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DERMATOVENEREOLOGY
INVENTION
Patent of the Russian Federation RU2098139

METHOD OF IMMUNOCORRECTION IN AUTOIMMUNE PROCESS

METHOD OF IMMUNOCORRECTION IN AUTOIMMUNE PROCESS

The name of the inventor: Novikov AI; Okhlopkov VA; Tsypin AB; Manuylov B.M.
The name of the patent holder: Tsypin Anatoly Borisovich
Address for correspondence:
Date of commencement of the patent: 1993.10.13

The invention relates to medicine, in particular to immunology and dermatology, and concerns the correction of immunity in autoimmune disorders accompanying psoriasis. After preliminary haemodilution and premedication, perfusion of the patient's blood in the vein-venous variant is performed through xeno-spleen sections, previously activated by ultrasound of weak intensity 0.3-0.4 W / cm 2 in pulsed mode 50 imp / s, for 8-10 minutes by scanning movement Through a layer of physiological solution 0.5-1 cm high, with perfusion done at a volumetric rate of 75 - 80 mm / min for 40 to 45 minutes 2 - 3 sessions with an interval between them in 3-5 days at the beginning of the course of traditional complex therapy .

DESCRIPTION OF THE INVENTION

The invention relates to medicine, namely, to dermatology, and can be used in the treatment of psoriasis.

A method for treating bronchial asthma with hemosorption is known, where perfusion of blood is carried out through an isolated donor spleen. Blood from the patient's vein entered the artery of the spleen and, passing through the natural vascular network, from the splenic vein entered the opposite ulnar vein of the patient.

The disadvantage of the method is its complexity and insufficient efficiency, because The rate of perfusion is small, and frequent breakthroughs in the spleen tissue are observed.

A method is known for treating a septic condition by hemoperfusion through sections of the donor spleen layered on the surface of fragments of activated carbon encapsulated.

The disadvantage of the method is its complexity.

A method of immunocorrection is known in the autoimmune process, when an isotonic buffer solution is perfused through the natural vascular network of the donor spleen, which is then administered to the patient.

The method allows to influence the already developing autoimmune process, but it has the same disadvantages.

The main objective of the invention is to simplify the process of hemoperfusion and increase the sorption capacity of the spleen in the treatment of psoriasis.

This object is achieved in the method of immunocorrection in an autoimmune process involving the administration of an immunomodulating agent by perfusion through a donor spleen included in an extracorporeal system, for example, in the treatment of psoriasis, after puncturing the cubital veins, hemodilution and premedication is performed, and then perfusion of blood through the splenic tissue sections , Previously activated by ultrasound, with a volume perfusion rate of 75 80 ml / min for 40 45 min 2 3 sessions with an interval of 3 to 5 days at the beginning of the course of traditional complex therapy.

The method is carried out as follows

The patient is treated with 2 3 blood perfusion sessions through the sections of the donor spleen pre-treated with ultrasound, at a volume perfusion rate of 75 80 ml / min for 40 45 minutes at intervals of 3-5 days, with a course of conventional therapy.

All measures for obtaining donor pork spleen were carried out under sterile conditions. The spleen was taken from a healthy animal immediately after slaughter. Washed from the blood with a heparinized isotonic sodium chloride solution and in a sterile bag of the shipping container at a temperature of 4-6 ° C was delivered to the operating room. The spleen was cut in thin layers of 2 3 mm in physiological saline at a temperature of 37 ° C. To increase the membrane-energy potential and improve the microcirculation of the cells, the sections of the splenic tissue in the tray were activated by weak intensity ultrasound (0.3 0.4 W / cm 2 ), In a pulsed mode (50 pulses / s) for 8-10 minutes by scanning movements through a layer of physiological solution 0.5-1 cm in height. The volume and length of the chamber were sufficient to allow the waves to uniformly penetrate and activate each unit of volume. Cell activity increased by 15-20%. Perfusion was performed in the venous-venous variant. After puncturing the concurrent veins, hemodilution was carried out with a solution of rheopolyglucin, premedication including: 30 mg of prednisolone, 2 ml of taewegil and 10,000 units of heparin. Simultaneously, the activated sections of the spleen were washed with 2000 ml of isotonic sodium chloride solution to "pure water" and treated with heparinized saline (10,000 units of heparin per 10 ml of 0.9% sodium chloride) for 20 min. After preparation of the patient and extracorporeal system with xeno-spleen hemoperfusion was performed through sections of the spleen, previously activated by ultrasound. Hemoperfusion was carried out at a volume rate of 75 to 80 ml / min for 40 to 45 minutes. After the end of the procedure, pressure bands were applied to the venous puncture sites for 2 hours. Xenosplenosorption sessions were performed at the beginning of the course of complex therapy.

An example . Patient B. 30 years old, was hospitalized with complaints about the presence of rashes in the area of ​​the skin of the trunk, extremities, accompanied by itching. Sick for 12 years. In the last 3 years, the disease has progressed without clinical remissions, outpatient and inpatient treatment has not been effective.

