Physiology of chronic inflammatory processes and their treatment

Proceeding from the known views of the functioning of the immune system, the main mechanism of its effector activity in fighting foreign material is development of an inflammatory process. The process also involves other systems or components, which results in the formation of a functional system intended for the most efficient elimination of the foreign agent. Thus, an inflammatory process is a normal defensive reaction of the body and, in a favorable case, reflects the normal work of the immune system. Two types of the inflammatory response have been identified depending on the character of the functional system formed: the subclinical inflammatory response (SIR) to minor stimuli and the clinically full-blown inflammatory response (FIR) to high doses of an antigen. A normally proceeding acute inflammatory process is clearly differentiated from a chronic inflammatory process (CIP). The latter may proceed with an impaired or normal reaction of the immune system to a foreign agent (specific and nonspecific CIPs) or with a hyperreaction of the immune system (allergic CIPs). A preformed dominant of the unbalanced functioning of the immune system is maintained by a CIP focus in a shock organ and underlies the CIP. However, this extends only to the FIR functional system. Adaptive activation of the SIR inhibits the unbalance dominant in any CIP. These theoretical conceptions underlie an original method of dosed immunotherapy, which consists in SIR activation with low doses of various agents in order to normalize the inflammatory process. Considering the different reactivity of the body in different individuals, the main problems are selection of the starting dose and further control of the doses administered. This difficulty has been overcome as a result of the development of a simple sensitive test for controlling the drug dose. Practical application of the proposed principle enabled stable results to be obtained in curing CIPs.Translated from Fiziologiya Cheloveka, Vol. 31, No. 1, 2005, pp. 100–113.Original Russian Text Copyright © 2005 by Lebedev, Ponyakina, Kozachenko.