Elimination of the toxic effect of copper sulfate is accompanied by the normalization of liver function in fibrosis

The search for biologically active compounds that regulate liver function in fibrosis is an urgent medical and biological problem. A working hypothesis was tested, according to which low molecular weight biologically active compounds from Pleurotus ostreatus and Sacharamirses cerevisiae are capable of exerting immunomodulatory and antitoxic effects after intoxication of the body with ions of heavy metals, in particular copper sulfate. Elimination of the toxic effect caused by copper sulfate can also ensure the normalization of liver function in various pathologies, in particular with liver fibrosis. When determining toxicity, a study was carried out on Wistar rats, and when studying the effect of low molecular weight biologically active compounds on liver function, clinical trials were carried out on volunteers. The activity of alanine aminotransferase, aspartate aminotransferase, actonitase and glutathione peroxidase, as well as the content of bilirubin and lipid hydroperoxides were determined. It was shown that preliminary administration of biologically active compounds to rats at a dose of 0.05 mL/100 g of body weight provided the formation in some animals (up to 80%) of resistance to the toxic effect of copper sulfate (dose 2.5 mg/100 g of body weight). Such stability is associated with a shift in the balance of “prooxidants-antioxidants” towards antioxidants. The data obtained in the clinic on volunteers with liver fibrosis and hepatitis also testify in favour of the membranotropic action of biologically active compounds. Biologically active compounds provided a decrease or complete restoration of the activity of transferases (ALT and AST) in the blood serum of these patients, with the exception of one patient out of 20 examined. Our experiment has shown the relationship between the elimination of toxicity to the action of copper sulfate and the normalization of liver function in patients. The results obtained indicate that it will be promising to use a complex of low molecular weight components from P. ostreatus and S. cerevisiae as an antidote and hepatoprotective agent.

Hepatosplenomegaly in liver cirrhosis is caused by reactive oxygen species formation, an increase in apoptosis and autophagy, and pronounced autoimmune reactions

Various factors of infectious and toxic genesis can lead to the liver cirrhosis, often accompanied by complications such as recurrent bleeding due to portal hypertension against the background of hepatosplenomegaly. Metabolic changes and disturbances in immunoreactivity occur in the liver and spleen. To substantiate the choice of personalized treatment tactics for patients with hepatosplenomegaly, we investigated individual metabolic predictors and immunopathological processes in patients with: liver cirrhosis and hepatitis B (HBV) and/or hepatitis C (HCV) viruses (I group, n = 52); with herpes viruses CMV (cytomegalovirus) and EBV (Epstein-Barr virus) (II group, n = 48), and with splenomegaly and frequent recurrent bleeding associated with hereditary enzymopathies (III group, n = 15). We used the methods of immunoturbidimetry; enzyme immunoassay; light, fluorescence and confocal microscopy. In group I (HBV/HCV), we revealed a decrease in the C4 component; a significant increase in the phagocytic index and phagocytic number, a reduced number of active phagocytes and the digestion index; a decrease in the IL-1β content and an increase in IL-18 and IL-6. In group II (CMV/EBV), we revealed a high activity of the C3 and a low activity of the C4 component against the background of a high level of ROS in neutrophils; the antineutrophil antibodies (ANCA) formation in 85.7% of patients (71.4% –perinuclear antibodies (pANCA) to myeloperoxidase; 14.3% – cytoplasmic antibodies (CANCA) to proteinase 3). Also, in group II, an increased level of pro-inflammatory cytokines IFN-γ, IL-1β, TNF-α, IL-18 and anti-inflammatory IL-6 was detected. Changes in links of immunity in II group led to the formation of autoimmune reactions in 64.7% of patients, which was expressed in the development of a broad range of antinuclear antibodies ANA (11 specificities, including ANA to chromatin and chromatin-associated proteins, to proteins cytoskeleton, enzymes and enzyme complexes). In group III, we revealed a low absorption capacity of neutrophils, a high frequency of antineutrophil antibodies pANCA occurrence and cANCA (in 67.2% of the examined), and low concentration of TNF-α. The developed model of the stepwise change of immunological markers makes it possible to substantiate the choice of a complex targeted treatment, including antiviral and immunotropic therapy.