Objectively: the elements of the rash are presented in the form of papules, the size of 3 15 cm. The color of the rashes is stagnant red. On the skin of the scalp, diffuse lesions are noted in the form of plaques covered with whitish scales. When scraping papules symptom stearin stain, pinpoint bleeding. Nail plates have indentations a symptom of a "thimble".

Subjectively: rashes are accompanied by itching.

Diagnosis: common psoriasis. Plaque shape. Progressive stage. It was decided to conduct xenosplenosorption, given the lack of effect from previous therapy and the long absence of remissions.

According to the invention, xenosplenosorbtion included hemodilution and premedication, and then blood perfusion through slices of the spleen, sonicated. Hemoperfusion was performed at a rate of 75 ml / min for 45 min. The next day after the procedure, the patient significantly reduced the itching of the skin, which on the second day stopped completely. Decreased edema and infiltration on the affected skin. The appearance of new rashes stopped. Traditional therapy is prescribed: 30% sodium thiosulfate, Aevit, 2% sulfuric salicylic ointment. After 3 days, the procedure was repeated. The volumetric perfusion rate was 80 ml / min, duration 40 min. After a repeated session of xenosplenosorption around the lesion, a pseudoatrophic corolla was formed, the rashes were completely cleansed of scales and after 5 days the papular elements quickly regressed. Significant improvement occurred 10 days after the second procedure. Against the background of the treatment, the biochemical and immunological parameters of blood have improved. The patient was discharged. At a repeated examination 10 days after the discharge of psoriasis, the patient was not identified, i.e. There was a clinical recovery. Another examination of the patient after 3, 6 and 12 months did not reveal any relapse of the disease.

Example 2 . Immunograms were studied in patients with plaque psoriasis to isolate the signs of immune status and the appointment of xenosplenosorption. 22 patients with psoriasis aged from 17 to 67 years were under observation. All patients were treated long and unsuccessfully in the clinic. At the time of the study, the psoriatic process was represented by multiple extensive plaques of stagnant red color with silvery scaling without a tendency toward peripheral growth. Individual patients were occasionally harassed by itching.

Prior to the appointment of efferent therapy (non-drug stimulation of natural immunity systems, patients underwent immunological examination for tests of the 1 st and 2 nd levels.The indices of immunity of patients with psoriasis prior to and after sorption therapy are given in the table.

In patients with low phagocytic reactions (21 ± 2,0), elevated levels of IgM and CEC indicate involvement of the immunity system in the pathogenesis of psoriasis. In all patients, 3 xenosplenosorption sessions were included in the treatment package according to the proposed procedure at intervals of 3 to 5 days. With xenosplenosorption, along with elimination from the body endotoxins, the CEC noted pronounced immunostimulation due to release into the bloodstream of the recipient of biologically active substances from the donor spleen and realized by a significant increase in the phagocytic activity of leukocytes.

7 days after the end of the course of sorption therapy, the immunogram was re-examined. Patients had leukocytosis and a tendency to increase the proportion of lymphocytes and phagocytic neutrophils. The CEC content tended to decrease.

Clinical recovery or significant improvement was observed in 16 (72.7%) of 22 patients.

Already on the 3rd-5th day after xenosplenosorption psoriatic efflorescence paled and was cleared of scales. Later on, during 2 xenosplenosorption sessions in 11 patients, the compaction of psoriatic plaques was significantly accelerated, a pseudo-leukemic corolla appeared on their periphery, and then a complete solution of the rashes with the formation of hyperpigmented spots appeared; In 5 patients complete regression of the rash was observed in 70 80% of the skin. The remaining 6 patients showed only a weakening of the psoriatic process, which consisted in the reduction of plaques, their liberation from scales.

Experience in the application of the method showed its high efficacy in patients with plaque chronic psoriasis with low rates of phagocytosis and a slightly elevated level of circulating immune complexes (CEC).

The proposed method allows to influence the already developed autoimmune process with elimination of endotoxins from the body, circulating immune complexes and increase in the blood of phagocytic activity of leukocytes.

The proposed method will shorten the treatment period and prolong the periods of remission of psoriasis without adversely affecting the body.

CLAIM

A method of treating psoriasis comprising immunocorrection, characterized in that after preliminary hemodilution and premedication, perfusion of the patient's blood in the veno-venous variant is performed through sections of xeno-spleen, previously activated by ultrasound of weak intensity 0.3 0.4 W / cm 2 in a pulse mode of 50 pulses / S for 8-10 minutes by scanning motion through a layer of physiological solution 0.5-1 cm high, with perfusion carried out at a space velocity of 75 80 mm / min for 40 to 45 minutes 2 3 sessions with an interval between them of 3 to 5 days at the beginning Course of traditional complex therapy.

print version
Date of publication 01.04.2007гг