[Imbalance in the proteinase-inhibitor system in obstetric sepsis and septic shock]. / Disbalans protinazno-ingibitornoi sistemy pri akusherskom sepsise i septicheskom shoke.

The condition of proteinase-inhibitor balance was studied in blood plasma of patients with obstetric sepsis. Hypoproteinemia (due to a massive blood loss and toxic effect) was shown to result in a 2-5-fold decrease of the activity of endogenous proteinases in blood plasma versus the control group. The activity of alpha-macroglobulins was also by 2 times lower versus the controls, while the activity of alpha 1-antichymotrypsin and of an acid-stable inhibitor of trypsin was found to be higher by 20-30%. A degree of imbalance of proteinase/inhibitor depends on a disease severity.

[Processes of modification of lipoproteins. Physiological and pathogenetical role of modified lipoproteins]. / Protsessy modifikatsii lipoproteinov, fiziologicheskaia i patogeneticheskaia rol' modifitsirovannykh lipoproteinov.

The review is devoted to modification of lipoproteins (Lp) connected with various biological processes. Possible mechanisms of Lp oxidation and the nature of oxidants involved in to these processes are considered. Specific attention is paid to the participation of proteolytic enzymes in modification of Lp.

[Extracorporeal circulation methods in the treatment of nonspecific aortic arteritis]. / Lechenie bol'nykh nespetsificheskim aortoarteriitom s pomoshch'iu metodov ékstrakorporal'nogo krovoobrashcheniia.

AIM: Development of a protocol of multiple-modality treatment of patients with nonspecific aortoarteritis (NAA) making use of plasmapheresis and specific plasma adsorption of proteinases. MATERIALS AND METHODS: Six patients with NAA aged 15 to 58 years were examined using ultrasonic dopplerography, magnetic imaging, and angiography of the large vessels. Red cell sedimentation rate was assessed, cathepsin G activity, antitryptic activity, and content of C-reactive protein in the blood measured. Drug therapy was supplemented by repeated sessions of plasmapheresis and specific plasma adsorption on immotin. RESULTS: After sessions of plasmapheresis (n = 17) and plasma adsorption (n = 13), increased cathepsin G activity dropped by at least 30% (in 3 patients it normalized), the content of C-reactive protein decreased in the presence of normal antitryptic activity (in patients with decreased activity it normalized and in those with increased values a tendency to normalization was observed). Red cell sedimentation rate decreased, particularly so 1 and 2 months after treatment; the patients felt better. CONCLUSION: Multiple-modality treatment of NAA patients making use of plasmapheresis and plasma adsorption decreases the activity of the inflammatory process.

[The biochemical and clinical aspects of the participation of granulocytes and their proteinases in a vascular wall lesion]. / Biokhimicheskie i klinicheskie aspekty uchastiia granulotsitov i ikh proteinaz v porazhenii stenki sosudov.

Some components of plasma and granulocyte proteolytic system, granulocyte activation degree were evaluated in 15 patients with nonspecific aortic arteritis (NAA) and 12 hereditary hypercholesterolemia (HHC) patients. Catepsin G activity in blood plasma of NAA and HHC patients was higher than in donors 8-9 and 6-fold, respectively (p < 0.001). Granulocyte collagenase activity, spontaneous NBT test values in them were higher than in donors 6 and 4-fold (p < 0.02 and p < 0.01, respectively), 2-fold (p < 0.005 and p < 0.001, respectively). The data obtained confirm the suggestion on the presence of an inflammatory component not only in pathogenesis of NAA, but also in HHC causation.

[Monoclonal antibodies to the trypsin-binding domain of trypsin inhibitor from human urine]. / Monoklonal'nye antitela k tripsinsviazyvaiushchemu domeu ingibitora tripsina iz mochi cheloveka.

