[Bivalent cations of the bronchial contents in the pathogenesis and clinical picture of bronchial asthma].
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Biomedical subjects
Publications and source records attributed to G B Fedoseev.
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Altogether 300 patients suffering from bronchial asthma were examined for serotonin metabolism, the kallikrein-kinin system and histamine. A study was also made of the information relations of the indicated parameters to diverse groups of the signs using Shannon's technique. It has been revealed that serotonin and the kallikrein-kinin system are of importance in the pathogenesis of changes in the efficacy of the diffusion lung capacity in severe bronchial asthma. The authors discuss the significance of excessive accumulation of serotonin and bradykinin as a marker of the impairment of endothelial function of pulmonary vessels, specified by the damaging action of free radicals and immune complex allergic vasculitis as well. Histamine along with macrophages act as delimiters of allergic inflammation, with their action being mediated by negative feedback.
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The paper is concerned with the results of medicamentous, reflex and combined methods of the treatment of 685 patients suffering from respiratory allergoses. Corporeal acupuncture (CA), intal specific hyposensitization (SH) increased 100 times the resistance to allergens; auricular acupuncture (AA), combination of CA with intal increased it 100-fold; SH and CA 1000-fold. CA significantly reduced whereas SH raised the content of IgE in plasma. The content of IgE remained practically unchanged when SH was coupled with CA. The latter one significantly raised plasma cAMP and decreased plasma cGMP. The highest clinical efficacy was attained with the use of combined CA, SH and intal.
Twelve patients with preasthma (PA) and 27 bronchial asthma (BA) patients were examined for the effect of magnesium sulphate aerosol on bronchial sensitivity and reactivity to acetylcholine (ACC) and graded physical exercise (GPE) as well as on bronchial patency recorded by general plethysmography and pneumotachography. Inhalation of the drug was established to exert no bronchodilatory action but reduced, as compared with placebo, nonspecific hyperreactivity of the bronchial tree and blocked the ACC induced increment of histamine in the exhaled air condensate. The data obtained allow bronchial smooth muscles and mast cells to be regarded as targets for magnesium sulphate. The drug properties discovered may serve a prerequisite for its use in the combined treatment of BA patients and those with PA.
The antigenic composition of tissues was shown to be of importance in the formation of bronchial asthma on the basis of the clinicoimmunological data with regard to histocompatibility antigens in 235 patients suffering from bronchial asthma and preasthma. Well-defined correlations were established between the development of bronchial asthma with carriership of antigens A2, B13, B21 and B35, between the disease pattern and nature of its course and antigens B7, B12, B27, B35, B40 together with their combinations. Possible variants of the relationship between the body traits and certain mechanisms by which bronchial asthma develops are under discussion.
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The electrical activity of the smooth muscle of the trachea was studied on sensibilized ovalbumine rats. The role of intramural ganglions of the airway was shown.
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Analysis is made of the results of a comprehensive examination of 313 bronchial asthma patients. The examination included the revealing of the information relations of the absolute count of blood eosinophils, their changes after administration of a standard dose of adrenaline, the eosinophil count in sputum and bronchial secretion. Significant information relations with the build-up parameters, alterations in bronchial patency, a number of immunological and biochemical characteristics were discovered. Analysis of the measure of the information relation evidences the pathogenetic and prognostic role of eosinophils in bronchial asthma.
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As a result of a comprehensive clinical and functional examination of 217 patients with bronchial asthma, including study of HLA-antigen composition of their tissues, a relationship between B13, B21 and B35 antigen carriers and susceptibility to bronchial asthma as well as associations with the form of the disease, its severity and some features of its course were found. Clinical examples confirming these arguments are illustrated. Possibilities of individual prognosis at a clinic are grounded.
Plethysmography and pneumotachography were applied to measure bronchial permeability, and reactivity of the bronchi in 10 patients with pre-asthma and 17 with asthma upon administration of magnesium sulfate aerosol (solution osmolality 260 mmol/l, pH-6.6). Though the drug inhalation did not induce bronchial dilatation, it diminished both hypersensitivity and hyperreactivity of the bronchial tree to acetylcholine. These properties of magnesium sulfate in the absence of unwanted sequelae when introduced endobronchially allow its advocating in combined treatment of asthma and pre-asthma.
In 46 bronchial asthma (BA) patients, a study was made of the effects of calcium antagonists (CA) (corinfar, perdipine) on bronchial sensitivity and reactivity determined on bronchospasm induction with the increasing doses of acetylcholine. A single intake of 20 mg of a CA in BA patients significantly improved bronchial sensitivity and reactivity (the rise of the PD25 and the decline of the alpha angle). 20 patients were treated with corinfar for two weeks after administration of the basic therapy. As a result, the clinical status as well as bronchial sensitivity and reactivity improved in the majority of BA patients. While assessing the efficacy of the treatment with corinfar after half a year it was established that in 9 out of 13 BA patients, the PD25 increased and the alpha angle diminished. Thus, CA reduce bronchial hypersensitivity and hyperreactivity to acetylcholine in BA patients.
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Altered bronchial sensitivity and reactivity are the basis of different variations of bronchospasm. In addition to exogenous agents, endogenous regulation factors such as adrenal and ovarian hormones are believed to make an important contribution to their development. Asthmatics showed the lowest sensitivity and the highest hyperreactivity to acetylcholine as compared to patients with preasthmatic conditions or chronic bronchitis and healthy consanguins of asthmatic patients. Disturbances of glucocorticoid homeostasis, related to various (adrenal, extra-adrenal (transcortin) and cellular) mechanisms of corticosteroid insufficiency, occurred in the majority of asthmatics and asthmatic bronchitis patients. Identification of various mechanisms of glucocorticoid insufficiency opens up actual approaches to increasing the efficiency of an individual therapy.