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An evaluation was done of immunological parameters in the post accident period in 41 examined person. Of these, 26 subjects had chronic maxillary sinusitis, 15 were healthy persons (control group). In patients with chronic maxillary sinusitis, the state of the T-system of immunity has been shown to be characterised by a drop in the total count of T-lymphocytes, T-helpers, T-suppresors. Parameters for humoral immunity are characterised by elevation of the peripheral blood levels of B-lymphocytes, prominent disimmunoglobulinaemia--significant reduction of class G immunoglobulins and macroglobulins. The T-cells-helpers ratio is significantly reduced both in group I and group II. Reduction has been ascertained in the ratio of those T-cells-suppressors blocking antibody formation by B-lymphocytes. In patients after the Chernobyl accident, there was noted a significant decline in the functional activity of macrophages.

As many as 102 children living in the territories affected by radioactive contamination were examined. Total equivalent doses of irradiation of the thymus gland over the period of 1986-1996, the intrauterine period included, ranged from 4.24 to 25.9 mZv, those for red bone marrow varied from 4.7 to 35.5 mZv. Parameters characterizing cellular and humoral links of immunity were studied. Changes were revealed in many immunological indices, the association of which indices results in formation of activational, depressive, and undifferentiatable types of immunological disturbances with clinical manifestations of allergic and infectious syndromes of immunological deficiency.

Particular features were studied of immunogrammes in those children presenting with thyroid pathologies (hyperplasia of the thyroid gland, autoimmune thyroiditis, nodular goiter) who live in the territories affected by contamination with radionuclides. An analysis was carried out of particular characteristics of immunity in children depending on the level of contamination in the region where they reside. The results obtained suggest changes in the T and B links of immunity in children with thyropathy.

As many as 1492 residents of populated areas in Zlynka District of Bryansk Province were studied. There were 628 children and 864 adults in the series. Contamination with radionuclides in the territory of residence was of the order of 40/km2 and above; the level of cesium deposition in the body of the examinees ranged between 0.4 to 3.4. Deviations from the norm in the peripheral blood were detected in 15% of adults and 36% of children. These were manifest by hypochromic anemia, by eosinophil- and lymphoid-type leukemoid reactions, and by other disorders that resulted from nutritional imbalance, deficiency of iron of varying genesis, helminthic invasion, allergic states. Concurrent cellular and humoral immunity shifts coupled with the deviations from the norm in the indices for the thioldisulphide system attest to the need for designing of measures to secure long term observation over health state of the population residing in the contaminated territories.

A total of 92 patients with duodenal ulcer (DU) who took part in the elimination of aftereffects of Chernobyl accident in 1986 were examined. Of these, 46 patients (group I) developed DU against the background of persisting hepatitis. The above patients demonstrated significant increase in the peripheral blood levels of hemoglobin and red cell count as well as immunoglobulins of all classes and circulating immune complexes in blood serum. By far the commonest among group I patients (compared to group II) were such events as allergization of the organism and duodenogastric reflux. Based on the studies made a conclusion is drawn to the effect that it is necessary that specific agents capable of improving hemodynamics, endowed with immunocorrective and antiallergic activity should be included into a complex of therapeutic measures designed to treat those patients with hepatitis having been exposed to ionizing radiation, together with those means capable of normalizing the pyloroduodenal portion motor-and-evacuatory function to prevent the DU development.

Over the period of 1986-1990 a comprehensive evaluation was carried out in a series of a 5578 subjects exposed to ionizing radiation because of Chernobyl NPP breakdown, using hematologic, immunologic and biochemical methods of investigation. The above series included liquidators of aftermath of the accident, residents of Pripyat' and Kiev. Changes were revealed in all the parameters studied. In view of the abnormal changes in the values for blood, immunologic status and biochemical tests characterizing the functional state of the liver in those subjects having been in the area of abnormal radiation, as well as its potential remote sequelae, it is advisable that the above contingents of the population be under prophylactic management.

The immunoglobulins content was measured in blood serum of 233 individuals who took part in the elimination of effects of ChNPP breakdown. Distributive patterns of phenotypes, antigens and genes of HLA system depending on levels of Igs G, A and M have been studied. A positive association of some HLA antigens with concentration of immunoglobulins of certain isotypes was found out.

Among cardiovascular diseases registered in the Chernobyl wreckers neurocirculatory dystonia and hypertension occur most frequently. Combined treatment including electric sleep, iodinebromine baths, therapeutic exercise, massage relieves clinical symptoms, promotes positive rearrangement of hemodynamics, a decrease in myocardial hyperkinesis and vegetative dysfunction, an increase in cardiovascular reserves, correction of hypersympathicotonia and immune disorders.

