[The late results of thrombocytapheresis in bronchial asthma patients]. / Otdalennye rezul'taty trombotsitafereza u bol'nykh bronkhial'noi astmoi.

A long-term follow-up (within 18 months) has been conducted of bronchial asthma (BA) patients (a total of 29 cases with atopic, aspirin and mixed BA forms) subjected to thrombocytapheresis. The examination performed in 1-2 month intervals included a berotec test, assessment of platelet aggregation, platelet intracellular calcium metabolism, external respiration function (ERF). The treatment resulted in remission of 4-18 month duration. It was characterized by ERF normalization, high sensitivity to sympathomimetics, platelet status improvement. The best results were achieved in the groups of atopic and aspirin asthma patients. The findings allow recommendation of thrombocytapheresis as a method of choice in combined therapy of BA.

[Use of plateletpheresis in the treatment of bronchial asthma]. / Primenenie trombotsitafereza dlia lecheniia bronkhial'noi astmy.

It was shown that platelets of asthmatic patients notwithstanding the disease form are more sensitive to the stimulating action of platelet-activating factor (PAF) in aggregation response and intracellular Ca2+ influx induction than platelets of healthy donors. Intracellular Ca2+ influx was measured using the fluorescent probe Fura-2. Platelet apheresis was applied attempting to normalize the "hyperactivated" state of asthmatic patients' platelets. Platelet apheresis was performed using the on-line cell separator Fenwal CS-3000 in 27 patients without any considerable side effects. The mean platelet yield was 400-600 X 10(9) cells; the blood platelet count restored immediately after the treatment. Positive clinical effect (complete reduction of asthmatic attacks for at least 2 months, improvement in respiratory function parameters) was observed in 19 out of the 27 patients (70%). The clinical effect correlated well with the normalization of in-vitro platelet response to PAF.

[The thrombocyte function of bronchial asthma patients]. / Issledovanie funktsional'nogo sostoianiia trombotsitov u bol'nykh bronkhial'noi astmoi.

The functional characteristics of platelets were estimated in patients with different asthma forms (atopic, aspirin-sensitive and mixed ones). It was shown that platelets of asthmatics with the atopic and aspirin-sensitive disease forms are more sensitive to the stimulating action of platelet activating factor (PAF) in aggregation response and intracellular Ca2+ influx induction than platelets of patients suffering mostly from the recurrent bronchopulmonary infections with atopic component (so-called "mixed" asthma) and more activated than platelets of healthy donors. Intracellular Ca2+ influx was measured using the fluorescent probe Fura-2 in platelet suspension. Platelet aggregation was measured on aggregometer by two methods (Born's method and correlational photometric method) in platelet-rich plasma. PAF was used as inductor of platelet aggregation and fluorescence response. The antiallergic drugs ketotifen and sodium cromoglycate (intal) caused a 30-40% inhibition of PAF-induced aggregation of asthmatics' and healthy donors' platelets. It may be concluded that platelets of atopic and aspirin asthmatics are more active, their "hyper-reaction" to PAF is expressed by higher aggregability and the lower PAF concentration threshold.

Hyperactivation of platelets in asthma and introduction of platelet apheresis as treatment procedure.

Functional characteristics of platelets (Pts) were estimated in patients with different asthma forms (atopic and aspirin-sensitive). It was shown that Pts of asthmatics notwithstanding disease form are more sensitive to stimulating action of platelet-activating factor (PAF) in aggregation response and intracellular Ca2+ influx induction than Pts of healthy donors. Intracellular Ca2+ influx was measured using fluorescent zond Fura-2. Antiallergic drugs--ketotifen and sodium chromoglycate--caused 30-40% inhibition of PAF-induced aggregation of asthmatics' Pts. Platelet apheresis (PtA) was applicated attempting to normalize "hyperactivated" state of asthmatics' Pts. PtA treatment was performed using on-line cell separator Fenwal CS-3000 in 27 patients without any considerable side effect. Mean Pt yield was 400-600 X 10(9) cells; blood Pt count restored immediately after treatment. Positive clinical effect (complete reduction of asthmatic attacks for at least 2 months, improvement in respiratory function parameters) was observed in 19 out of 27 patients (70%). The clinical effect correlated well with the normalization of in vitro Pt response to PAF. It may be concluded that platelet apheresis has to be introduced as the treatment method for bronchial asthma, particularly in the patients with PAF-induced "hyperactivation" of Pts in vitro.