Modern imaginations concerning the structure, genetics and function of the main complex of hystocompatibility of the human being known as a HLA-system are presented in the lecture. Total methods of investigation of HLA-antigenes coupling with diseases were mentioned. Directions of immunological studies during allergical diseases were surveyed. Results of coupling HLA-antigenes and pollinosis, bronchial asthma, allergic contact dermatitis et al. were observed. The applied role of HLA-markers was shown in prognosis of predisposition to allergic diseases, in prognosis of the course character and the therapy efficacy, in estimation of the occupational hazard of pathology progressing.

Apartments of sensitized to pyroglyphid mites patients were examined in Moscow. Detected in 91% of the apartments, pyroglyphid mites were found to form the nucleus of their fauna. Two species of pyroglyphid mites, D.pteronyssinus and D.farinae, absolutely prevailed. Moreover, in 14% of the apartments the mite E.maynei was detected. Storage mites were detected in 27% of the apartments.

Concentrations of mite allergens were found to vary: 0—12.6 mkg/g of dust for Der p I, 0—13.5 mkg/g of dust for Der p II, 0—3.48 mkg/g of dust for Der f I, 0—7.2 mkg/g of dust for Der f II. Allergens Der p I and Der p II prevailed in 59% of the apartments, and Der f I and Der f II in 27% of the ones. The correlation ratio was 0.9592, p<0.01, for D.pteronyssinus and Der p II it was 0.4132, p<0.1, for D.pteronyssinus and Der p II; r=0.9365, p<0,01, for D.farinae and Der f I and 0.9075, p<0,01, for D.farinae and Der f II.

Among the examined dwellings, in 14% of the apartments, the allergen exposure to D.pteronyssinus (Der p 1, Der p II) exceeded 10 mkg/g of dust. Apartments with that highest level of allergens D.farinae (Der f I, Der f II) were not found. In 50% of the apartments, the concentration of Der I and Der II D.pteronyssinus and D.farinae varied in the range of 2 to 10 mkg/g of dust. In 14% of the apartments, the concentration of mite allergens did not exceed 0.4 mkg/g of dust. In remaining 22% of those, the exposure of mite allergens was higher than 0.4 mkg/g of dust in account to some individual allergens, but did not reach the level of 2 mkg/g of dust.

The efficiency of specific immunotherapy of allergical diseases in mite-sensitized children was shown. The effectiveness of the treatment was manifested by the regression of clinical symptoms, the decrease of the total IgE level, and the increase of levels of IgG and IgG4 allergen-specific antibodies. The treatment gave positive results in 85.99% of patients. The study proves that, before making a decision to use specific immunotherapy, the examination of patients with clinical, immunological, and acarological methods is necessary.

A comparative clinical and immunological study of specific immunotherapy with three allergens in comparison with placebo was performed in 60 patients with pollinosis sensitized to timothy grass (Phleum pratense) pollen. These allergens were: the commercial timothy pollen allergen, the purified timothy pollen allergen (PTPA), and purified timothy pollen allergen conjugated with polyoxidonium (PTPA-PO). The specific immunotherapy with PTPA-PO demonstrated the higher clinical efficacy, the lack of systemic reactions, the significant decrease of skin and nasal sensitivity to specific allergen and histamine, and increased specific IgG antibodies production.

The effectiveness of the intensive method of specific hyposensibilization with bacterial allergens, Neisseria perflava and Staphylococcus aureus, was investigated in 30 patients with infectional-allergic bronchial asthma. All the patients were examined before and after 6 months of treatment with clinical and allergical methods; the respiratory function and the bronchial reactivity were evaluated. After 6 months of the treatment, there was an excellent effect in 10% of the patients, a good one in 60% of latters, a satisfactory effect in 27% of the patients. No effects were noted in 3% of the patients. The bronchial reactivity decreased after the treatment.

The parallel study was carried out to investigate the state of bronchial tree and gastrointestinal mucosae in patients with atopic syndrome and urticaria and with the absence of any active complaints. The investigation was carried out with use of clinic, hystologic, hystochemic, morphometric, and bacterioscopic methods. The obtained data testifies about the great impairment of bronchial and gastrointestinal tract mucosae in the patients, that was manifested not only by the presence of eosynophilic inflammation, but the persistence of piloric helicobacteries and intestinal campulobacteries. That demands a special therapeutic correction.

