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Biomedical subjects

G A Konovalov

Publications and source records attributed to G A Konovalov.

At least 19 recordsLinked to original sources
PubMed2002

[Apheresis of immunoglobulins - new approach to the treatment of severe dilated cardiomyopathy].

Two courses of immunoadsorption with 'Ig Adsopak' were used in the treatment of a patient with dilated cardiomyopathy (DCM) during which all class G and partially class M and A immunoglobulins were removed. Every course consisted of 5 daily procedures and resulted in removal of 98% of immunoglobulins. This was associated with complete removal of autoantibodies to beta1-adrenoreceptor. After the end of a course loss of immunoglobulins was replenished by intravenous infusion of Pentaglobin and Oktagam. Echocardiographic study carried out before, during and after second course of apheresis revealed reduction of left and right ventricular and atrial volumes and dimensions, improvement of contractility of anterior part of interventricular septum and of anterolateral left ventricular wall. As efficacy of drug therapy of dilated cardiomyopathy is low and facilities of cardiac transplantation are limited the method of therapeutic apheresis reveals novel perspectives of the treatment of dilated cardiomyopathies.

Blood Component Removal↗
PubMed1995

Development of immunosorbents for apoB-containing lipoproteins apheresis.

Three types of sorbents were developed for the specific removal of atherogenic apoB-containing low-density lipoprotein (LDL) and lipoprotein LDL (a) (Lp[a]) from human plasma. Two sorbents contained monospecific sheep polyclonal or mouse monoclonal antibodies against human apoprotein B-100. The third one was intended for specific removal of Lp(a) and contains sheep antibodies against human Lp(a). Thirty patients were treated for up to 9 years by LDL apheresis with anti-LDL immunosorbents. A pilot study of Lp(a) apheresis with 3 patients was conducted during 3 years. The results showed that extracorporeal immunosorption is safe and effective for lowering LDL and Lp(a). These procedures may be used both for metabolic investigations and for studies on possible regression of atherosclerosis.

Adolescent↗
PubMed1992

C3a and C5a anaphylatoxins bind to heparin-based sorbent in low density lipoprotein apheresis: in vitro and in vivo investigations.

Plasmasorption on a heparin-based sorbent was performed in vitro. It demonstrated affinity of the C3a and C5a anaphylatoxins for the sorbent: C3a was removed almost completely (97%), and the C5a concentration decreased on average by 55%. The plasma level of C3a and C5a complement components was also monitored during the procedure of clinical extracorporeal low density lipoprotein (LDL) apheresis on the sorbent in patients with familial hypercholesterolemia. A two- to threefold increase in C3a (up to 1,500 ng/ml) was observed after plasma separation by the IBM 2997 cell sorter. Subsequent processing of the plasma through the column led to the low level of C3a detected (less than 50 ng/ml), demonstrating significant uptake of C3a by the sorbent column. The removed C3a was found in the eluate obtained after regeneration of the sorbent with 2 M NaCl solution. No significant increase in C5a was found during the procedure. Nevertheless, some C5a was detected in the eluate from the sorbent. The content of C3a and C5a in patients blood after the treatment was approximately the same as it was initially, 200-500 ng/ml for C3a and less than 10 ng/ml for C5a. The removal of C3a and C5a anaphylatoxins by heparin-based sorbent should be regarded as an advantage of this type of plasmasorbent.

Adsorption↗
PubMed1991

[The dynamics of the concentrations of immunoglobulins and circulating immune complexes during low-density lipoprotein apheresis in patients with hereditary hypercholesterolemia].

Sessions of-low density lipoproteins (LDL) apheresis using sorbents with mono- and polyclonal antibodies possessing the most selective and specific effect with respect to LDL provoked a less marked decrease of the concentrations of immunoglobulins and circulating immune complexes. This attests to their high selectivity and specificity. Sorbents with dextran sulfate and heparin sepharose exerted a more evident influence on the concentrations of these serum components. However, that was not accompanied by any clinical manifestations of immune deficiency. The use of plasmapheresis brought about a more pronounced lowering of the concentrations of the serum components under study.

Adolescent↗
PubMed1991

[The plasmoimmunosorption of low-density lipoproteins in the treatment of patients with hereditary hypercholesterolemia].

The authors describe the experience gained with the use of apheresis of low density lipoproteins with the aid of the Soviet immunosorption columns with polyclonal and monoclonal antibodies in patients with hereditary hypercholesterolemia resistant to the diet and hypolipidemic drug therapy. High specificity of apheresis of low density lipoproteins and high efficacy of the use of the sorption columns to correct hypercholesterolemia have been demonstrated.

Adolescent↗
PubMed1991

[Specific plasma sorption of proteinases--a new approach to the treatment of acute pancreatitis].

