At immunoproductive processes in endothelium of patients with coronary atherosclerosis and endocarditis a phase dynamics of innate immunity represented by polytypic Ca(2+)-dependent autoprecipitating proteins of nonclonal recognition of surface cell membrane components (CMC) have been revealed. In case of coronary atherosclerosis the organism reaction to expressed CMC is manifested basically by intensified synthesis of cathodic complement-C3-similar autoprecipitin, but in case of endocarditis--by consumption of one with formation of anodic autoprecipitin and by intensified synthesis of autoprecipitating immunoglobulin G. These membranotropic autoimmune reactions are identical with the organism reactions to alien (heterologous) agents and differentially participate in development both of basic disease and perioperational complications after cardiac operations using trans- and implants, hence, they should be taken into account during membrane-stabilising and immunocorrecting therapy of recipients.
The role of humoral constituents of the innate immunity in altering of tolerance and formation of immune response to autoreactive cell membrane components during both primary endocardithis and atherosclerosis processes and secondary ones, following reconstructive implantation on heart was investigated. The ways of restoration of the tolerance to membrane components and elimination of immune deficiency during the treatment of primary and secondary immunopathy of the cardiovascular system before and after implantation were considered.
Calcium-dependent innate immune response with participation of the superfamily of immunoglobulins to several intra- and extracorporal xenobiotics were studied at 216 recipients during synthetic cardiac valves implantation or veins transplantation in coronary arteries. It was shown that immediate immune response to xenobiotics was manifested by generation of the antitissue anodical autoprecipitin with specificity to the surface cell membrane component. This reaction initiated and regulated the subsequent dynamics of the two different fibrinogen autoimmune complexes formation, resulting in development of the immunogenic damages of blood circulation. Correction of these rapid innate immune responses is important for prevention and normalisation of the xenogenic damages of blood circulation during trans- and implantation on the heart impaired with endocarditis or aterosclerosis.
The manifestation of bioincompatibility in the shape of complement-dependent changes: solubilisation and inhibition--of immune complexed formation was investigated in patients at the prosthetic cardiac operations with using artificial blood circulation, artificial cardiac valves and heterotopic vascular grafts. It was established, that the solubilisation of the precipitate, preformed by plasmic fibrinogen with antifibrinogenic immunoglobulin, and inhibition of hemagglutinating activity of normal autoantibodies in plasma appeared in several minutes after the contact of alien mains with own blood circulation system. These changes of formation of immune complexes in plasma, caused by complement activation, had a selective and reversible nature and were followed breaches of blood circulation. Estimation of early, functional indexes of bioincompatibility, displaying by changes of immune complex formation, may be helpful in prognostic relation in patients with immunocomplex diseases at prosthetic cardiac operations.
Humoral manifestations of bioincompatibility were studied at early stages (during several hours and days) after operations using non-peculiar to heart trans- and implants: aortocoronary bypass at 102 patients with coronarosclerosis and implantation of artificial cardiac valves at 145 patients with endocarditis. In the various postoperation stages the formation of the structurally and functionally different types of the nonclonal specific autoprecipitins to autological membranocellular components was revealed at recipients by methods of double immunodiffusion and immunoelectrophoresis. These autoprecipitins such as: early, activated and tardly, synthesized under effect of alien agent--may be useful as diagnostic and prognostic indicators of bioincompatibility and its clinical consequences at the earliest period after cardiac operations using trans- and implants.
The generation in plasma the anodic autoprecipitating protein, or autoprecipitin (AAP), as the bioincompatibility reaction under influence of a number of alien components during cardiac operations with using cardiopulmonary bypass, heterotopic vascular autotransplants and artificial valve implants was studied in 257 patients. Selective formation of the AAPs in result of their inductors effect was discovered by the methods of immunodiffusion and immunoelectrophoresis in blood of patients within operation periods and early postoperation hours. Repeated and reiterated generation of the AAPs due to bioincompatibility in patients with coronarosclerosis and endocarditis, undergoing prosthetic cardiac operations may favour developing reaction of immediate hypersensitivity with complications and has prognostic value.
The peculiarities of an inductive phase in an immune response to xenobiotics were studied before and during cardiopulmonary bypass at surgical implantations on heart. It has been determined that an early xenogenic induction of the forming the humoral innate immune receptors-namely the anodic (anionic) autoprecipitins-to the surface component of the cellular membrane, depended on the xenobiotic properties, as well as on the initial immunopathogenic: immunocomplex and immuno adsorptive-processes in the cardiovascurlar system. The intensity of this reaction correlated with both subsequent acute disorders in the blood circulation and reducing the resistance to exogeneous (inter-current) infection in the patients with atherosclerosis and endocardits.