Using the model of the infectional process during donor immunization with the staphylococcus anatoxine betha-2-adrenergic receptors of lymphocytes were studies with the increase of intrapulmonary c-AMP as a result of the adrenaline stimulation. The first group contained 33 donors without specific antitoxic antibodies in serum, the second one contained 5 donors with the initially increased level of the latter. During the immunization process, there was the increase of the antibodies level to 5.8±0.85 MU in the first group and the hyperergic response with the antibodies level increase to 12.0+3.5 MU in the second one. After 21 days, the additional incubation of lymphocytes with anatoxine (in vitro) did not influence on the adrenergic response level in the first group, and there was the sharp decrease of betha-2-adrenergic receptor function to 18.8% in the second one versus 54.9% in intact lymphocytes. Probably, the adrenergic blockage in conditions of bacterial hypersensibilization is similar, by its character, to the adrenergic receptors blockage during bronchial asthma.

The clinical immunological study was carried out in 342 patients with pulmonary destructive tuberculosis and chronic obstructive bronchitis complicated with the COS presence in blood. It was shown that the COS presence influenced, as a burden, on the immune state and the clinical course of the certain pathology. Use of differentiated immunocorrective therapy (T-activin and mielopid) in that contingent allows to normalize total immunological parameters and to increase the efficacy of treatment.

The character and the degree of the functional interaction between basal chains of immunity and hemocoagulation during disease evolution were investigated in 114 patients with chronic bronchitis (CB) including 24 ones with nonobstructive and 18 with asthmatic forms of the disease. 36 healthy volunteers were as a control group.

During three days after hospitalization, the studies were carried out. The cell dependant immunity, circulating immune complexes, and the total hemolytic activity of complement were determined. The phagocytai activity of leukocytes was evaluated with the standard technique. The hemostasis state was estimated with the kaolin-kefalin time count and autocoagulogramm parameters.

The hemocoaulation analysis revealed the presence of chronic intravessel blood coagulation (IBC) which was testified about by hypercoagulation, moderate pro- and anticoagulants consumption, and the shift dynamics of hemostasis during the CB progressing. Coupling with that, the immunological reactivity is depressed, that defines the evolution rate of the disease.

The influence of hyposensitization by specific allergen on populations and subpopulations of lymphocytes in 24 patients with atopic dust bronchial asthma were investigated. The determination ofsurface lymphocyte antigens has been carried out using the monoclonal antibodies of the home series LT. It was show, that specific hyposensitization accompanied with significant increased of CD8+ lymphocytes subpopulation in peripheral blood and normalized immuregulatory index. This effect was independent of clinical results.

The result obtained confirm the important role of activation suppressor T-lymphocytes in development of effect by specific immunotherapy in allergic diseases.

Basing on the active role of platelets (Pt’s) in bronchial asthma (BA) pathogenesis, the influence of plateletapheresis (PtA) on bronchial asthma and Pt’s functional activity was investigated. PtA was used in 88 patients with various asthma forms. 41 patients with atopic BA, 28 patients with “mixed” asthma, and 19 ones with aspirin BA were treated. The clinical state and the Pt’s functional parameters (aggregation, intracellular Ca²⁺, Pt’s secretion, levels of Pt’s-binding IgE) were evaluated. The therapy was efficient in 86% of patients with atopic BA, in 62% of ones with aspirin-sensitive BA, in 46% of patients with “mixed” BA. The results of the study demonstrated that PtA restores normal platelet functional status parameters, especially in atopic patients with dramatic clinical course of the disease.

The functional state of the heart and features of hemodynamic of pulmonary and systemic circulation were studied in 444 male and 92 female patients (536 total) aged 20 to 75 years with chronic nonspecific pulmonary diseases (CNPD). The control group contained 36 healthy persons. According to clinical, hemodynamical, and respiratory disorders, the patients were divided into 2 groups with 79 and 421 persons correspondently. The first group contained patients with pulmonary insufficiency primarily without any signs of cardiac insufficiency. The second group was characterized by expressed cardio-pulmonary insufficiency, and it was divided into subgroups according to heaviness levels of the disease.

Results of the study showed that during pulmonary insufficiency the hemodinamic indices were decreased. The attaching of cardiac insufficiency caused disorders of systemic hemodynamics and pulmonary hemodynamics. Patients in the second group with light stages of the disease occupied the intermediate state. The correlational dependence between hemodynamic parameters, the development of the disease, and instrumental signs of the development was found. The complex study allows to consider about the specific case of pulmonary or cardiac insufficiency prevalence.