Three MAb M2, B6, P1 (IgG1 type) against human urinary trypsin inhibitor (UTI), a glycoprotein with antiinflammatory properties, have been produced by hybridization of mouse myeloma cells P3O1 with spleen cells of immunized mice BALB/c. Competitive ELISA-examination of the peroxidase conjugates of M2, B6, and P1 MAb in the presence of the trypsin binding domain shows the M2 antibody to possess the highest affinity for this domain. On the basis of the MAb M2, a competitive ELISA of UTI concentration in urine is proposed. ELISA-detectable changes in the UTI content of urine from patients with nephritis without renal failure can be considered as an early index of renal parenchyma damage.

[Intensification of the effect of exogenous plasminogen activators on lysis of fibrin blood clots due to a decrease in the level of alpha-2- antiplasmin by a plasmasorption method]. / Usilenie deistviia ékzogennykh aktivatorov plazminogena na lizis fibrinovykh sgustkov iz plazmy za schet snizheniia urovnia alpha-2-antiplazmina metodom plazmosorbtsii.

Using plasminogen-Sepharose 4B chromatography, a 50-70% reduction in the alpha-2-antiplasmin (alpha-2-AP) content in human and dog blood plasma was reached. The decrease in the alpha-2-AP concentration in human and dog blood plasma markedly enhanced the lysis of fibrin clots formed from the plasma under the action of urokinase and streptokinase. Thus, the lysis of model clots for a definite period of time for human and dog blood plasma depleted for alpha-2-AP by 50-70% required 5-8 and 3-6 times as low urokinase and streptokinase concentrations as those needed for the clot lysis in the native plasma. The decrease in the fibrinogen concentration in human blood plasma caused by plasmosorption on plasminogen-Sepharose enhanced the model fibrin clot lysis by urokinase and streptokinase, however, by no more than 5-10%. Hence, the increased efficiency of plasminogen activators in the given model system can be accounted for by the decline of the antiplasmin potential of the blood plasma.

[The use of streptokinase preparations in pleural empyema and pyopneumothorax]. / Primenenie preparatov streptokinazy pri émpieme plevry i piopnevmotorakse.

Prevailing fibrin-formation in the pleural cavity entails hypoactivity of trypsin-like proteinases and a high inhibitory potential in the serum and pleural exudate. Streptokinase preparations appeared an effective means of pharmacological pulmonary decortication in patients with high pleural levels of plasminogen. The authors obtained higher efficacy of conservative therapy for pyothorax when they used a specially designed technique of intrapleural administration of streptokinase-activated fresh frozen plasma of the same group. The outcomes of the disease were also improved noticeably.

[A new method of isolating acid-stable trypsin inhibitor from human urine]. / Novyi metod vydeleniia kislotostabil'nogo ingibitora tripsina iz mochi cheloveka.

A novel procedure for isolation of an acid-resistant trypsin inhibitor from human urine (UTI) is described. The method is based on the use of immobilized on an insoluble matrix monoclonal antibodies specific for the given inhibitor. The use of Immotin (which represents an immobilized on Sepharose 4B UTI) as precolumn during affinity chromatography makes it possible to significantly prolong the immunoadsorbent life and to increase the inhibitor yield up to 92% of its original content in the urine. The preparation obtained with the use of an immunoadsorbent contains predominantly the native form of the inhibitor whose molecular mass is about 44 kDa.

[Use of thermo- and acid-stable proteinase inhibitor to suppress proteolytic activation in pulmonary inflammation]. / Ispol'zovanie termo- i kislotostabil'nogo ingibitora proteinaz dlia podavleniia aktivatsii proteoliza pri vospalenii legkikh.

A comparative study of thermo-acid stable proteinase inhibitor from rabbit serum and commercial drug contrykal was made on rats and in vitro experiments. Both inhibitors in equal doses effectively suppress proteolytic activity during initiation of lung inflammation. It was shown that the thermo-acid stable inhibitor possesses higher than contrykal, antielastase activity. A high effect of the acid stable inhibitors in the treatment of lung disease is suggested.

