Low-volume discrete plasmapheresis in therapy of acute destructive lung and pleural diseases

Plasmapheresis with an exfusion volume of 1500–1600 ml has a pronounced detoxification effect in acute destructive lung and pleural diseases (ADLPDs) but can disturb volume balance and produce hypo- and dysproteinemia. The efficacy in pulmonary abscesses and gangrene was compared for standard discrete plasmapheresis (DPP, exfusion 1500–1600 ml) and low-volume DPP (LVDPP, exfusion 600–750 ml), which produces fewer volume-related complications. To increase the detoxification effect, LVDPP was combined with shortwave ultraviolet modification of erythrocytes to be reinfused (UME) in 29 patients or erythrocyte treatment with saline (ETS) in 21 patients or Hemodez (ETH) in 26 patients. The highest detoxification effect was observed for LVDPP-UME. The detoxification effect of LVDPP-ETH was comparable with that of DPP, and the effect of LVDPP-ETS was lower. LVDPP did not produce hypoproteinemia, while standard DPP aggravated it. LVDPP-UME and LVDPP-ETH normalized the proteinogram, while LVDPP-ETS did not improve the proteinogram nor aggravate dysproteinemia. LVDPP considerably decreased mortality and increased the rate of recovery with cicatrization of cavities. LVDPP-UME had the most pronounced effect in this respect, while the effect of LVDPP-ETS was lower. Thus, LVDPP-UME produced the best results in treating ADLPDs.Translated from Fiziologiya Cheloveka, Vol. 31, No. 2, 2005, pp. 96–102.Original Russian Text Copyright © 2005 by Fomin, Byakin, Piksin, Fedoseikin.     

Haemophilus influenzae biovars in patients with acute and chronic inflammatory lung diseases

In the study of the biological properties of 175 H. influenzae strains isolated from patients with acute and chronic inflammatory lung diseases (ILD) and from donors, a wide spread of biovars I, II and III (according to Kilian) was revealed; these biovars constituted 80% of the cultures under study. In donors, H. influenzae strains were characterized by a wide spectrum of biovars, but biovars I, II and VI constituted more than a half (64.2%) of the strains obtained in the course of these investigations. In acute ILD, only H. influenzae biovars I, II and III were isolated with the prevalence of biovar II (56.4%). In chronic ILD, all H. influenzae biovars were represented, but biovars II and III prevailed (58.7%). The four-fold difference in the occurrence of H. influenzae strains belonging to undetermined biovars was established in donors in comparison with ILD patients (46.7 +/- 9.8% and 12.0 +/- 2.5%; p less than 0.001).     

微流控芯片技术在肺部炎性疾病研究和诊断中的进展

微流控芯片技术是指一种将生物、化学等诸多领域的样品从制备、反应到分离检测等多种操作单元高度集成在一块芯片上的技术,由网络状微通道构成,可以通过流体操控整个系统。相比构建模型的传统方法, 具有便携性、高通量、可模拟在体微环境等优势,在研究疾病的诊断、发病机理研究以及药物筛选等方面有着广阔的应用前景。肺部炎性疾病是临床常见的多发病,通常由于细菌、病毒、真菌感染引起。早期肺炎常缺乏明显的呼吸系统症状且症状多不典型,但病情进展快,难以诊断。近年来,微流控芯片技术已经逐渐用于肺部炎性疾病的研究中。尤其是可以再现人肺泡毛细血管界面 (即活肺的基本功能单元) 的关键结构、功能和机械性质的“芯片肺”模型的应用,很好地在体外呈现了肺泡-毛细血管界面模型的生理相关性。相比细胞和动物模型,这种多功能微实验平台具有非常大的优势。文中针对微流控芯片技术在肺部炎性疾病研究和诊断中的进展进行了综述,旨在为肺部炎性疾病的研究和诊断提供新思路。     

Antibiotic sensitivity of Haemophilus influenzae isolated from patients with inflammatory lung diseases

In 1980-1986 the sensitivity of 2,045 H. influenzae strains isolated from the bronchial contents of patients with inflammatory lung diseases were studied. This study revealed that 60-80% of H. influenzae cultures circulating in Leningrad were sensitive to tetracyclin, chloramphenicol and erythromycin. During the period of observation the tendency towards the decrease of the number of highly sensitive H. influenzae cultures and the increase of the number of strains resistant to all antibiotic preparations was followed. Most of H. influenzae strains isolated in Leningrad were sensitive to penicillin, oleandomycin and ampicillin. In 1983 the appearance of H. influenzae strains, multiresistant to antibiotics, was noted. In 1986 these strains constituted 4.5% of all isolated cultures.     