The clinical course was studied of duodenal ulcer as were results of hematologic and immunologic investigations in those persons (n = 86) having taken part in the elimination of the aftermath of the Chernobyl accident. It has been ascertained that concomitant disorders have a marked effect on the clinical symptoms of ulcer disease in above patient population. Values for blood hemoglobin and state of cellular and humoral immunity are proposed to be used for predicting the disease course and determining efficacy of the therapy instituted.

Imbalance was revealed in the proportions of T-lymphocyte subpopulations in those persons engaged in activity in mining employment who had been exposed to a complex of the radiation accident factors. Maximum reduction in the lymphocyte suppressor activity was recordable in those patients in whom the doses of radioactive irradiation received exceeded 25 s Gy. Depression was found of humoral immunity manifested by a drop in the absolute as well as relative numbers of B-lymphocytes and fall in the blood serum levels of Ig G, A. The results of study of clinical-biochemical and immunologic parameters of blood permit individualized therapies be developed, prophylactic measures to be devised to deal with the relevant pathologic processes and conditions in the cohorts examined.

The aim of this study was to determine an influence of ionized radiation on the prevalence of Cryptosporidium and Pneumocystis carinii (P. c.) infections in children inhabitants of settlements affected by radionuclides after Chernobyl accident. Survey of children from day-care centers for prevalence of Cryptosporidium was carried out in Bryansk region, Russia, and Gomel and Mogilev regions, Belarus; children from cities Mogilev and Gomel as well as small town Pochep, Bryansk region, serve as control clean zones. Survey for P. c. seroprevalence was carried out in town Novozybkov, Bryansk region, Specific Ab to P. c. determined by "Pneumo-test" system (Nyarmedic. Moscow. Russia), an evaluation of immune status included assessment of Ig in serum and saliva by Manchini method. Results of the study were as follows: 1) of 432 healthy children surveyed for Cryptosporidium oocysts 352 were from affected regions: the prevalence in Bryansk region was 8% vs. 2.8% in control, in Gomel and Mogilev 4.1% vs. 2.8%. 2) Prevalence anti-P.c. Ab accounts 56.3% in children and 78.2% in adult inhabitants of Novozybkov vs. 30% in children of control group. Special interest presents an relationship of seroprevalence P.c. and secretory immunity examined twice with 2 month interval. At the first survey IgG in seropositive for P. c. children was found in 36.8% (vs. 23.1% in control) and secretary IgA in 13.2% vs. 5.8% in control. At the second survey IgG was found in 53.4% vs. 21.8% and IgA in 2.7% vs. 1.8% in control. Taking into consideration the known fact that IgG and IgA in saliva are result of their transudation from blood through the inflammatory mucosa we consider that long ionized radiation impairs the barrier function of mucosae.

Clinical examination with immune status assessment of more than 300 healthy persons, who worked in 30-km Chernobyl NPP zone four years after the accident was carried out. The clinical characters of immune deficiency were detected in 6.67% of examined persons and appeared as repeated respiratory diseases. Significant increase in mean level of leukocytes and lymphocytes was revealed. Activation of T-helper link of cell immunity was determined by increase of CD4+ cells in 35.2% of examined persons, that were lower than in people who took part in Chernobyl accident amelioration in 1986. Decrease in content of T-cells and B-cells was observed in 1/4 and 3/4 of persons correspondingly by rosette assays. No changes in serum immunoglobulins level was observed.

It has been detected that children evacuated from the zone with the elevated radioactivity level have the increased number of chromosomal and chromatid aberrations. The frequency of chromatid aberrations is 2.1-fold lower in country-side children than in children from industrial towns. Cytogenetic disturbances in immunocompetent cells correlate with the level of immune imbalance. Children born in families of liquidators of the ChNPP accident in the first year after their return from the accident zone have substantial cytogenetic and immune disturbances. Children living near sources of atmospheric pollution are characterized by the 3-4-fold increase in frequencies of chromatid anomalies and by the development of a pronounced immunodeficiency.

We studied immunologic status in patients with stage II hypertensive disease (HD): there were 92 Kievans and 46 subjects living in the area with excessive radiation within a 30-km radius of the Chernobyl Nuclear Power Plant; control group comprised 20 apparently healthy men (donors of the city station of blood transfusion). In HD patients the T-lymphocyte count was found to be reduced as was the content of T-suppressors and T-helpers, the activity of the B-immune system tending to be on the increase. Suppression of the T-lymphocyte suppressive function and elevation of the immunoglobulin G content result in an accelerated formation of circulating immune complexes, this indicating evolution of disturbances in immune complexes and an influence being exerted on the development of vascular affections and progression of atherosclerosis being promoted in these patients. Changes in the immune system tended to be more pronounced in st. II HB patients residing in the area with abnormal radiation than they were in the same category of patients--inhabitants of Kiev--this being supposedly a reason for disease progression in them.