Characteristics of the response of the microalga (Dunaliella viridis) to cerium compounds in culture

Recently, nanobiotechnology has been developing intensively; therefore, various properties of nanoparticles, which depend on their origin, concentration, and size, are of interest. It is known that CeO2 nanoparticles cause a positive biological effect. These particles are able to penetrate through biomembranes. At the same time, there are assumptions about a high degree of biological risks when using nanomaterials, and it is obvious that the biosafety of nanomaterials is decisive in the development of new products, including for medicine. The cytotoxicity of samples of cerium salts and cerium dioxide nanoparticles of different sizes was assessed at different concentrations using D. viridis. The cytotoxicity level by morphological and functional disorders of D. viridis was investigated, as determined by the change in cell shape, accumulation of inclusions, loss of flagellum, change in nature and movement, the formation of micro- and macroaggregates by D. viridis cells and exometabolite release. The cytotoxicity coefficient was calculated as a quotient of total detected changes divided by their number. It was shown that cerium salts (cerium (IV) ammonium nitrate and cerium (III) chloride) had pronounced cytotoxicity, which exceeded cytotoxicity values of the control by 7 and 6 times, respectively. Cerium dioxide nanoparticles with a size of 6 nm at a concentration of 0.01 M showed intermediate cytotoxicity, which exceeded control values by 3.5 times, and after the effect of nanoparticles with a size of 2 nm at a concentration of 0.1 M, the cytotoxicity coefficient corresponded to control values. The addition of inactivated blood serum to the incubation mixture resulted in a decreased cytotoxic effect of cerium dioxide. The use of D. viridis as a test system will supplement the arsenal of biotesting tools for nanomaterials and the study of the mechanisms of their effect.

[Liver-induced fibrosis in young and old animals is accompanied by age-dependent changes in bone marrow cells.]

The hypothesis of dependence of the functional characterizations of bone marrow cells (BMC) - proliferation rate, direction proliferation, etc. - not only by the age of animals, but also on features of BMC microenvironment was verified. Two methods of changing the microenvironment were used. There were in vivo (induction of liver fibrosis in young and old animals) and in vitro (transfer of young and old animals BMC obtained in intact animals and animals with fibrosis into the same standard culture system). CuSO4-induced liver fibrosis and CCl4-induced liver fibrosis had a different effect on the ratio of cell types in the bone marrow in young and old animals. Thus, in young animals, regardless of the type of liver fibrosis inducer, the relative number of morphologically identifiable cell types decreased. This was accompanied by an increase in the number of identified cell types against the background of CuSO4-induced liver fibrosis and did not change against the background of CCl4-induced liver fibrosis in old animals. The proliferative activity of BMC isolated from old animals and transferred to an in vitro culture was superior to that of young animals. This is due to the large number of lymphocytes in the bone marrow of old animals by 167% and the specific composition and characteristics of the BMC microenvironment in old animals.

Features of self-tolerance loss in patients with different clinical phenotypes of myasthenia

The incidence of myasthenia gravis which is characterized by progressive muscular weakness on the background of structural disorders of the thymus, has increased. Myasthenia gravis is a multifactorial autoimmune disease, it has a pronounced clinical heterogeneity, and therefore the standard diagnostic and treatment protocol is not always effective. To substantiate an individual approach to the treatment of various clinical forms of myasthenia, we conducted a study of mechanisms and markers of loss of central and peripheral self-tolerance in thymus-independent myasthenia (M) and thymus-dependent myasthenia gravis with thymus hyperplasia (MH) and thymoma (MT), involving a total of 427 patients examined. In patients with different phenotypes of myasthenia, we used the methods of spectrophotometry, flow cytometry, enzyme immunoassay. In patients with MH on the background of lymphofollicular thymus hyperplasia we revealed a pronounced humoral sensitization in comparison with the reference values: the concentration of C4 complement, C-reactive protein, circulating immune complexes and the initiation of an indirect autoimmune reaction a reliable increase in autoantibodies (AAbs) to the α1 and α7 subunit of subunit of nicotinic receptors (nAChR). In M and MT groups a high similar titer of AAbs to other epitopes was revealed: DNA, β2-glycoprotein I, membranes of intestinal and stomach cells, lung, liver, kidney cells. A pronounced blast-transforming response to the presence of the mitogen PHA was revealed in the MT group. In the MT group, a decrease in the content of CD4+ CD28+ co-stimulatory molecules and in the MH group, a decrease in СD4+ CD25+ Treg lymphocytes was revealed. Individual methods for correcting the loss of self-tolerance in patients with different clinical phenotypes of myasthenia were justified taking into account the use of immunosuppression, specific viral-neutralizing immunoglobulins and massive IgG immunoglobulin therapy, and the application of anti-inflammatory recombinant interleukins.