Free radicals mediate amphetamine-induced acute pulmonary edema in isolated rat lung

Intravenous amphetamine abuse may cause serious cardiopulmonary complications via unknown mechanisms. We investigated the role of free radicals in the amphetamine-induced lung injury using isolated rat lungs. Adding amphetamine into the perfusate caused dose-dependent increases in perfusion pressure and lung weight. Amphetamine increased the filtration coefficient (K(f)) by 90 +/- 20% and 210 +/- 10% at doses of 10 microM and 50 microM, respectively, as compared to the baseline level. Pretreatment with dimethylthiourea (DMTU), an oxygen radical scavenger, abolished the pulmonary hypertension, lung weight gain, and permeability changes. We also examined the effect of amphetamine on free radical generation in polymorphonuclear leukocytes (PMN). Adding phorbol myristate acetate (PMA, 1 nM) enhanced the chemiluminescence indicating the functional viability of the isolated PMN. Amphetamine (50 microM) significantly enhanced the chemiluminescence generation of PMN by 152 +/- 26% as compared with the baseline value. Combination of amphetamine and PMA increased free radical formation by 360 +/- 85%. In summary, our results showed that amphetamine may cause acute lung injury by overproduction of free radicals. Although amphetamine can activate PMN, the source of free radicals remains to be determined.     

Taurine and inflammatory diseases

Taurine (2-aminoethanesulfonic acid) is the most abundant free amino acid in humans and plays an important role in several essential biological processes such as bile acid conjugation, maintenance of calcium homeostasis, osmoregulation and membrane stabilization. Moreover, attenuation of apoptosis and its antioxidant activity seem to be crucial for the cytoprotective effects of taurine. Although these properties are not tissue specific, taurine reaches particularly high concentrations in tissues exposed to elevated levels of oxidants (e.g., inflammatory cells). It suggests that taurine may play an important role in inflammation associated with oxidative stress. Indeed, at the site of inflammation, taurine is known to react with and detoxify hypochlorous acid generated by the neutrophil myeloperoxidase (MPO)–halide system. This reaction results in the formation of less toxic taurine chloramine (TauCl). Both haloamines, TauCl and taurine bromamine (TauBr), the product of taurine reaction with hypobromous acid (HOBr), exert antimicrobial and anti-inflammatory properties. In contrast to a well-documented regulatory role of taurine and taurine haloamines (TauCl, TauBr) in acute inflammation, their role in the pathogenesis of inflammatory diseases is not clear. This review summarizes our current knowledge concerning the role of taurine, TauCl and TauBr in the pathogenesis of inflammatory diseases initiated or propagated by MPO-derived oxidants. The aim of this paper is to show links between inflammation, neutrophils, MPO, oxidative stress and taurine. We will discuss the possible contribution of taurine and taurine haloamines to the pathogenesis of inflammatory diseases, especially in the best studied example of rheumatoid arthritis.     

Microflora of the bronchial contents in chronic lung diseases]

The parallel bacteriological and mycological study of the contents of the bronchi in patients with various forms of chronic pneumonia provided a clearer picture of the causative agents of the disease. The composition of microflora in the bronchial contents corresponded to the severity of the process. Uncomplicated chronic pneumonia took its course with a bacterial monoculture, belonging predominantly to the family of pyogenic cocci, present in the discharges. The formation of abscesses and the development of bronchioectases proceeded of bacterial and mycotic associations. The development of malignant tumors was accompanied by the colonization of the pulmonary ways by a variety of organisms, including bacteria of the fecal flora.     

