Extracorporal immunophamiacotherapy is a cellular engineer immunocorrection mode allowing to use pharmacologically activated ex corpora cells-regulators of the immune system and corticodistant mediators produces. This way is carried out technically by following manner: leucocytes are extracted from blood with the fractionator and are incubated in the drug solution during some hours, then are washed and reinfused to a patient. This method allows to evacuate a part of lymphocytes from the action media of suppressor factors an d after their activation with drugs to use for the functional activity reparation of the patient immunity. This way provides the sharp reparation of the decreased parameters of the immunity activity up to normal values. In the study, the experimental basing and results of its clinical trials on models of heavy atopic syndrome, Liell’s syndrome, and atopic bronchial asthma treatment.

Investigation data of the 2—10 year duration in 147 patients with idiopathic lung fibrosis are presented. 52 of the patients obtained corticosteroid therapy and 5 of the ones were treated with corticosteroids and plasmapheresis and/or lymphocytapheresis. Complex treatment application with hemapheresis allowed to reach the stable remission more frequently than during the pharmacotherapy in patients with exogenous allergic alveolitis, and to decrease markedly the number of protracted disease. The supplement of hem apheresis in patients with this form of the disease despite of medication treatment significantly increased the efficacy of the therapy and in 2/3 of cases allow ed to achieve the stabilization. The corticosteroid dose decrease as a result of hemapheresis allowed to diminish or remove completely side effects of the steroid therapy in 2/3 of cases.

In the article, the authors offers to execute aspirin desensitization by the slow every w eek inclination of the acetylsalicilic acid quantity beginning from m inim al doses of the drug obtained by patients in severe cases of the asthma when the sensitivity coefficient is greater or equal 2.0.

If the very high sensitivity to ciclooxygenase blockers and of the relapses of the disease present during the desensitization, hemosorbtion is an effective way to prevent exaccibation or to decrease the salicylic sensitivity.

Serum of patients with exacerbation of infection-dependent bronchial asthma caused the decrease of the phagocytic activity of autologic and donor neutrophils. Plasm apheresis inclusion to com plex therapy of the disease promoted the increase of parameters of the phagocytic number and the phagocytic index of neutrophils.

Moreover, plasmapheresis decreased the depressing effect of patient serum of this asthma form on the phagocytic activity of autologic neutrophils. This fact may be a basis for plasm apheresis use in patients with this asthma form for exacerbation prevention.

Pulmonary microcirculation features in patients with exogenous allergic alveolitis (EAA) during various phases of the disease and under various therapeutic programs were studied. The microcirculation was estimated with radionuclear drug Tc99. Moreover, the aggregation ability of erythrocytes was studied. Considerable disorders of microcirculation progressing in the interstitial pulmonary tissue during active inflammation were revealed in patients with EAA. The braking action of treatment programs using plasm apheresis on microcirculation disorders was found. The com m on basis pharmacotherapy of EAA was not capable to brake the microcirculation disorders progressing estimated with radionuclear methods independently from clinical results of treatment. Aggregation ability disorders of erythrocytes were well corrected with basis pharmacotherapy and with plasmapheresis.

Levels of serum PA F were investigated in patients with various bronchial asthma (BA) forms and in various forms of the clinical manifestation of the disease before and after plateletapheresis (PtA). 15 patients with BA (9 atopic and 6 aspirin-sensitive ones) and 4 healthy donors were examined. The examination demonstrated that only tracks of PA F in the healthy donors are registered but in BA patients the PAF levels were significantly increased. It was found, that in patients with atopic BA the PAF levels were almost by two times higher than in aspirinic BA ones. Moreover, the PAF level in a great extent depends on the disease degree. The serum PAF level was decreased in 42% in average after trobmocytapheresis.

The study demonstrates the features of thrombocytapheresis action and develops the imagination about its action mechanisms.

The functional status of platelets (Pt’s) was investigated characterized the activity extent of cells and their role in bronchial asthma (BA) pathogenesis. The trombocytal aggregation, the intracellular calcium metabolism,

the trombocytal ATP-secretion, and the level of trombocyte binding IgE were studied. It was found, that in patients with BA the characteristics of the functional status are considerably increased in comparison with healthy donors. That is in agree with the literature data of the active role of trombocytes in various BA -forms pathogenesis and initiates new approaches to the development of new pathogenetic methods of BA treatment.

Blood trombocytes in 4 male patients with infectionalallergic bronchial asthma (BA) were investigated with electronomicroscopic and morphometric methods during the trombocytapheresis. The study was carried out before, after immediately, and a day after the trombocytapheresis. 5 healthy male donors of blood thrombocytes were as a control. It was revealed, that in patients with BA trombocytes arc in the state of the physiological excitement, that was testified by the share increase of spheric trombocytal forms and the trombocytes with squares greater than in normals; and by the presence of the large number of appendixes in trombocytes, by the enlargement of their superficial-vacuolar system, and by the increase of their aggregation ability.

The aferesis considerably decreases the number of active forms of trombocytes and influences of their aggregation ability. A day after the trombocytapheresis, moderate renovation of the cellular pool appears by means of mature forms of the trombocytes being in the inactive state.