[The effect of cytokine therapy on the results of surgical treatment of patients with acute ulcerative gastroduodenal bleeding]

AIM

To improve the results of surgical treatment of patients with acute ulcerative gastroduodenal bleeding using immune correction with β-leukin.

MATERIAL AND METHODS

Urgent and elective operations were performed in 120 patients with gastroduodenal ulcers. Patients of the main group (n=63) received systemic cytokine therapy with β-leukin in addition to conventional treatment. Pre- and postoperative immune correction was absent in the comparison group.

RESULTS AND DISCUSSION

There was preoperative imbalance of antiphlogistic and proinflammatory cytokines in comparison group. Severity of this process depended on blood loss. Therapy with interleukin decreased severity of cytokine imbalance.

Young and old animals use various strategies of metabolic adaptation to Cu-induced liver fibrosis

The role of the prooxidant-antioxidant and immune systems in formation of age-related adaptive responses to chronic effects of toxic substances (copper ions) was studied. In this purpose in young and old animals by multiple sequential administration of copper sulfate was induced liver fibrosis. Using this model the characteristics of prooxidant-antioxidant and immune systems, and physiological characteristics of were assessed. The Cu-induced liver fibrosis was accompanied by the oxidative stress and a significant reduction in cell immune activity. In the case of elimination of oxidative stress by introducing exogenous antioxidants (mix factor) in animals with fibrosis was recovered efficiency, body weight, the content of red blood cells. In old animals the restoring of the changed parameters of cellular immunity was more effective than in the young. Young and old animals used different metabolic strategies of adaptation to toxic environmental factors.

[State of immune and cytokine status in acute ulcerative gastroduodenal bleeding]

The paper analyzes the results of a survey of 37 patients with acute ulcerative gastroduodenal hemorrhage. During endoscopy found that 7 patients the cause of bleeding was gastric ulcer, duodenal ulcer in 27 and 3 concomitant ulcer. Hemostasis was evaluated by J. Forrest and the severity of blood loss was assessed by the A.A. Shalimov: with blood loss was mild in 11 patients, the average degree--12 and with severe--14. In all patients on admission in the peripheral blood were studied state of cellular, humoral and cytokine profile: CD3+, CD4+, CD8+, CD4+/CD8 + and CD19+, FI, FF, CEC, IgA, M, G, TNF-α, IFN-γ, IL-1, IL-2, IL-4, IL-6, IL-8 and IL-10. In general patients with on admission revealed significant changes in the immune and cytokine status. In cellular immunity occurs immunosuppression. Disturbances in humoral immunity manifests itself in increased levels of lymphocytes in blood loss and hardships of all multi-directional changes in the concentration of immunoglobulins depending on the amount of blood loss. When there is an imbalance in cytokine status, the depth of which depends on the degree of blood loss.

[Effect of combined and local cytokine- and ozone therapy on the indices of lipid peroxidation, endogenous intoxication and ferroproteins in diffuse peritonitis]

The article analyzes the results of effect of combined and local cytokine- and ozone therapy on the indices of lipid peroxidation, endogenous intoxication and ferroproteins in 111 patients with diffuse peritonitis. It was shown, that combined sequential local and systemic cytokine and ozone therapy allows correcting the expression of endogenous intoxication and lipid peroxidation in diffuse peritonitis. This method suppresses an inflammation in the abdominal cavity. At the same time, it accelerates the elimination of intestine atony and thereby potentiates the possibilities of traditional methods of treatment.

