The clinico-immunological parallels of hemosorption using different sorbents in the treatment of bronchial asthma patients

A comprehensive clinical and functional and allergo-immunological comparative evaluation was done of hemosorption involving the KAU, SKN hemosorbents, "Gemosfer" and a DNA-containing sorbent in 341 patient with bronchial asthma. SKN sorbent were found out to have a more pronounced positive effect on clinical signs and functional activity of immunocompetent cells. The above sorbents appeared to significantly enhance sensitivity of bronchial beta-adrenoreceptors; besides, they allow the dosages of systemic corticosteroids to be substantially brought down. The KAU and "Gemosfer" hemosorbents caused, to a certain degree, a blockade of the phagocyte system of blood, and, to a considerably lesser extent, affected the level of autoimmune processes. Thus, hemosorption should involve SKN sorbents or an SKN-based DNA-containing sorbent.     

The comparative efficacy of hemosorption and xenosorption in bronchial asthma patients

The authors studied comparative clinical, immunologic, laboratory and functional effectiveness of hemosorption (HS) on charcoals and xenosorption (XS) on donor pig spleen in bronchial asthma patients. XS was administered in 60 patients, HS was applied to 91 patient. There was no significant difference in immunologic characteristics between the patient groups. However, XS had a more apparent positive influence on the external respiratory function, degree of allergy and unspecific inflammation, as well as on general clinical effectiveness.     

Aevit and glutamic acid in the treatment of patients with bronchial asthma

To elucidate the effect of antioxidants aevit and glutaminic acid on the course of bronchial asthma (BA) and free radical processes in this disease, 54 BA patients were divided into 2 groups: glucocorticoid-untreated and glucocorticoid-treated. Each of two subgroups made of these groups either received antioxidants (AO) or not. The response was assessed by clinical BA symptoms and free radical processes reflecting production of active oxygen forms by leukocytes (PAOFL) and free radical peroxidation (FRPO). PAOFL was studied using luminol-dependent chemiluminescence (CL). CL basal and stimulated values were calculated. FRPO was measured by plasma levels of malonic dialdehyde. Aevit and glutaminic acid treated BA patients improved clinically and exhibited reduced CL of PAOFL and malonic dialdehyde in plasma compared to BA patients on conventional therapy or conventional therapy plus glucocorticoids. Aevit and glutaminic acid are recommended for BA patients.     

Sex hormone metabolism in middle-aged and old patients with bronchial asthma]

Tests were conducted with two groups of growing albino rats kept on a ration with hydrogenated fat containing 62 and 26 per cent of non-saturated fatty acids transisomers. The latter were found to accumulate in the lipids of the animal organs and tissues reaching their maximum level by the 4th week of the experiments. On switching the rats to a ration containing no transisomers their exponential fall in the lipids of the organs and tissues was recorded. From these investigations it follows that the non-saturated fatty acids transisomers taken up by the organism together with edible fats become involved in metabolic processes and are utilized by the organism alongside with other fatty acids.     

Role of peptide-leukotrienes in bronchial asthma]

In the present study the prognostic value of both DNA ploidy and the proliferative activity of tumour cells were studied in a series of 76 consecutive patients suffering from gastric tumours. DNA ploidy and the proliferative index (as measured by the percentage of S-phase cells) were determined by flow cytometry using fresh tumour specimens. The presence of DNA aneuploid clones by flow cytometry was detected in 62% of the cases (mean DNA index of 1.63 +/- 0.46; range 1.08-2.92), the mean proportion of S-phase cells being of 18.4 +/- 11.5%. In comparison with diploid cases, aneuploid tumours showed a higher proliferative activity (cases with more than 15% S-phase cells: 18.4% versus 6.1%, p = 0.0001) as well as a higher incidence of node involvement (95% versus 68%, p = 0.001). By contrast, no significant differences were detected with respect to sex, age, histologic grade and type, clinical stage, tumour size and the incidence of extranodal involvement. Upon grouping the patients according to the proportion of S-phase cells no significant differences were observed for the clinical and biological parameters explored except for an association between a high percentage of S-phase cells and the presence of DNA aneuploidy (40% versus 96%, p = 0.0001). Regarding survival the presence of DNA aneuploidy was significantly associated with poor outcome as compared to the diploid cases (median of 15 versus 26 months, p = 0.005). By contrast, the proportion of S-phase cells did not predict patients's outcome. Multivariate analysis of prognostic factors showed that the presence of DNA aneuploidy (p = 0.003) together with the histologic type (p = 0.03) and the existence of extranodal metastases (p = 0.05) were the best combination of prognostic factors for survival prediction.     

The effect of glucocorticoids on mineral metabolism in bronchial asthma patients]

Nuclear-absorption spectrophotometry (AAC-508, Hitachi, Japan) and selective ionometry (microlyte, Kone, Finland) were employed to measure magnesium and calcium concentrations in the serum, red cells, lymphocytes, 24-h urine and exhaled air moisture in 40 patients with hormone-dependent asthma (BA) and 15 BA patients given beclomet, becotid in inhalations and injections of hydrocortisone, prednisolone and dexason. Intravenous infusions and steroid inhalations in moderate doses for 10-14 days induce only insignificant changes in bivalent cation homeostasis. Complications associated with deranged mineral metabolism occurred more frequently in BA patients on long-term (at least 4 years) courses of oral glucocorticoids. Increased renal and bronchial excretion of magnesium and calcium in patients with hormone-dependent BA with complications of glucocorticoid therapy shows its significant contribution to development of steroid osteopathy and myopathy.     