The efficacy of theopec was studied in 67 children aged from 5 to 15 years old suffered from bronchial asthma. A satisfactoiy clinical effect was reached in 80.6% of the patients after the 10th day of treatment with theopec. The favorable influence of theopec on the currence of bronchial asthma was accompanied by the improvement of ventilation function of the lung. During the continuous treatment with theopec the equivalent concentration of theophylline in blood serum were attained after 4 days. The treatment with theopec is recommended in dose 15 to 19 m g/kg/day under the control of theophylline concentration in serum.

The study of the liposomal remedy for inhalational application named as Lipin was earned out in two groups of patients with various forms of bronchoobstructive diseases (bronchial asthma, chronic obstructive bronchitis). The remedy was diluted ex tempore with saline and was dispersed by the ultrasound inhalator. 9 patients comparable in sex, age, the disease duration, with the general group of the patients were inhalated with saline and were as a control. To estimate the influence of the liposomal remedy on the hyperreactivity of the bronchial tree the supplemental study in 12 patients aged 18 years with bronchial asthma (BA) in the remission was earned out. The hyperreactivity syndrome was diagnosed on results of bronchial challenge with metacholine. The obtained results allow to testify about the greatest efficacy of the remedy in the group of patients with BA and in cases when the bronchial conductivity disturbance is formed by obstruction on distal and intermediate levels of bronchi especially. Most nonsatisfactory results were obtained in patients with obstructive bronchitis. The preliminary inhalation with phospholipidal liposomes, as well as the 6 day course medication, allows to diminish essentially the metacholinic reactivity of the airway.

87 patients with nonspecific lung disease (NLD ) complicated with respiratory distress syndrome were medicated with complex treatment in com bination with Lipin (the com pound of phospholipids). All patients were investigated by routine clinical, complex functional and immunological tests including ventilatory and oxygen-transport function of the lung, acid-base balance and blood gases, T- and В-systems of lymphocytes, T-cell subpopulation content, the level of autoimmune processes and nonspecific resistance. It was found that Lipin had positive influence on alveolar ventilation, improved oxygen perfusion through the airohematological membrane, decreased arterial hypoxemia, economized ventilatory function. The mechanism of the action is based on the surfactant system normalizing in lungs which had been disturbed by pulmonary disorders. Lipin had the normalizing influence on immune status owing to the oxygen regimen improvement. This influence was strongly pronounced on peripheral phagocytes and T-lymphocytes. Moreover, the positive dynamics has been obtained rather quickly.

Relations of cellular elements and microorganisms in impression smears obtained in various levels of the bronchial tree and pulmonary parenchima were studied in sectional samples from 22 persons with chronic bronchitis complicated with acute lobular pneumonia (ALP) and lung infarction complicated by bacterial pneumonia (IP). The control group included 29 autopsy samples from persons without pulmonary pathology. Single oriented pathological changes in cytobacteriogramms of the smears on the large bronchi level were obtained in case of chronic bronchitis complicated with ALP and IP formed as a result of cor pulmonale decompensation. The revealed changes were characterized by the dramatic increase of the neutrophils number as a result of the significant decrease of the relative number of epithelium cells and the considerable rise of the absolute number of bacterii per 100 cells. In peripheral pulmonary tissue, in IP niduses in comparison with ALP niduses, the significantly greater relative number of lymphocytes was noted during the significantly small number of epithelial cells. The absolute number of bacterii per 100 cells of the smears was significantly greater during ALP at the expense of microorganisms disposed intracellularily.

Values S of the microviscosity of erhytrocite membranes (EM ) (values of lipid wellregulation within the membrane) and the Tau-value (the correlation time of rotation rate) were studied with the technique of the electrone spin resonance using spin probes. The activity of POL was determined by them alone dialdehyde concentration. The investigations perform ed in 10 healthy donors, 12 patients with acute pneumonia and 13 patients with prolonged pneumonia allowed to discover enhancement of S-value indicating the increase in the microviscosity of the outer layer of EM and decrease in the microviscosity of inner layer in patients with pneumonia. In patients with prolonged pneumonia a normalization of spin-labelled probe parameters in EM occurred after inhalation therapy with using liposomes containing intal and prednison, which was combined with the disappearance of clinico-roentgenological manifestations of pneumonia. Changes in microviscosity of EM indicate the structural rebuilding of EM in pneumonia.

During complex treatment of 12 patients with severe cardio-pulmonary insufficiency appearing on the background of the prolonged duration of chronic purulent obstructive bronchitis and infection -dependent asthma, the sustained high-frequency mechanical lung ventilation (SHFMV) was used with course application.

The analysis of the hemodynamic parameters changing and the gas content of arterial blood revealed the ability of SHFMV to increase considerably the efficacy of the treatment as a result of quick compensation of arterial hypoxemia, of the considerable decrease of the intrapulmonary blood shunt, and of the decrease of the pulmonary vascular resistance. During the oxygen inhalation through the facial mask, this changes were expressed negligibly or were absent with the minimal clinic effect.