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%.

Acute Disease↗
PubMed1990

Apheresis of low density lipoproteins using a heparin-based sorbent with low antithrombin III binding capacity.

A sorbent based on heparin fraction with low affinity for antithrombin III is proposed for low density lipoproteins apheresis in hypercholesterolemia. Heparin was fractionated on antithrombin III-Sepharose; fractions with high and low affinity for antithrombin III were immobilized on CNBr-activated Sepharose 4B. Both sorbents appeared to have an LDL-binding capacity essentially similar to that of the sorbent based on unfractionated heparin. However only plasmasorption on a low affinity heparin-containing sorbent did not reduce plasma antithrombin III. Hence the use of this sorbent may be advantageous over the currently applied sorbents with unfractionated heparin in the treatment of familial hypercholesterolemia.

Absorption↗
PubMed1990

Heparin-sorbent for low density lipoproteins removal in hypercholesterolemia.

Heparin-sorbent was developed in the USSR Cardiology Research Center for LDL-apheresis in patients with familial hypercholesterolemia. Clinical trials of the sorbent were started in 1985. Heparin-sorbent has a high capacity for LDL. One column (400ml) can remove 3 - 6g of LDL cholesterol, depending on the initial LDL content in the plasma. The sorbent demonstrates a high stability, it can withstand more then 75 sorbtion-desorbtion cycles with only a slight loss of the initial capacity. It means that one column can work for 1,5-2,0 years when used weekly. Heparin-sorbent is the sorbent of limited selectivity, apo-B content in eluate is 40-60% of the total protein content, but it is important that it does not bind HDL.

Binding Sites↗
PubMed1990

[Effect of bezamidine on plasma cholesterol and triglyceride levels in patients with familial hyperlipoproteinemia].

The hypolipidemic agent bezamidine, a fibroic acid derivative (KPKA, Yugoslavia), was applied to treat Types 2a, 2b, 4 and 5 familial hyperlipoproteinemias. The highest reduction in plasma cholesterol and triglyceride concentrations was found in patients with Types 2b, 4 and 5 familial hyperlipoproteinemias. No clear-cut adverse effects of the drug were found during 3 months.

Adolescent↗
PubMed1990

[The effect of plasmapheresis and the plasmasorption and immunosorption of low-density lipoproteins on the humoral immunity function of patients with hereditary hypercholesterolemia].

It has been shown that prolonged use of plasmapheresis with a 7-day interval in patients with hereditary hypercholesterolemia is potentially dangerous because of possible development of immunodeficiency. LDL plasmasorption and immunosorption produce a beneficial effect on the concentration of immunoglobulins. It is assumed that immunosorption permits the elimination not only of lipoproteins but also lipoprotein-containing immune complexes from the blood channel.

Adolescent↗
PubMed1990

[Experience with the use of plasmapheresis in the combined treatment of children with the crush syndrome].

Plasmapheresis (PP) was applied to the treatment of 5 children aged 6-14 years with the crush syndrome. The multimodality treatment using antibiotics, erythrocytic mass, rheologically active preparations, hemodialysis and blood rheologically active preparations, hemodialysis and hemoperfusion carried out for 6-7 days before PP did not bring about any appreciable improvement of the patients' status. The patients failed to get rid of anuria and manifested the signs of increasing intoxication. The treatment with PP consisted of 1 to 6 procedures, in the course of which 70 to 85 of the design volume of the circulating plasma was removed. The use of PP resulted in the disappearance of myoglobin from the patients' blood and urine, in the normalization of the coagulogram, a considerable decrease of the content of medium molecules, and in the appearance of the first urine towards the end of the procedure. Thus, the introduction of PP into multimodality treatment of the crush syndrome made it possible to eliminate anuria, disseminated intravascular coagulation, and to noticeably reduce intoxication and to clear the blood off myoglobin.

Adolescent↗
PubMed1989

Effect of plasmapheresis on the liver uptake of ApoB-lipoproteins labeled with technetium-99m.

To study liver low density lipoprotein (LDL)-receptor activity before and after plasmapheresis, [99mTc] very low density lipoprotein (VLDL) was used. Autologous VLDL was labeled, sterilized by filtration, and administered intravenously to patients under a gamma camera. The uptake of lipoproteins in the liver was measured by scintiscanning. Liver activity curves were generated for each patient. The liver activity in patients with the heterozygous form of familial hypercholesterolemia (FH) and in patients with symptomatic atherosclerosis (SA) without hereditary deficit of LDL receptors was reduced as compared to healthy people. Plasmapheresis enhanced the liver uptake of the 99mTc-labeled lipoproteins in atherosclerotic patients. Thus, labeled metabolites could presumably be of use in assessing the effect of plasmapheresis on liver function.

Adult↗