This multicenter study investigated the possibility of reducing mortality rate by administering natural lung surfactant additional to standard therapy to treat patients after cardiac surgery who developed an acute respiratory failure (ARDS/ALI).A total of 78 patients (1998)(1999)(2000)(2001)(2002)
The paper presents the results of a standard and complex treatment method using the peptide drug thymus thymalin in patients with COVID-19. One of the mechanisms of the immunomodulatory effect of thymalin is considered to be the ability of this peptide drug to influence the differentiation of human hematopoietic stem cells (HSCs). It was found that, as a result of standard treatment, patients in the control group showed a decrease in the concentration of the pro-inflammatory cytokine IL-6, C-reactive protein, D-dimer. The addition of thymalin to standard therapy accelerated the decline in both these indicators and the indicators of the T cell system. This has helped reduce the risk of blood clots in COVID-19 patients. The revealed properties of the thymus peptide preparation are the rationale for its inclusion in the complex treatment of coronavirus infection.
Three pulmonary surthctant preparations: from human amniotic fluid, from bronchoalveolar lavage fluid, and from cattle lung tissue homogenate were tested in preclinical studies. The preparations are nontoxic, possess no mutagenic, teratogenic, and allergic activities and do not modify visceral morphology after repeated injections. After a single intratracheal administration the drugs normalize arterial blood oxygenation in 15-30 rain and arrest the respiratory distress syndrome in dogs, which is confirmed roentgenologically and clinically. Key Words: respiratory distress syndrome; surfactant; pharmacological properties; therapeutic activityThe respiratory distress syndrome (RDS) is one of the major causes of neonatal and adult mortality [3,5]. About 30,000 babies with RDS are annually born in Rnssia; in the USA 150,000 RDS cases are recorded annually in adults. In RDS 15-30% newborns and 50-70% adults die [3,5,7]. In preterm newborns RDS is caused by immaturity of type 2 alveolocytes and the resultant primary deficiency of puhnonary surthctant (PS) [2]. In RDS of adults, PS deficiency is secondary, developing as a result of structural and functional disorders in the airblood barrier. It often develops after multiple injury, sepsis, shock lung, radiation injury, etc. Natural and synthetic PS preparations have been widely used all over the world: smwana (USA), surfactant-TA (Japan), curosurf (Italy), alveofact (Germany), exosurf (UK) [8].We developed a technologically inexpensive method for preparing natural PS and chalacterized their physicochemical properties. Three preparations were studied: human PS isolated from parturients' amniotic fluid, PS from bronchoalveolar iavage fluid (PS-BLF), and PS prepared by water-salt extraction of finely dispersed cattle lung (PS-WSE).The pharmacological and therapeutic properties of these PS preparations are studied.
Surfactant-BL was administered to rats via the inhalation route from day 1 or day 8 after intratracheal injection of bleomycin. Bronchoalveolar lavage and morphological characteristics of the lungs were compared. Administration of surfactant-BL at the early terms efficiently reduced the severity of bleomycin-induced alveolitis and atelectases.
Background: Damage to lung surfactant, which is responsible for the lung local immunity, may contribute to the development of bronchial inflammation in patients with bronchial asthma. Different doses of glucocorticoids produce a stimulating or inhibiting effect on the synthesis of the surfactant protein (SP-A) mRNA. Lung surfactant disorders may negatively influence bronchial homeostasis and aggravate the condition of patients with bronchial asthma and COPD. The objective of this study was to evaluate the influence of long-term inhaled corticosteroids (ICS) on the phospholipid levels of the lung surfactant in rats.Methods and Results: Inhalations of prednisolone hemisuccinate (PH) were given to white non-pedigree rats weighing 180-200 g at a dose of 0.3 mg/kg daily for 30 days. Already by the end of the first study period (10 days), lung surfactant phospholipid levels were found to decrease significantly from 1.35±0.060 mg to 1.02±0.045 mg (P<0.001). The decrease was further recorded at Day 20 and Day 30 of the inhalation period: down to 0.94±0.042 mg (P<0.001) and 1.04±0.047 mg (P<0.01), respectively. The phospholipid content continued to decrease after termination of inhalations down to 0.80±0.036 mg (P<0.001) and 0.63±0.028 mg (P<0.001) at Day 40 and 50 of the experiment. By Day 60 of the experiment (30 days after termination of PH), the phospholipid content in the lung surfactant was restored to the baseline level of 1.29±0.058 mg.Conclusion: The content of lung surfactant was found to decrease significantly as a result of long-term ICS treatment, which may have a negative effect for chronic lung diseases. (Int J Biomed. 2016;6(3):167-169.).
