General and local humoral immunity in patients with peptic ulcer

Systemic and local humoral immunity and nonspecific defense factors were investigated in 88 patients with duodenal peptic ulcers and 18 patients with gastric ulcers. In acute conditions, nonspecific defence was depressed and blood IgG level was increased in peptic ulcer patients. An increase in complement titre, C3 and lysozyme, and a decrease in IgG were recorded after treatment, although normal levels were never attained. Salivary, gastric-juice and duodenal-content secretory IgA levels were characteristically increased during acute phases of peptic ulcer; salivary IgA declined after treatment. The disturbance of nonspecific defence, systemic and local humoral immunity, demonstrated in patients with peptic ulcers, may be regarded as a possible ulcerogenic mechanism.     

Reactions of humoral and cellular immunity in peptic ulcer in relation to the condition of the gastric mucosa

A total of 160 persons including 50 patients with duodenal ulcer (DU) and 38 with gastric ulcer (GU) were examined for antibodies to the parietal cells of the stomach (PCA) and cell cellular immunity responses to autologous antigen from the gastric mucosa. It was shown that both PCA of the stomach and cell immunity responses in patients with GU and DU occurred in an insignificant number of cases. No differences were revealed in the humoral and cellular immunity in GU and DU persons with and without concomitant gastritis or in the stage of exacerbation and ulcer cicatrization.     

The content of gastrin, bombesin and somatostatin in the blood and gastric juice of patients with duodenal and gastric peptic ulcer]

Ninety patients suffering from peptic ulcer and 25 healthy subjects were examined for the content of gastrin, bombesin and somatostatin in blood and gastric juice. Among patients with duodenal ulcer, 2 groups were distinguished: group I included patients in whom peptic ulcer occurred before 30 years; the majority of the patients manifested blood hypergastrinemia, a decrease of bombesin concentration and normal somatostatin concentration; gastric juice was characterized by a lowering of somatostatin concentration and unchanged gastrin concentration; group II was made up of patients who developed peptic ulcer after 30: in the majority of the patients, gastrin concentration was reduced under basal conditions, after loading it was unchanged; in part of the patients, blood somatostatin concentration was elevated, in 16 in exacerbation and in 19 in remission; in the remainder, it was unchanged. The concentration of bombesin in blood remained unchanged. In gastric juice, gastrin concentration was increased only after histamine administration, somatostatin concentration was unchanged whatever the disease stage. In patients with gastric ulcer, gastrin concentration in blood was elevated only under basal conditions, being unchanged in gastric juice irrespective of the disease stage. Meanwhile, the concentration of bombesin was lowered both under basal conditions and after insulin administration, the concentration of somatostatin was decreased both in blood and gastric juice whatever the disease stage.     

The diagnostic value of the histamine test in studying the gastric juice of patients with duodenal peptic ulcer]

Measurements were made of the content of pepsin and hydrochloric acid in gastric juice from 96 duodenal ulcer patients, obtained under the conditions of basal secretion and after histamine administration in the submaximal dose. The disease was marked by changes in the response to histamine on the part of gastric glands. In duodenal ulcer patients, histamine primarily stimulates pepsin secretion whereas in healthy subjects, secretion of hydrochloric acid is predominant. Based on the regularity thus revealed, a new test (the ratio of the histamine index of pepsin to the histamine index of hydrochloric acid) was developed. This test is of importance for the diagnosis of duodenal ulcer and predicting the gravity of the course it may run.     

Status of cellular immunity in patients with Astrakhan fever

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.     

Changes in gastric secretory function in peptic ulcer patients after gastric resection

Gastric function was studied in 69 peptic ulcer patients in the long-term period after gastric resection according to Billroth-I and Billroth-II. Enzyme-producing function of the stomach was appraised according to the blood pepsinogen content, acid-forming function was assessed with the aid of intragastric pH-metry, and mucus-forming one in accordance with the content of hexosamines and sialic acids in gastric juice. The patients showed different alterations in gastric function. A correlation analysis was used to establish the role played by the neurohormonal systems (leu-enkephalin, beta-endorphin, gastrin, somatotropin, triiodothyronine, thyroxine, cortisol) in the derangement of secretory function of the resected stomach. The data obtained enable one to come closer to understanding the ineffectiveness in some cases of drug and surgical therapy of peptic ulcer. On the other hand, specification of the regularities of the impairment of secretory function of the stomach will be helpful in elaborating methods of gastric function correction at the neurohormonal level.     

Diagnosis and treatment of gastric campylobacteriosis in patients with peptic ulcer and chronic gastritis

The endoscopic picture of peptic ulcer was studied in 104 patients; the gastric mucosa of 30 per cent of the patients was infected with Campylobacter pyloridis (CP) and had acute erosions in the pyloroduodenal zone. Erosions in uninfected patients were found in 3 per cent of the cases. The predominant lymphoid infiltration of the mucous coat of the stomach was revealed in 60 ulcer patients irrespective of the CP infection. Mucous infiltration with polymorphonuclear leukocytes was found in 13 chronic gastritis patients (in 6 of them gastritis was combined with CP infection). The urease test was positive during the first hour in 82 per cent of the cases in the presence of a large number of CP in histological specimens. Treatment of 31 patients with gastric campylobacteriosis using various antibacterial agents or their combination revealed that continuous 2 months bismuth subnitrate medication was more effective for gastric mucosa disinfection. In addition, favourable results were often obtained when a combination of two antimicrobial agents was used.