Nedocromil sodium in treatment of bronchial asthma

Clinical study on efficiency of the nedocromil sodium (Tilade, Fisons) was performed in 20 patients with atopic and nonatopic bronchial asthma. The drug was administrated in dose of 8 mg per day for 2 months which allowed to renounce regular using of Beclocort forte after 7 days of the treatment. In both types of bronchial asthma the positive effect of nedocromil sodium was confirmed, causing increase of pulmonary ventilation and decrease of bronchial hyperactivity. Especially profitably effect was noticed in atopic bronchial asthma in which statistically important increase of peak expiratory flow (PEF) was obtained and decrease of bronchial hyperreactivity by PC20 for histamine was observed (p < 0.05). Mentioned above spirometric parameters did not differ in statistically important pattern in patients with nonatopic bronchial asthma, when Beclocort forte group with Tilade group compared. Neither important differences in general number of cells nor percentage composition of cell smears were observed in bronchoalveolar lavage fluid.     

Inhaled glucocorticosteroids in treatment of bronchial asthma

Studies of bronchial asthma pathogenesis, conducted over many years, have shown that inflammatory process plays a major role in the development of this disease. Glucocorticosteroids are agents with strongest antiinflammatory activity and together with beta 2-agonists are thought of as firstline therapy in the treatment of bronchial asthma. New inhaled glucocorticosteroids are preparations with small systemic activity, despite the fact, that some of them are more lipophyllic than the others, despite the differences in solubility, affinity to lung tissue, different serum concentrations and affinity to receptors. Even with the tremendous progress in increasing efficacy and lowering side effects of inhaled glucocorticosteroids, no ideal preparation was found so far, however the antiinflammatory activity was increased and the dose lowered, which means increasing clinical efficacy and lowering the systemic effects. Only in the future we can hope for developing an ideal preparation of inhaled glucocorticosteroid with common specificity towards lung tissue and direct influence on the target cell, and maybe even on a specific gene.     

A method for intermittent hypoxic exposures in the combined treatment of bronchial asthma patients

The method of intermittent increasing normobaric isocapnic hypoxia was used for the treatment of bronchial asthma. The parameters of respiration, metabolism, free-radical processes and immune system were monitored before and after training. The therapeutic diagnostic complex "Hypotron" (Ukraine), which allowed to determine the individual reactivity of the patient's respiratory system, tolerance to hypoxia, and to choose an optimal program of treatment, was used. The hypoxic training resulted in considerable increase of lung vital capacity, maximal ventilation and forced expired velocity. Normalization of initially increased free radical processes, accompanied by a decrease in the lipid peroxidation products was observed. The hypoxic training positively influenced specific and nonspecific immunological status, and appeared to be associated with a far better stimulation of lymphocytes and neutrophils.     

The effect of kavinton on bronchial tonus in bronchial asthma patients

Intravenous cavinton given in a dose of 10 mg for 3 days was studied for its effects on bronchial tone in 40 patients with bronchial asthma. Respiratory parameters were pneumotaxometrically determined and cerebral circulatory parameters were rheographically measured prior to and following the drug injection. The findings have demonstrated that cavinton significantly decreased bronchial tone improved cerebral circulation, particularly in patients with bronchial asthma and chronic cerebral circulatory disorders.     

Beclomethasone dipropionate aerosol in the treatment of chronic bronchial asthma

In a double-blind, randomized study, 93 corticosteroid-independent patients with chronic bronchial asthma were treated with either beclomethasone dipropionate aerosol at 400 mug per day of its vehicle for 4 wk to determine and compare the effectiveness and safety of the preparations. Evaluations made before, at weekly intervals during, and 1 wk after treatment indicated that beclomethasone dipropionate aerosol was superior to its vehicle is improving FVC, FEV1, FEF25%--75%, and clinical signs and symptoms, and in the overall evaluations by both the investigators and the patients. Plasma cortisol levels measured at the end of the second and fourth weeks were not substantially different from those before treatment in either group. No significant side effects or abnormalities in laboratory results were noted.     

The effect of the Russian inhalant glucocorticosteroid budesonide on bronchial inflammation and hyperreactivity during the long-term treatment of bronchial asthma patients

11 patients with severe bronchial asthma entered a randomized trial of glucocorticosteroid budesonide of Russian produce. Of them 6 patients received inhalations of budesonide (800 micrograms/day for 6 months), 5 control patients did not receive the drug. As shown by investigations of external respiration and bronchoalveolar lavage with estimation of cytogram, metacholine provocative tests, fiber bronchoscopy, budesonide inhalations relieved clinical symptoms of asthma, bronchial hyperreactivity and inflammation.     

The effect of the special instruction of bronchial asthma patients on the efficacy of their treatment

As the data collected in a survey we conducted show, a major part of the modern general practitioner's work continues to be in the field of family medicine. This fact is also confirmed by the results of other surveys of general practice today. Patients still appreciate their GPs as a source of good medical care and counseling for the whole family. Our own study has shown that most patients would even like to see an expansion of the GP's counseling activities. The duration of the doctor-family relationship extends over many years, and is frequently longer than a decade.