with an increase in the length of illness and statistically significant differences depending on the severity of the manifestation of the infectious phenotype of CVID was recorded. The obtained results determine the importance of evaluating the cellular link of the immune system in patients with CVID, including as a prognostic criterion for the severity of the course.

[Perftoran in the endotoxicosis correction in purulent-inflammatory urological diseases]. / Perforan v korrektsii éndotoksikoza pri gnoinosepticheskikh urologicheskikh zabolevanii.

Perftoran (PF) was used within a complex intensive care of 74 patients with purulent-inflammatory urological diseases and with signs of generalized inflammation. Positive effects were found to be made by PF on the parameters of microcirculation, oxygen status, dynamics of the serum content of cytokines, condition of their balance and immune status, which entailed a regression of endogenous intoxication and arrested the inflammatory lesion in the kidneys. PF cut the intensive care time of patients with complicated urological infection by 4.2+/-0.4 days (p < 0.05). The conclusion is that PF is a novel pathogenetic treatment method applicable to patients with purulent-inflammatory urological diseases.

[Efficacy and adverse effects of using large doses of corticosteroid preparations administered every other day]. / Effektivnost' i pobochnye iavleniia primeneniia kortikosteroidnykh preparatov v bol'shikh skheme po cherez den'.

The authors analyze the efficacy and side effects of prednisolone administered to 600 patients for myasthenia and polymyositis in a dose of 0.8 to 1.5 mg per kg body weight every other day for a period ranging from 3 months to 10 years. Practically complete remissions and substantial improvement were attained in 74% of the patients. None of them showed pronounced symptoms of hypercorticism. Of the side effects the most frequent were luniform face, vegetative disturbances, hirsutism. It is shown that the degree of the side effects is associated not with the duration of the prednisolone treatment, but with initially large doses of the hormone. Transition to supporting therapy in a dose of 0.4 to 0.6 mg/kg led to a substantial diminution and disappearance of the corticosteroid-produced side effects.