Microflora of suppurative inflammatory foci in surgical patients and its sensitivity to antibiotics

Materials from 1134 patients with various surgical infections were tested. From the materials collected from purulent inflammatory foci 2137 cultures were isolated. Many of them belonged to Micrococcaceae (63.7 per cent). Cultures belonging to Enterobacteriaceae and Streptococcaceae were isolated from 50.9 and 25.2 per cent of the patients respectively. Isolates belonging to other families were less frequent: diphtheroids were isolated from 13.3 per cent of the patients and Pseudomonas spp. were isolated from 10.6 per cent of the patients. The majority of the isolates of diverse taxons were sensitive to gentamicin (73 to 98.4 per cent). As the second active antibiotic the following should be indicated: fusidin, active against staphylococci (S. epidermidis and S. aureus, 70.5 and 83.3 per cent respectively); ristomycin, active against micrococci and diphtheroids (75.3 and 79.1 per cent respectively); ampicillin, active against S. faecalis (61.3 per cent); polymyxin, active against the trib microbes Escherichia, Klebsiella and Pseudomonas (75.5, 64.3 and 71.4 per cent respectively). No second antibiotic active against a significant percentage of various species of Proteus, fecal alkali forming bacteria, and A. calcoaceticus was stated. Sporulating aerobes were sensitive to the majority of the antibiotics.     

Leukinferon in immunological correction of acute inflammatory diseases of the abdominal organs]

Addition of (intramuscular+intravenous) leukinferon (LF) to the schemes for the treatment of acute peritonitis promoted a more rapid positive development of the time course of clinical signs and decreasing of leukocytosis in the presence of a pronounced tendency to normalization of the main immunological indices i. e. the counts of differential T-lymphocytes and T-helper cells. There was also activation of neutrophil phagocytic function. A rapid decrease in objective signs of endotoxicosis was recorded: the intoxication leukocytic index and the level of medium-mass molecules. In parallel with the decrease in the intoxication leukocytic index, there was a decrease in cytosis of the peritoneal exudate. The use of LF in the treatment of elderly patients with acute cholecystitis eliminated the clinical signs and normalized the main laboratory indices without surgical interventions which allowed one to make a planned operation with the minimum risk.     

The hydrophobicity of gram-negative bacteria isolated from patients with inflammatory and suppurative-destructive lung diseases]

Hydrophobic properties of 11 enterobacterial strains and 12 Pseudomonas aeruginosa strains isolated from patient with inflammatory and purulent destructive diseases of the lungs were studied. The hydrophobic properties of the isolated bacteria were determined by the method of salting out with ammonium sulfate. A high correlation (r = 0.56) between the above-mentioned properties of gram-negative bacteria and their isolation rate from patients with destructive diseases was established. The hydrophobic properties of bacteria were supposed to be of importance in the process of the colonization of pulmonary tissues with bacterial flora.     

Characteristics of Klebsiella strains isolated from patients with acute intestinal diseases

A total of 203 Klebsiella strains isolated from patients with acute intestinal diseases were studied. The biochemical variants were determined by taking into account the complex of such signs as the capacity for producing indole, hydrolyzing urea, utilizing sodium malonate, fermenting inositol, dulcitol, sorbose, adonitol, synthesizing acetylmethylcarbinol, reacting with methyl red. The strains under study were found to belong to 36 K-types. Klebsiella strains with K-antigens 20, 2, 62, 60, 21, 40 showed the highest isolation rate.     

促炎症消退介质脂氧素与炎症性疾病

脂氧素是炎症过程中产生的具有特征性三羟四烯结构的花生四烯酸衍生物,因具有独特的促炎症消退功效而成为目前炎症研究和新药开发的焦点.越来越多的研究征实,脂氧素代谢及效应的异常与临床多种炎症相关性疾病的发生发展关系密切.目前认为炎症自限机制发生障碍才是炎症失控的根本原因,而"促炎症消退"成为炎症治疗的新策略.     

Adenosine in inflammatory joint diseases

Inflammatory joint diseases are a group of heterogeneous disorders with a variety of different etiologies and disease manifestations. However, there are features that are common to all of them: first, the recruitment of various inflammatory cell types that are attracted to involved tissues over the course of the disease process. Second, the treatments used in many of these diseases are commonly medications that suppress or alter immune function. The demonstration that adenosine has endogenous anti-inflammatory functions and that some of the most commonly used anti-rheumatic medications exert their therapeutic effects through stimulation of adenosine release suggest an important role for purinergic signaling in inflammatory rheumatic disorders.