[Comparative estimation of efficacy of the immunecorrecting combined three- level cytokino- and ozonotherapy in complex treatment of extended peritonitis]

The results of surgical treatment of 211 patients, suffering extended peritonitis (EP) of various etiology, were analyzed. The peritonitis severity was graded in accordance to Mannheim's index of peritonitis (MIP). The patients were divided on two groups. In 60 patients (group of comparison) the basic treatment was conducted, without immunocorrection. The patients of the main group were divided on three subgroups. To the patients of the first subgroup (43) 400 ml of ozonated isotonic solution (OIS) of sodium chloride was infused intravenously additionally in the contents of basic therapy, as well as peritoneal-enteral detoxication using OIS was conducted. In a second subgroup a regional intraabdominal endolymphatic ozonotherapy (OTH) was conducted to 57 patients with OIS and peritoneal-enteral sanation using medical ozone. In the 3d subgroup in 51 patients additionally were applied intravenous infusion of OIS and peritoneal-enteral sanation with medical ozone. To these patients cytokinotherapy was conducted, when splenopid was applied intravenously, intraperitoneally and enterally simultaneously. The indices of the T- and B-immunity links, phagocytic activity of neutrophils, including phagocytic index, phagocytic number, the completeness of phagocytosis index, as well as the content of the tumor necrosis factor alpha (TNF-alpha), gamma-interferon (IFN-gamma) and interleukins (IL) - IL-1, IL-2, IL-4, IL-6, IL-10 were estimated in the blood serum in dynamics. The combined staged three-level (systemic, intraperitoneal and enteral) application of natural cytokins and medical ozone have promoted mutual potentiating of their action, significant efficacy of the immunemodulating therapy in comparison with such systemic and local OTH.

[The influence of ozone therapy to some immunological parameters in patients with generalized peritonitis]

The immune status of the surgical treatment of 103 patients with generalized peritonitis (GP) were discussed. Patients were divided into two groups. Comparison group included 60 patients who received conventional combined therapy, main group - 43 patients, who, along with the standard complex treatment measures, were used local and systemic intravenous ozone therapy (OT). The severity state of patients evaluated by Mannheim peritoneal index (MPI). To assess the immune status in blood of the patients with GP were studied the level of lymphocyte subpopulations (CD3+, CD4+, CD8+, CD11a+, CD19+), the phagocytic activity of neutrophilic granulocytes, concentration of immunoglobulin A, M, G, and the content of circulating immune complexes (CIC). Studies have shown that GP is accompanied by changes in the functioning of the immune system, the severity and extent of which depends on the severity of MPI. The conventional basic therapy is not effective in correcting of these disturbances. Using the local and systemic OT in the complex of therapeutic measures in individually selected patients with GP have a positive effect on some level of immunity with a tendency to restore the immune system dysfunction.

[Supposed role of "metabolic memory" in formation of response reaction to stress-factors in young and adult organisms]

The influence of the combined long-lasted influences of sulfur sulfate and diet restriction in young (3 month age) and adult (21 month age) Vistar rats on activity of glucose-6-phospatase, alaninaminotranspherase (ALT), aspartataminotranspherase (AST), and on phosphorilating activity of liver mitochondria was studied to investigate the role of metabolic memory on the peculiarities of response reaction. The young animals not differed from adult ones in the possibility of inducing activity of glucose-6-phospatase, ALT, and on phosphorilating activity after the influence of sulfur sulfate and diet restriction. The age-related differences in glucose-6-phospatase and transpherases and phosphorilating activity existing in control disappeared after the long-lasted action of sulfur sulfate and diet restriction. The answer reaction in enzyme activity to stress factors applied many times depends upon the metabolic memory formed in the process of adaptation, and the age of animals have no influence on it. In some relation the ontogenesis may be considered as a result of adaptation genesis. The metabolic memory can change the answer of the system to the stress influence. There are three types of modification of the answer to stress factors: the answer remains unchanged (metabolic memory), "paradox answer" formation, and super activation of the metabolic system.