Studied were particular features of peripheral blood, certain immunological and biochemical indices under long-term exposure of human body to radiation after the accident at the Chernobyl Nuclear Power Plant. The study comprised 5578 individuals. The examinees were liquidators of the Chernobyl accident sequels (n = 1052), inhabitants of Pripyat evacuated from the town (n = 850), the Kiev SSBT primary donors (n = 1738). Control group consisted of 936 Kievans who had been examined before the accident between 1982-1985 by the same methods. The results obtained allowed for the most informative indices to be found in order that risk groups might be formed.

Among 33 patients with Stage II hypertension, 25 persons were inhabitants of the Russian radionuclide-contaminated areas and 8 patients had no prior contacts with ionizing radiation (control). All the patients examined were maintained within 4 weeks on a diet, radioprotective effect of which was realized due to the elevated content of sulfur containing amino acids, antioxidants and complexes. In the patients who lived in the radionuclide-contaminated areas, a moderate activation of lipid peroxidation was detected simultaneously with marked alterations in the humoral component of the immunity system, which involved a considerable increase in the levels of IgG and complements C3 and C4. A decrease in content of malonic dialdehyde and diene conjugates as well as normalization of IgG and decrease in content of IgA, IgM and C3 were observed in blood plasma of the patients on diet. Supplementation of omega 3 polyunsaturated fatty acids (omega 3-PUFA), 5 g/day and alpha-tocopherol, 12.5 mg/day, to the diet elevated the serum concentrations of all lg classes, which suggests the presence of an immunomodulating effect of omega 3-PUFA. Moreover, the content of malonic dialdehyde was not increased in blood plasma if 3-PUFA was used. Hence, increased alpha-tocopherol levels should be used in the treatment of these patients with omega 3-PUFA (up to 5-7 mg per g PUFA) in order to stabilize lipid peroxidation.

A study of the blood sera of 50 children from the zone contaminated by radionuclides due to the Chernobyl accident was conducted to determine the immune status (level of immunoglobulin of Ig classes (A,M,G), presence of serum autoantibodies, determination of active anti-Sm antibody zones). A statistically valid increase of the IgM and IgG, reduction IgA levels was found. Antibodies to thyroid, smooth muscles, parietal cells, mitochondria were not found; 7% of patients showed autoantibodies to DNA and antinuclear factor.

The immune state of 77 cleanup workers of Chernobyl power plant accident suffering from vegetative dystonia was studied. The group of comparison consisted of 10 vegetative dystonia patients, who were not subjected to the ionizing radiation influence. The workers showed no specific changes of immunity, but immune state disturbances among them were more frequent and more pronounced that in ordinary vegetative dystonia patients.

The comparative study of the isolation rate, level, antigenic and class specificity of serum antibodies to the causative agents of purulent septic infections (Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis) and acute enteric infections in healthy adults with different ABO blood groups before (836 persons) and after (1,429 persons) the catastrophe at the Chernobyl nuclear power station was made. The study revealed the fact that the genesis of antibodies directed against different microorganisms can be stimulated without additional antigenic challenge in the form of disease or immunization, which was definitely indicative of the influence of small radiation doses in Kiev on the humoral immunity of the population. The multifactor character of the dependence of antibacterial antibody formation under altered radiation conditions on the specific features of the infective agent and the intensity of its circulation among the population, individual immune responsiveness of the body and concrete radiation conditions was established.

Results are reported of an immunological examination of 534 patients with digestive diseases and 130 healthy persons. 282 patients subjected to radiation effects showed a marked and persistent T-lymphocytopenia, B-lymphocytosis, reduction of the content of T-helpers, T-suppressors, dysimmunoglobulinemia characterized by reduction of IgG content and excessive IgA secretion. These changes were observed during the period of exacerbation and remission requiring the use of immunocorrective agents.

A total of 455 women, both pregnant and nonpregnant ones, permanently living in zones I and II of ionizing irradiation, were examined in 13 months after the Chernobyl Power Plant accident. Monocyte phagocytic activity and humoral immunity parameters were under study. An imbalance of the immunity parameters were characteristic of all the examinees living in zone I: they presented with disordered phagocytic activity of the monocytes, elevated levels of circulating R proteins, reduced production of natural and specific antibodies, changed concentrations of the principal immunoglobulin classes. The immune status of women living in the zone II was found lowered at the expense of reduced phagocytic activity of the monocytes, production of natural antibodies and immunoglobulins, shifted to either sides R protein levels, this necessitating immunocorrective therapy before pregnancy onset.

Immunoassays of the 1st and 2nd levels were investigated in patients with acute radiation disease 12-36 mos. after irradiation. A decrease in the level of helper/inducer T-lymphocytes, a tendency to a decrease in the number of suppressors and an increase in the number of theophylline-stimulated T-cells in patients with acute radiation disease of the 3rd degree were observed. Control of the immune status of this group of patients is recommended.