EDITORIAL COLUMN
EDITORIAL
Initial molecular mechanisms of fibrogenic dust action on organism are based on prolonged formation of reactive oxygen species (RO S) in lungs. This phenomena is based on three processes. The first process is conditioned by activation of phagocytes with dust particles. The action is occurred by means of weak chemical interaction during contacts of the dust particle surface with the cell membrane. The second process is coupled with transformation of formed ROS on catalytic centres of the particle border layer. The third one is copupled with the energy defficit state and intracellular hypoxia development in the koniophage. The mentioned process plays a dominating role in koniophage death. The predominating forms of formed reactive oxygen depends on the chemical content, the molecular structure, and surface properties of dust particles. Generally, coal dust generates the superoxide oxygen anion-radical, quartz one generates hydrogen peroxid (H2O2), and asbest one initiates the hydroxilic HO radical. The formed ROS under the fibrogenic dust influence not only causes koniophage death, but stimulates synthesis of interleukine I and other intermediaters regulating the growth of lymphocytes and fibroblasts. The ROS are the cause of relative deficit of proteasa inhibitors and also the cause of appearance of antigens as a result of oxidative protein modification with hydrogen peroxid. All the fibrogenic dusts are characterized by the ROS featured ability of causing the development of more and less manifestated local and generalized mutagen effects. The ROS plays a role indetermination of the ways and methods concerning the respirable dust fraction excretion from lung. They plays a role in localisation of pathologic changes and in manifestations of the diseases developing under the fibrogenic various type dust influence.
ORIGINAL STUDIES
46 patients with bronchial asthma (BA) were examined to evaluate the features of the bronchial asthma pathogenesis free radical component including the increased generation of reactive oxygen species by leukocytes (GROSL) on the background of inhibiting influence of trombocytes, CO2 and histamine. GROSL was tested by the luminol dependent chemiluminescent method. It was found that the ketotifen block in mast cells induced the increase of GROSL on the background of the inhibiting influence decrease of trombocytes, CO2, and histamine in 42% of patients with allergic BA. The analogic results were obtained in patients with nonallergic BA. Thus, the obtained data testify about the essential role of free radical processes in pathogenesis of both allergic and nonallergic BA. Apparently, the free radical component may be the basis of the BA development in some patients.
The intensity of stimulated with non-specific activators luminol dependent blood hemiluminescence (ChL) was estimated with the presence of non-steroid antiinflammatory drugs (NAID) analgin and aspisol in 52 patients withaspirinic bronchial asthma. The control group contained 10 persons without pathology evidence and 11 patients with atopic bronchial asthma. The ChL coefficient Was 0.59±0.01 in patients with clinical signs of intolerance to NAID during the peroral analgin test and was 1.33+0.02 in the control group. The positive clinical desensitization effect was accompanied with the ChL coefficient increase. Thus, blood predincubation with NAID in patients with aspirinic bronchial asthma decreases the stimulated ChL intensity. The ChL test with NAID can be used to control the desensitisation effectivity.
The histamine effect on leukocytal generation of reactive oxygen species (LGROS) with Si02 stimulation was investigated by the luminol dependent chemiluminescence (ChL) method in 65 patients with bronchial asthma and in 19 donors. Histamine decreased LGROS in most of the donors, while in most of patients it increased LGROS. The reaction increase degree and the reaction frequency depended on form, stage, severity degree and duration of the disease. It was concluded that histamine can be included into the bronchial asthma pathogenesis not only by the way of direct bronchoconstriction stimulation, but with of the increase of LGROS. The supposition was made about possibility of the certain reaction use as an additional test for estimating the exacerbation degree and prognosis of the bronchial asthma course.
The CO2 effect on phagocytal generation of reactive oxygen species was studied in 40 bronchial asthma infants obtaining therapy with hypercapnic hypoxic gas mixture (HHGM) inhalations. It was found that chemiluminescence intensity parameters were greater in that patients during the postattack period than in healthy infants. During the intermedia period, the parameters decreased but were significantly higher than in controls. The satisfactory leucocyte sensitivity to CO2 was found in 37.5% of patients, that well correlates with positive clinical effect. The lower effect from HHGM was noted in 62.5% of infants with the decreased reaction to CO2. The role of leukocytes in bronchoconstriction was shown.
Functional levels of hemostasis and peroxide lipid oxidation (PLO) were observed in the article in dependence on COPD formation stage and on season. There were examined 417 patients, aged 18—65 years, which were distributed between groups according to formation stage of chronic bronchitis (CB) and bronchial asthma (BA). The group of the disease threat contained 103 patients, the predisease stage one — 122 patients, the nosological manifestation one — 123 patients, and the group of obligate com plications — 69 patients. The comparison group contained 52 healthy volunteers. The result analysis showed that CB and BA formation is accompanied by growing activation of blood coagulation system. The activation achieved its maximum during summer and autumn. PLO processes also changed accordingly to season increasing during the disease formation threat and declining a few in predisease stages. The disease formation was accompanied certainly by the maximal PLO activation and the antioxidant enzyme activity decrease.
Parameters of peroxide lipid oxidation (PLO) and enzyme antioxidant defense were studied in 100 patients with chronic bronchitis (CB) and 35 healthy persons. The activation of PLO processes and the antioxidant defense enzyme activity decrease were found in CB patients in comparison with healthy persons. There was shown the correction possibility of the mentioned impairments by means of antioxidant treatment complex including sublingual medication of selenium in dose of 2—2.5 μkg per one body weight kilogramm.