Background: Damage to lung surfactant (LS) enabling the lung local immunity may contribute to the development of bronchial inflammation in patients with bronchial asthma.
-НИИ пульмонологии ГБОУ ВПО «Первый РезюмеВыраженный вентиляционно перфузионный дисбаланс, приводящий к хронической дыхательной недостаточности (ХДН), имеет раз ную природу при обструктивном и рестриктивном типах дыхательной недостаточности (ДН). Хроническая обструктивная болезнь лег ких (ХОБЛ) и идиопатический фиброзирующий альвеолит (ИФА) являются типичными представителями этих видов респираторной патологии. Целью исследования явилось определение особенностей нарушения кровообращения в легких у больных обструктивными (ХОБЛ) и интерстициальными (ИФА) заболеваниями легких и выявление некоторых закономерностей изменений кровотока при раз личных патофизиологических механизмах формирования ДН. Материалы и методы. Проведен анализ результатов лучевых методов исследования: мультиспиральной компьютерной томографии (КТ) и мультиспиральной компьютерной ангиографии, однофотонной эмиссионной КТ у пациентов (n = 150) с эмфизематозным типом ХОБЛ III-IV стадии в сочетании с ХДН или правожелудочковой недостаточностью и пациентов (n = 45) с ИФА в стадии формирования «сотового» легкого. Результаты. При ХДН у больных как с обструктивной, так и с интерстициальной патологией развиваются значительные нарушения кровообращения в легких, чему способ ствует ремоделирование в зоне паренхимы, а также сопутствующая сосудистая патология (тромбоэмболия легочной артерии, тромбоз in situ), онкологические и персистирующие инфекционные воспалительные процессы. Своевременная диагностика изменений, проте кающих в легочной паренхиме и сосудах, позволяет своевременно назначить адекватную этиологическую терапию и существенно повлиять на прогрессирование и прогноз заболевания. Заключение. В результате лечебных мероприятий у больных ХОБЛ легкой и сред ней степени тяжести достоверно чаще, чем у пациентов с ИФА, восстанавливается редуцированный кровоток в местах ишемии легочной ткани, где еще не развились необратимые изменения, особенно при присоединении сосудистой патологии. При наличии не обратимых морфологических изменений в паренхиме легких, приводящих к развитию ХДН, у больных как при обструктивном, так и рестриктивном типах респираторной патологии лечебные мероприятия практически не влияют на состояние микроциркуляции в ма лом круге кровообращения. Ключевые слова: хроническая обструктивная болезнь легких, идиопатический фиброзирующий альвеолит, легочная гипертензия, дыха тельная недостаточность, однофотонная эмиссионная компьютерная томография, мультиспиральная компьютерная томография, пер фузия. SummaryThe aim of this study was to describe particularities of pulmonary circulation in patients with obstructive (chronic obstructive pulmonary disease (COPD)) or restrictive (idiopathic pulmonary fibrosis (IPF)) diseases and to study tendencies of pulmonary blood flow disorders in different patho logical mechanisms of chronic respiratory failure (CRF). Methods. Results of image examination (multislice computed tomography, computed angiography, single photon emission computed tomography) were analyzed in 150 patients with severe stage 3-4 COPD (phenotyp...
Results of comparative assessment of level of antibodies of IgG to SARS-CoV-2 in dynamics at standard and complex methods of treatment with use of medicinal peptide medicine of a timus of a timalin for patients with COVID-19 are presented in article. It was found that as a result of standard treatment, patients showed a decrease in antibody levels by 53% after 104 days. The addition of thymalin to standard therapy slowed down the decline of this indicator. So, a similar indicator in patients who took thymalin was only 21%. This contributed to maintaining strained adaptive immunity. The detected immunomodulatory properties of the preparation of thymalin with respect to COVID-19 can be reflected both in the formation of an effective immune layer of the population through natural immunization, and in the process of antibody formation during vaccination of target contingents.
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