[The role of immune disorders in formation of local and systemic complications of severe acute pancreatitis]

There were studied the factors, which initiate the immune response in severe acute pancreatitis, in 57 patients of both gender ageing from 16 to 66 years, in whom the acute pancreatitis severity had constituted 3 marks and more (according to the Ranson criterions). In majority of the patients the combined type of the immune disorders had prevailed. The first stage of the disease was characteristic for metabolic hyperactivity occurrence with raising of HLA-DR+ level as well as of immunoregulating coefficient at the expense of the T-helpers quantity increase. In 47.1% of the patients with aseptic pancreonecrosis also the HLA-DR1 leukocytic antigens were revealed in combination with normal phagocytic activity of neutrophils present in 85.3% of them. In these patients also most frequently were revealed such antigens as HLA-A1 (in 20.6% of observations), HLA-A9 (in 29.4%), HLA-B13 (in 30.4%), HLA-B16 (in 20.6%). In 51.2% of patients, suffering infectionized pancreonecrosis, there was revealed HLA-DR2 lymphocytic phenotype. In them there were noted high suppressive activity of T-lymphocytes, lowering of phagocytic activity of neutrophils, activation of the aberrant adhesion molecules (ICAM-1, ICAM-3) on the background of higher concentration of interleukin-8 present in the blood serum in comparison with such in patients, suffering aseptic pancreatic necrosis.

[Persisting viral infection, serum antibodies and chromosome instability in myasthenia]

There were examined 94 patients, aged from 22 to 68 years, with myasthenia, in whom morphological changes of thymic gland were revealed. In 89% of observations there was established the infectioning by cytomegalovirus, in 10%--hepatitis B, in 9%--hepatitis C. In 5% of patients there were observed coexistence of cytomegaloviral infection and hepatitis. In all the patients the trustworthy increase of the chromosomal aberrations frequency in comparison with spontaneous level of mutation was revealed. High diagnostic validity of chain reaction with polymerase in the viruses persistence determination was noted. The results of investigation of serous immunoglobulins to the virus neutralizing antibodies ratio may be applied for the indications elaboration in the lymphosorption and immunocorrection application in patients with myasthenia more than 4 years in course.

[Substantiation of indications for low-intensity laser irradiation in combined preoperative care of patients with ulcerative gastrointestinal hemorrhage]

Indications for the low-intensive laser application in preoperative procedure scheme were speculated on the ground of complex investigation data in 175 patients with gastrointestinal ulcerative hemorrhage (GIUH). Indications for intravascular laser blood irradiation (IVLBI), for the projectional action on thymus, spleen and their combined application are established. For the reliable hemostasis guarantee the conduction of laser therapy is the most effective one.

[The significance of gastric helicobacteriosis in the genesis hemorrhage from duodenal peptic ulcer]

Based on a comprehensive analysis of findings from examination and surgical treatment of 196 patients with bleeding pyloroduodenal ulcers, it was found out that patients with concurrent helicobacteriosis of the stomach are prone to more unfavourable course of their illness, which fact is evidenced by a greater loss of blood and higher risk for bleeding recurrences. A classification is proposed by the authors, taking advantage of the data from endoscopic, microscopic and immunoenzymatic techniques, with the purpose of providing an assessment of degree of severity of helicobacteriosis of the stomach.

[State of stress-limiting and stress-responsive systems of the body in pancreatic necrosis during systemic-toxic phase]

Results of dynamic investigation of beta-endorphins and hormonal state were analysed in 34 patients with pancreonecrosis aged from 23 to 54 years. The dependency of this indexes on the severity of clinical course and presence of complications was determined. The correction ways of injurious action of stress-reaction in pancreonecrosis were proposed.

[Cytogenetic effect of barbiturate anesthetizing substances in a human peripheral blood leukocyte culture]

It is found that hexenal and sodium thiopental in vitro produced a two-fold increase of frequency of chromosome aberrations as compared with the control and this effect was not dose-dependent. The anesthetics under study affected in vitro 3H-thymidine incorporation into DNA of lymphocytes, and a ten-fold hexenal dose intensified 3H-thymidine incorporation. The frequency of chromosome aberrations in vivo was at the level of the spontaneous mutation after use of sodium thiopental and slightly increased hexenal.