The use possibility of vital fluorochromes like 2,7-dichlorfluorescin acetate, dihydrorhodamine, and hydroethidine was discussed to study phagocyte oxygen metabolism. The sensitivity of the fluorochromes to reactive oxygen species (ROS) was studied in model radical producing systems. The data about interaction in molar ratio 1:1 between superoxide radical and hydroethidine were obtained. The fluorochrom sensitivity to proteins, phospholipids, DNA, and pH was studied to estimate the artefact probability. Correlation between extra- and intracellular productions of ROS in peritoneal and alveolar macrophages and polymorphonuclear leukocytes was evaluated. Possible mechanisms and the result valuability are discussed.
The ferrous ion content in blood serum and free liver ferrum and their interaction with changes of peroxide lipid oxidation (PLO) processes in hepatic and pulmonary tissue were studied during various periods of chrysotil—asbestos influence. The effect of natural rhutinum flavonoid from P-vitamin on these parameters was also investigated.
The free ferrum pool state was studied by EPR-spectroscopy with nitrozil g-factor complex (2.03) formation evaluation.
After a month, the significant increase of oxyprolin in the pulmonary tissue was found after a single intratracheal injection of 50mg of powder. The enforcement of peroxidation processes in hepatic and pulmonary tissues was also found (at 1.4 and 1.7 times respectively). The total ferrum content in blood serum corresponded to the control value. Moreover, the transferrin content was decreased at 1.3 times, that testify about the ferric content decrease in blood serum. The free ferrum content was also low in hepatic tissue. The single rhutinum instillation did not influence on the dust toxic action.
After 6 months since powder inhalation, the enforcement of PLO processes in hepatic and pulmonary tissues was discovered (at 2.8 and 1.5 times respectively). The ferrum content was higher in 20%, that can be explained by its extraction from ferritin. The studied flavonoid showed the expressed antiasbestos action after three month therapy only.
The possibility of intracellular free iron registration by the electron paramagnetic resonance method with' desferal use as iron chelator was demonstrated in the study. The essential increase of desferal available iron was found in liver, kidney, and spleen during experimental hemochromatosis. Heart, lungs, and brain were more resistant to free iron accumulation.
The effect of haptoglobin on H2O2 dependent chemiluminescence (ChL) of native and modified with H2O2 or HOCl haemoglobin was studied. It was shown that haptoglobin decreases the native haemoglobin ChL intensity and the number of radicals formed during the reaction of haemoglobin with H2O2. It was supposed that the effect of haptoglobin is conditioned primarily by the haemoglobin catalytic activity decrease through Hp—Hg complex formation. It was shown that haptoglobin inhibits effectively H202-dependent ChL of both native and preincubated with H2O2 or HOCL haemoglobin.
The medication effect on oxidative metabolism of various phagocyte types was studied by the luminol dependant chemiluminescent (ChL) method for investigating the troventol action mechanism. Peroxide lipid oxidation (PLO) in liver, lung, and brain homogenates was investigated to com pare the effects of atropine and atrovent.
It was found that troventol inhibited the ChL-response of alveolar macrophages (AM) in 50—60% in comparison with placebo. That effect is considered to be explained by its influence on generation mechanism s of reactive oxygen species (ROS) by certain cells. Moreover, troventol did not influenced on activation of peritoneal macrophages.
As well the generation inhibition of ROS by AM with troventol as the effect absence in peritoneal macrophages are considered to be depended on features of reception interaction with phagocytes.
It was shown by the model system of lipid autooxidation in the brain homogenate that troventol has a great antioxidant activity. Nevertheless, it was not found any essential inhibition of PLO processes by the drug during the PLO induction with ferrous ions in lung and liver homogenates.
It was suggested that the inhibition may be conditioned by the various lipid content and the antioxidant delivery of various tissues as well as by microsomal function of the detoxitizing system w here this drug like the other xenobiotics is hydroxilized.
This work is dedicated to the study of the application possibility of the recirculative unit “Potok 150M” (it works according to the principal of the combined electrostatic and mechanical filter) for optimisation of air environment (AE) in the interior premises. With the unit operating under experimental and natural conditions the quality of AE was estimated according to indexes of concentration of aerosol particles (AP), microbe flora (M F), viruses and fungous flora (FF) in air and biologically active gaseous substances (BAYS). The unit ensured the effective drop of AP, MF, FF, styrolene, butylacetate, heptane, O-xylene, benzole, I-m ethy-3-ethylbenzole, 2-methylheptane and other BAYS in AE. The moderate enrichment of AE with light air ions and ozone was also registered. Time of unit operation unit was determined by concrete conditions of micro climate and architecture of premises. Thus, the recirculative unit “Potok 150M” allows to attach qualities to AE according to claimed demands of modern healthy dwelling and hospital premises.
The air-cleaner “P otok-150M” was installed in the wards as an extra treatment parallel with the universally recognized complex of therapeutic treatment for 34 patients with atopic, mixed, infections and professional forms of bronchial asthma. The positive dynamics in the patients’ feeling was marked after the 7th—10th day of the curing according to their objective conditions of health and daily peakflowmeter data. At the end of the therapeutic course of treatment, 41.2% of patients the statistically-significant growth of the exhale volume was found in com parison with the data before treatment as well as indices in the control group. Considerably fast achievement in cilinic remission, decrease of hyperreactivity of bronchi and hypersensitivity to aetiological agents were marked as a result of air-cleaner “Potok-150M” application in treatment of patients with bronchial asthma.
REVIEW
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САМООЦЕНКА ПРОФЕССИОНАЛЬНОЙ ПОДГОТОВКИ ВРАЧА-ПУЛЬМОНОЛОГА
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