Search

Aim: To ascertain regularities of development of cellular immunity in patients with Astrakhan fever (AF) with reference to AF severity, treatment and course., Material and Methods: Cellular factors of immunity--relative and absolute contents of T-lymphocytes (early and late), T-helpers and T-suppressors, B-lymphocytes, neutrophils (early and late)--were studied in 75 patients with AF (63 patients with moderate and 12 patients with severe disease) in the course of the disease progression (weeks 1-5). The patients received antibacterial treatment--doxicyclin, rifampicin and doxicycline in combination with alpha 2-realdiron and gamma-reaferon., Results: Examination of immunocompetent cells has revealed suppression of T- and B-immunity for 2 weeks in moderate AF and 3 weeks in severe AF. The number of T-helpers was low for 3 weeks while of T-suppressors rose beginning from week 2. Immunoregulatory index Tx/Tc remains low till the end of the disease. The number of early and late neutrophils increased since weeks 2 of the disease in moderate and week 3 in severe AF., Conclusion: Doxicycline efficiency was higher than that of rifampicin. Interferon preparations decrease relative number of early and late T-lymphocytes, neutrocytes and T-helpers but their absolute number is at the control level. Relative content of T-suppressors and B-lymphocytes is as in controls but their absolute content is higher.

The results of the study of the level of pancreatic hormones (insulin, glucagon, C-peptide and trypsin), carried out with the aim of finding out the character of relationship between hormonal disturbances and the state of carbohydrate metabolism, as well as the influence of oral rehydration therapy (ORT) with glucose-salt solutions on the function of the pancreas, are summarized. All subjects to be examined were divided into two groups receiving different kinds of ORT. The patients in group 1 (153 subjects) were treated with glucosolan and in group 2 (73 subjects), with sodium citrate in an amount of 2.5-5 lit. over the 6-hour period of treatment. The determination of the content of immunoreactive insulin, glucagon C-peptide and trypsin in the blood as the characteristics of the hormonal activity of the pancreas has made it possible to find out disturbances in the incretory and excretory activity of the pancreas in patients with acute enteric infections of different etiology. ORT with glucosolan and sodium citrate facilitates the restoration of pancreatic function in 65-70% of in patients with acute enteric infections of different etiology.

ORT effectiveness for AII cases of different etiology was studied in two groups of patients: 153 patients as ORT received glucosalan (group 1), 75 patients underwent ORT with sodium citrate in solution from 2.5 to 51 within 6 hours. Both group 1 and group 2 patients benefited from the above solutions as following 6 hours of treatment their biochemical and clinical indices improved. The patients attained normal coagulation, filter-reabsorption renal function under disappearance of dehydration and intoxication symptoms. Availability and simplicity of ORT procedure enable its usage prior to hospitalization, in outpatient departments, at home, making hospitalization unnecessary if started at the initial AII stages.

A method for isolation of parahemolytic vibrios is suggested, based on their high mobility in semiliquid agar gel. A special semiliquid medium was designed and tried, containing agar-agar, peptone, sodium chloride, mannose, gelatin, indicator, Progress agent. The material is inoculated into the center of a petri dish. After incubation at 37 degrees C parahemolytic vibrios form macrocolonies on the surface of the medium, colored black against the red background of the medium. This method permits ruling out preliminary enrichment of the inoculation material in liquid medium, is more effective and rapid.

The extraction of acetone-dried bacteria by means of tris-glycine buffer has been found to yield the greatest number of antigens. Thus, up to 16 antigenic components with different electrophoretic mobility have been revealed in Y. enterocolitica. They include 4 thermostable proteins and 2 glycoproteins. Such antigens may be common and specific for each serovar. The presence of 1-3 surface antigens in common with the causative agent of plague has been revealed. Of these, the most active antigen has proteinaceous nature, and its mobility corresponds to that of rho-globulin. It is not identical with the surface Y. pestis antigen located in the albumin zone.

In the study of 255 V. cholerae strains unrelated to vibrio O group I (NAG vibrios), which were isolated from water bodies in the region of the Volga delta in 1977-1982, antibioticograms of 17 types were obtained and R factor was detected in 37.7% of the strains under study. The pronounced heterogeneity of NAG vibrio populations, evaluated in minimal inhibitory concentration (MIC) values with respect to different antibiotics, is specifically manifested by the presence of various dominating subpopulations of these microorganisms, depending on their sensitivity to some chemical drugs. Various representatives of the genus Vibrio were used as a model for demonstrating the ability of the microbial population to enhance its variability as regards MIC values with a seasonal rise in the number of microorganisms.

Antibody-forming cells were detected in the large intestine of patients with acute Flexner's dysentery by means of the modified Jerne - Nordin method of hemolysis in agar. This method allowed one to determine the classes of immunoglobulins produced by the cells contained in tissue microspecimens obtained by the biopsy of the intestinal mucosa. The maximum amount of antibody-containing cells could be detected on days 7-12 of the disease. The content of antibody-forming cells was shown to depend on the severity of dysentery, the duration of the disease and the therapeutic methods used in the process of treatment. IgA was found to be the most frequent antigen type.

The possibility of the diagnosis of dysentery caused by S. sonnei and S. flexneri, as well as the determination of the dynamics of the distribution of specific O-antigen in the patient's body, by means of the enzyme-linked immunosorbent assay system developed on the basis of antibody preparations obtained by immunosorption has been studied. The study has shown that for better diagnosis the use of fecal extracts is preferable in assays; when used in combination with bacteriological analysis, these assays make it possible to increase the confirmation of the diagnosis of dysentery by several fold.

The study of the washings obtained during rectoscopy from the mucous membrane of the large intestine with the use of a special attachment for a rectoscope revealed that this method had a number of advantages when compared with the study of coprofiltrates; in particular, this method allowed to obtain pure secretions of the mucous membrane free of fecal admixtures and to concentrate the gamma globulin fraction. The study of the dynamics of coproantibody secretion in acute dysentery revealed that coproantibodies were most frequently detected on the second week of the disease (reaching 85.7%), while immunoglobulins occurred in the protein fraction of the washings with almost the same frequency during the whole period of the disease.