[Specific plasma sorption of proteinases--a new approach to the treatment of acute pancreatitis]. / Spetsificheskaia plazmosorptsiia proteinaz--novyi podkhod k lecheniiu ostrogo pankreatita.

The authors treated destructive forms of acute pancreatitis for the first time by means of specific plasma sorption of proteinases with the use of a proteinase plasma sorbent which is an acid-stable proteinase inhibitor immobilized on sepharose (ASI-Sepharose). Specific plasma sorption of proteinases on ASI-Sepharose was applied to the treatment of 29 patients with various forms of acute destructive pancreatitis. At the end of specific plasma sorption procedure the activity of blood plasma proteolytic enzymes in the patients reduced by 60-75%, which was attended by marked improvement of the condition in most cases; aggravation of the patients' condition was not encountered. The mortality in this group was 20.7% and was due to complications occurring during the development of the main disease. The mortality rate among patients treated by specific proteinase plasma sorption is much lower than that recorded in the USSR for destructive forms of acute pancreatitis which ranges from 30 to 75%.

[Dynamics of changes in the protease-inhibitory balance in blood plasma of dogs with experimental acute pancreatitis]. / Dinamika izmenenii proteinazno-ingibitornogo balansa v plazme krovi sobak s éksperimental'nym ostrym pankreatitom.

Changes of proteinase-inhibitory system values in blood plasma of dogs with experimental acute pancreatitis (EAP) were studied in dynamics. Their diagnostic and prognostic values was appraised. Essential shifts were revealed in the proteinase-inhibitory balance in blood plasma of dogs with EAP of various severity. The concentration of trypsin- and chymotrypsin-like proteinases exceeded the normal values 1.8-3.3 times in these animals. Coefficients expressing the relation of antitryptic and antichymotryptic activities to the activities of the corresponding proteinases in the blood plasma of animals with EAP were indicative of diminished blood plasma inhibitory potential as compared to that in intact animals. The authors are the first to show the diagnostic and prognostic value of the antichymotryptic activity/chymotrypsin in blood plasma of dogs with EAP.

[Elastase and acid phosphatase activity in bronchoalveolar lavage fluid during chronic bronchitis]. / Aktivnost' élastazy i kisloi fosfatazy v bronkhoal'veoliarnom smyve pri khronicheskom bronkhite.

The dynamics of acid phosphatase and granulocytic elastase activities in bronchoalveolar washings of 40 patients with chronic catarrhal bronchitis was studied. In case of effective cure, the activities of these enzymes were increased shortly on the 10-13 days from beginning of the cure. In order to study the nature of this enzymes, the additional researches were conducted. These researches demonstrated that the macrophages were the source of the acid phosphatase, and the neutrophils--elastase. The transitory increase of the activity of both enzymes is favourable prognostical sign of disease's course.

[Variants of procedures of artificial blood circulation and the proteinase activity of the blood]. / Varianty provedeniia iskusstvennogo krovoobrashcheniia i proteinaznaia aktivnost' plazmy krovi.

The use of a "Cell-Saver" technique prevented hyperproteolysis and deletion of proteinase inhibitors in the blood plasma of patients during cardiopulmonary bypass. The technique also improved the course of the postoperative period, decreased the incidence of lung complications and prevented effectively postoperative bleedings. A prognostic value of alpha 1-proteinase inhibitor to trypsin activity ratio in the blood plasma of patients subject of cardiopulmonary bypass surgery has been demonstrated.

[Evaluation of the effectiveness of the use of specific hemosorption in acute experimental pancreatitis]. / Otsenka éffektivnosti ispol'zovaniia spetsificheskoi plazmasorbtsii pri éksperimental'nom ostrom pankreatite.

An effective method of plasma proteinases (trypsin, chymotrypsin. elastases) removal in dogs with acute pancreatitis has been suggested. The method is based on plasmasorption, using human urine acid-stable proteinase inhibitor immobilized on sepharose. The procedure of plasmasorption reduces proteinase levels in dogs with acute pancreatitis to 35-70%, with the animal life-span prolonged 8-fold.