Biomedical subjects
Publications and source records attributed to O M Nevskaia.
HLA antigens were studied in 121 patients with dissemination sclerosis and 50 patients with retrobulbar neuritis. In both diseases the rate of antigen B7 distribution was increased and that of antigens B17, B40 decreased. The data suggest that both diseases have common pathogenic links.
A comprehensive immunological examination of 20 patients with various clinical manifestations of lateral amyotrophic sclerosis (LAS) was carried out. The authors determined the total lymphocyte count, the percentage and absolute ratio of T- and B-lymphocytes of the blood, subpopulations of active, theophylline sensitive and theophylline resistant lymphocytes and also the content of serum immunoglobulins A, M and G as well as the circulating immune complexes (IC). Patients with LAS exhibited a decreased total count of blood lymphocytes and increased the percentage of B-cells and IgM. The ratio of the number of the theophylline resistant and theophylline sensitive cells was also found to change at the expense of a decrease in the latter (T-suppressors). Patients with different duration and severity of the disease were shown to have some differences in their immunological indices. The role of the immunopathological reactions in the pathogenesis of the disease is discussed.
Epileptic seizures were one of the clinical manifestations of multiple sclerosis in 12 out of the 800 patients studied. They were more frequent during the disease exacerbation and served as an indicator of the pathological process activity. The significance of immunological impairments in the genesis of these attacks is outlined.
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A study of HLA antigens in 55 patients with lateral amyotrophic sclerosis yielded the results which suggest that the risk of the development of lateral amyotrophic sclerosis is associated with HLA B18 antigen, while the character of the disease progression is related to HLA B27 and BW35 antigens. The patients displayed a decreased incidence of HLA B8 and B7 antigens.
The intensity of cellular and humoral immunity was shown to correlate with the acuteness and severity of disseminated sclerosis in 107 patients. During disease exacerbations, the patients displayed a decreased activity of T lymphocytes, which was determined by lymphocyte blast transformation, as well as high levels of cerebral, and low ones of complement fixing antibodies. The intensity of cellular reactivity was reduced in subjects with the most unfavourable, steadily progressing disease. The data obtained point to the necessity of a differential approach toward the immunotherapy of disseminated sclerosis. The deviations in the cellular and humoral phases of patients' immunity should be also taken into account.
In 65 patients with various clinical manifestations of disseminated sclerosis, the percentage and absolute content of T- and B-lymphocytes, as well as of the three classes of immunoglobulins (IgA, IgG, and IgM) were examined. Use was made of spontaneous and active rosette formation. B-lymphocytes were determined by the immunofluorescent method of detecting superficial immunoglobulins, and by complementary rosette formation. The serum immunoglobulins were determined by the radial immunodiffusion method. The content of T-lymphocytes in patients was found to vary, which was largely observed in patients with the remitting course of the disease. The content of B-lymphocytes and immunoglobulins G and M was found to be increased significantly, this increase being observed especially frequently at active stages of the disease. The importance of the discovered anomalies in the immune status for the disease pathogenesis is discussed.
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A classification of disseminated sclerosis summing up many years of follow up of 750 patients is proposed. According to this classification, the cerebral, spinal and cerebrospinal forms are distinguished. The cerebral form includes hyperkinetic and ocular disease varieties. Both childhood disseminated sclerosis and disease variety with a late debut are distinguished. Rare cases of familial disseminated sclerosis are marked. Acute disseminated sclerosis is considered only as a stage of chronic disease development.
Negative effect of thermal procedures (hot bath taking or intake of 1-2 glasses of hot water) was established while examining 105 patients with disseminated sclerosis. The patients' status worsening was marked also during sharp cooling, whereas improvement during moderate cooling without shivering. A definite diagnostic significance of thermal procedures in disseminated sclerosis is pointed out.
Examination of the histocompatibility antigens carried out in 62 patients of the Russian nationality suffering from disseminated sclerosis showed that the HLA-B7 antigen was encountered in them more frequently than in healthy people. The distribution of the A2 and A3 antigens of the HLA system was different depending on the character of the disease course, the A2 antigen was prevalent in a relatively benign, remitting process, while prevalence of the A3 antigen was characteristic for rapidly progressing processes that led to grave affections of the nervous system. In the patients' families two haplotypes, i. e. A2B7 and A3B7 were found to be prevalent.
Studies of histocompatibility antigens in 25 patients, Russians by nationality, suffering from multiple sclerosis showed that antigens HLA-B7 were found in them more frequently than in healthy subjects. Also prevalence of antigens A2 and A3 was noted in the patients, each antigen being prevalent depending on the process type. Antigen A2 was prevailing in patients with a relatively benign process, while antigen A3 was predominant in patients with a rapidly progressing disease that led to grave affections of the nervous system.
A description of 2 cases of disseminated sclerosis during exacerbations and paroxysms of dysarthria and ataxia in the clinical picture is given. These attacks are connected with processes of demyelinization and are differentiated with epilepsy. On the basis of neurophysiological studies the mechanisms of paroxysmal dysarthria and ataxia are discussed. The attacks were arrested under the influence of carbamazepine. The action of the drug is explained by its manifold properties.
The report contains a description of 3 families with disseminated sclerosis (2 siblings in each family). The detected changes in the immunological reactivity of these patients are correlated with the data of the previously studied 112 patients with disseminated sclerosis and speaks in favour of a neuroallergical reaction, the important role of which in the pathogenesis of disseminated sclerosis is at present generally acknowledged. Having in view the heredity of developing allergic reactions the authors suggest that there is a certain relation between the state of the immunocompetent systems and the predispositional factors in disseminated sclerosis. This serves as a basis for the assumption that disseminated sclerosis can be attributed to diseases with a hereditary predisposition where for the manifestation of the disease there should be an effect of exogenous (viral?) factors.
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