[The biomedical aspects of the problem of intoxication in infectious pathology].
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Biomedical subjects
Publications and source records attributed to S G Pak.
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To assess functional activity of leukocytes, lipid peroxidation and enzymes indicating the severity of organ lesion in food poisoning and acute dysentery, the investigators employed the techniques of luminol- and biacridine-activated chemiluminescence of pure granulocyte population and whole blood, plasma chemiluminescence, assays of AAT, AsAT, AP, LDG. A relationship was established between chemiluminescence of leukocytes and whole blood, between leukocytic functional activity and the disease duration and severity. Indomethacin treatment of the patients reduced intoxication, did not affect leukocytic function, diminished plasma chemiluminescence. Functional activity of leukocytes and the enzymes levels were prognostically significant. Low response of leukocytes to the stimulus, i.e. a small rise of functional activity, served an unfavourable prognostic sign. A role of active oxygen forms produced by leukocytes is suggested in pathogenesis of alimentary toxo-infection.
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Injection of Salmonella typhimurium endotoxin to the laboratory animals (rabbits) in dose of 1 mg/ml (LD84) induces the particular changes in the thrombocyte vessels system of hemostasis: decrease of aggregatory ability of thrombocytes, increase of thromboxane A2 and prostacyclin activation of lipid peroxidation process. Use of indomethacin--the cyclooxygenase inhibitor--leads to less progressive alterations of the studied parameters of the thrombocyte vessels hemostasis and lipid peroxidation processes.
Sixty patients with severe forms of acute viral hepatitis B (AVHB) without symptoms of acute hepatic encephalopathy (AHE) and 20 AVHB patients with such symptoms were examined for red blood cell and serum levels of dienic conjugates (DC), malonic dialdehyde (MDA), reduced glutathione (RG), activity of superoxydismutase (SOD), catalase, glutathione peroxidase-1 (GP1), glutathione peroxidase-2 (GP2), glutathione reductase (GR), glutathione transferase (GT). Elevated MDA and DC concentrations were found in grave AVHB, in coma and precoma DC reduced. MDA levels in precoma fell, in coma rose. The activity of SOD, GP1, GP2, GR and RG concentration were low, especially in AHE symptoms. GT and catalase activity proved high in severe AVHB with a trend to lowering in precoma and coma.
Luminol- and lucigenin-dependent chemiluminescence (CL) induced by zymosan, opsonized autoserum was used to study the oxygen-dependent bactericidal system of polymorphonuclear leukocytes (PNL) in patients with food toxico-infections, at different disease periods. Different modifications of CL were established to have analogous dynamics on days 1 and 2 of the disease and differences as to the period of convalescence. A correlation was revealed between the amplitude of CL and the intensity of the intoxication syndrome. The conclusion is made about the role played by granulocytes in the disease pathogenesis. The authors review potential mechanisms of participation of PNL free radicals in the pathophysiological shifts responsible for the development, course and outcome of food toxico-infections.
As many as 160 patients with acute virus hepatitis B (AVHB) were examined over time. Spectroscopy was used to study the activity of glucose-6-phosphate dehydrogenase (G-6-PDH), glutathione peroxidase-1 (GP1), glutathione peroxidase-2 (GP2), glutathione reductase (GR), glutathione transferase (GT) and to measure the concentration of reduced glutathione (GSH) in the blood serum and in red blood cells. Within the first days of the icteric period, the activity of all the enzymes rose, followed by reduction of the activity of G-6-PDH, GP1, GP2, GR and the concentration of GSH at the height of the disease. The GT activity remained high throughout the entire disease period.
The data on the clinical approval of the original enzyme immunoassay system for the determination of somatic O-antigen in the blood serum and urine of patients with acute Sonne dysentery are presented. The level of the antigen determined in the biological fluids of patients has been shown to depend on the severity of the disease. Different types of dynamic curves, reflecting the level of O-antigen in the biological fluids of patients with acute Sonne dysentery and characteristic of different clinical forms of the disease, have been established.
The sensitivities of ELISA systems for assays of Shigella sonnei O-antigen, developed on the basis of specific rabbit antibodies isolated from antisera by different chromatography techniques have been compared. The highest specificity and sensitivity of O-antigen determination (0.5-1 ng/ml) is achieved when using affinity-isolated antibodies to O-antigen. Clinical trials of this ELISA system have been carried out.
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In patients with toxic infections salmonellae were identified in 31% of cases. The patients were divided into two groups: the control group receiving treatment with infusion solutions and the test group treated, in addition to the usual scheme of therapy, with indomethacin in a daily dose of 150 mg. The study revealed that salmonellae isolated at the initial stages of the disease possessed highly pronounced adhesive properties. The adhesive properties of salmonellae isolated at the stage of convalescence from the patients of the test group were considerably less pronounced than those of salmonellae isolated from the same patients at the peak of the disease. In the control group no differences in the adhesive properties of salmonellae isolated from the same patients were established.
Blood plasma free radical lipid oxidation was studied in 98 patients with acute dysentery (AD) and 64 patients with food toxinfection (FTI). Free radical lipid oxidation was assessed by the intensity of chemiluminescence and the level of lipid peroxides. Activation of blood plasma lipid peroxidation was established with relation to a clinical variant of the disease. The effect of indomethacin on the parameters of free radical lipid oxidation was noted in patients with AD and FTI.
A study was made of the influence of the level and biological activity of plasma fibronectin of phagocytosis and opsonic activity of blood plasma in 147 patients with food toxinfections depending on a period and degree of severity of a course of disease. Plasma fibronectin concentration was determined by rocket immunoelectrophoresis. Fibronectin biological activity was assessed by cold heparin precipitation. Opsonic activity of blood plasma before and after fibronectin inactivation in it was investigated using indices of phagocytosis which was studied by optical microscopy. Food toxinfections were attended by a decrease in the level and biological activity of plasma fibronectin returning to normal during therapy and convalescence. A degree of the reduction of the level of plasma fibronectin reflected the severity of a course of food toxinfections. Phagocytic insufficiency developed in food toxinfections. One of its mechanisms was a decrease in opsonic activity of plasma fibronectin as a result of the reduction of its level.
After 10 minutes of endotoxin Salmonella typhimurium (1 mg/kg) injection into rabbits thrombocytopenia appeared, the aggregation and secretory function of circulating platelets reduced, the transformation of platelet forms from disk-shaped into spheroidal took place. On the surface of plasmatic membranes the pseudopodies and aggregates examining samples of PRP were observed. Indomethacin, blockator of biosynthesis of prostaglandins results in normalisation of morphofunctional properties of platelets.
A complex immunological examination of 68 salmonellosis patients and 227 patients with alimentary toxinfections of unknown etiology has been made in the process of their treatment by rehydration therapy. At the acute period of the disease, irrespective of its nosologic form, cellular immunity has been suppressed. Cell-mediated immunity factors have been shown to depend on the severity of the disease.
Altogether 57 patients with alimentary toxoinfections of obscure etiology and 39 patients with the gastrointestinal form of salmonellosis of average gravity were examined. Two methods were employed: rehydration and incorporation of indomethacin in the therapeutic scheme. The time course of the studied indices in the patients with salmonellosis was similar to dynamic changes in the patients with alimentary toxoinfections. The incorporation of indomethacin in the therapeutic scheme brought the indices of water-electrolyte metabolism and corticosteroid secretion more rapidly to normal.
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