[Basic problems of the reorganization of medical science].
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Biomedical subjects
Publications and source records attributed to V N Shabalin.
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Changes in the immunological parameters have been studied in the course of treatment with antithymocytic globulin and chemotherapeutic preparations included in the treatment protocols for aplastic anemia and acute leukemia. A possibility of determining the optimal immunocorrective agent dosage is demonstrated as related to its effect on the functioning of the immunocompetent cells in vitro.
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Clinical effectiveness of bone marrow transplantation has been analyzed in 83 patients with aplastic anemia. Bone marrow of non-related donors with high degree of histocompatibility, according to the antigen system HLA of loci A, B, C and DR, was used. Freshly prepared bone marrow was transplanted in doses from 3.4 x 10(9) to 15 x 10(9) myelokaryocytes. Immunosuppression was provided by corticosteroid hormones and antithymocytic globulin. Complete or partial remission lasting for more than a year was recorded in 56 patients. Formed elements of the donor's blood were detected in the blood of 39% of the patients (the observation period lasted from 1 to 8 months). Symptoms of a secondary disease were observed in 29% of the patients. Significant changes in the cellular immunity parameters were recorded in all the patients investigated. The character of the time course of these changes may serve as a prognostic factor of myelotherapy effectiveness.
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The study of chronic toxicity of polymerized hemoglobin solutions (PHb) has demonstrated the relationship between the dose of the solution administered and the level of functional and morphological changes induced in various organs of experimental animals. Lower doses (1.8 g/kg) of PHb had no effect on the values of protein and carbohydrate metabolism, while the high doses (10-15 g/kg) of PHb resulted in the impairment of protein synthesis, morphological changes in the spleen and lymphatic nodes.
Based on the data concerned with blood cells from 12 normal persons and 18 patients with acute leukemia, the action of the clinically applied cytostatics and hormonal drugs (6-mercaptopurine, cytarabine, vincristine, rubomycin) on granulocyte functions was investigated in vitro and in vivo (in patients). The respective characteristics were found to be in a good enough agreement, enabling the prediction of the effect of polychemotherapy on granulocyte functions (the digestion capacity). It has been established that each of the drugs under study changes the characteristics of granulocytes to a different degree. The individual sensitivity of the digestion capacity of phagocytes to the drugs under study does not depend on the disease pattern or initial characteristics of the phagocytic activity of the cells.
Study of the immune status in 51 patients with necrotic and pyonecrotic pancreatitis complicated by hepatic insufficiency revealed an extremely severe degree of inhibition of cellular and humoral immunity. The use of Anti-lympholin, an immunocorrector of a directed action, and reinfusion of the patients' blood irradiated with ultraviolet rays causes a marked immunostimulating effect, reduces the number of pyoseptic complications, and facilitates the reduction of fatal cases among the most serious contingent of patients with acute pancreatitis.
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Results of the investigation of immunological status in 62 patients with destructive pancreatitis complicated by hepatic insufficiency are presented. An extremely severe degree of immunodepression in the given contingent of patients was shown. It was established that the degree of inhibition of the cellular and humoral immunity in patients with destructive pancreatitis had direct relation to the degree of the functional insufficiency of the liver. A conclusion was made about the necessity to include immunocorrecting measures in the complex therapy.
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