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An attempt of the assessment of T-cells function in patients with gastric or duodenal ulcer has been undertaken. The studies involved 60 patients with gastric or duodenal ulcers and 47 individuals of the control group. Lymphocyte reactivity to different concentrations of concanavalin A and phytohemagglutinin has been assessed with leukocyte migration inhibition test. Lymphocyte T function has been examined also in patients with gastric or duodenal ulcers in reference to the theophylline-dependent and theophylline-sensitive subpopulation of T-cells. Leukocyte migration index values after phytohemagglutinin and concanavalin A did not differ significantly in patients with gastric or duodenal ulcers and theophylline-sensitive T-cells. Differences have been noted in the migration inhibition deficits. This phenomenon has been least frequent in case of phytohemagglutinin in the control group (5.8%) and most frequent in patients with gastric ulcer (62%). Percentage of patients responding to higher concanavalin A concentration (40 micrograms/ml) with leukocyte migration inhibition has been the highest in patients with duodenal ulcer. This index value has been significantly lower (p < 0.05) only in patients with duodenal ulcer and increased number of theophylline-dependent lymphocytes T. Increased reactivity of T-cells to higher concanavalin A concentration in patients with duodenal ulcer with theophylline-dependent T-cells in peripheral blood probably indicates increased the suppressor lymphocytes activity.

Eight strains of sonicated Helicobacter pylori (H. pylori) were pooled as group antigen to detect the serum IgG antibody to H. pylori in patients with various gastroduodenal diseases and subjects at health check-up. The enzyme-linked immunosorbent assay method used had a sensitivity of 94%, a specificity of 87%, and a positive predictive value of 96%. The prevalence of serum IgG antibody to H. pylori was 19.0% in patients with Type A gastritis, 76.0% in patients with Type B gastritis, 91.5% in duodenal ulcer, and 92.9% in gastric ulcer. Moreover, the prevalence of serum IgG antibody to H. Pylori in newborns was 53% (probably acquired from mother), in children below 10 years old was 25%. The detection rate gradually rose to 70% with the increase of age, but decreased to 40% in those over 70 years of age.

The paper presents the analysis of examination and treatment data on 80 patients with long-healing gastric ulcer (12 weeks or longer), of contributing factors (sex, age, ulcer site and size, smoking, alcohol abuse, associated diseases), of changes in the antral and fundal gastric mucosa as well as in immune system, of conservative treatment results.

The effect of cholinolytics in combination with antacids, belomet, solcoseryl and enterodes on humoral immunity was evaluated in 134 ulcer patients. Elevated levels of salivary secretory IgA and blood IgG, IgA, lowered blood IgD exhibited in ulcer exacerbation. Antibodies to oligopeptides isolated from the serum of ulcer patients occurred in 80.6% of the patients. Whatever the drug used, after-treatment levels of secretory salivary IgA and blood IgA dropped, blood IgD rose. Belomet treatment gave rise to higher titres of antibodies to oligopeptides. Solcoseryl, cholinolytics with antacids led to increased blood levels of IgM and reduced levels of IgG. Recovery of the indices occurred in patients on enterodes. It is stated that changes in immunity depend both on ulcer healing and direct action of antiulcer drugs.

The findings at examination of 42 patients with gastric ulcer exhibiting frequent relapses were comparatively assessed in relation to humoral and cellular immunity, presence of mucous microflora and Campylobacter pyloridis at the ulcer site. It is shown that in the presence of Campylobacter pyloridis specific differences in the immune response were not recorded. The same results were true for mucous microflora.

Serum levels of secretory IgA were measured in 66 patients with aggravation of peptic ulcer versus 52 healthy subjects. IgA concentrations in the patients were found elevated, the rise being dependent on the ulcer site, standing and severity of course. Treatment-induced decline of the ulcer exacerbation was accompanied by a fall in IgA levels. It is hold that serum IgA can serve a marker of gastroduodenal ulcer exacerbation.

This paper reports the variation of peripheral T lymphocyte subsets in patients before and after operation under epidural anesthesia using OKT monoclonal antibodies (McAb). The results show that TH and TS after anesthesia and during surgery were lower than before anesthesia and in normal controls (P less than 0.05). The ratio of TH/TS after anesthesia and during operation were lower than before anesthesia (P less than 0.05), but there was no significant difference with normal controls (P greater than 0.05). Therefore, we consider that the decrease in TH cells was one of the reasons for decrease in patient immune function during anesthesia and surgery. Five to seven days after surgery, patient TH cell levels tended to normalize. This showed that this abnormality was transient and reversible. The results also indicated that emphasising prevention of infection in post-operational case, should be done during the first 5-7 days after surgery.

The spontaneous and induced production of monokine++-interleukin-1 (IL-1) by the peripheral blood monocytes under the influence of autotransfusions of hemosorbent-treated blood (AHTB) was studied in 22 patients with an unfavorable course of ulcer disease. The spontaneous production of IL-1 was found to grow successively after a course of AHTB in patients with ulcer disease with terms of cicatrization more than 2 weeks. In patients with slow cicatrization of ulcers the IL-1 production did not change.

The authors relate the data on humoral and cellular immunity in patients with long nonhealing gastric ulcers. It has been shown that if these patients have Campylobacter pylori, there are no specific differences in the response of the immune system. During cicatrization, positive changes can be seen, namely an increase of T helper and decrease of suppressor activity of T lymphocytes together with a decline of the content of IgA and IgG.

The beneficial effect of low-energy laser radiation on the natural course of disease, morphologic characteristics of gastric mucosa and key elements of systemic hemostasis was observed in 98 patients with precancer of the stomach (gastric ulcer and chronic atrophic-hyperplastic gastritis with epithelial dysplasia). A correlation between clinical response and normalization of morphologic appearance and homeostasis makes the above-mentioned treatment modality promising and worth further development.

The disorders in immunologic reactivity in acute gastrointestinal bleeding were studied in dynamics in 160 patients. Pronouncement of disorders in the T-system of immunity, activation of the reactions of specific sensibilization and autoallergic phenomena depend on severity of the blood loss. In ulcer location in the duodenum, the performance of an organ-preserving operation with vagotomy and elimination of the ulcer which is a source of antigen stimulation is preferable.

Gastrin- and somatostatin-immunoreactive cells in biopsies taken from the prepyloric portion of the antrum from 15 patients with duodenal ulcer, 16 patients with gastric ulcer, and a control group of 19 patients without histopathological alterations of the antral mucosa were studied using peroxidase anti-peroxidase and immunogold-silver staining methods in combination with morphometry. Numerical densities and sizes (immunoreactive areas) of the cells demonstrated were measured and compared between all three groups. Gastrin- and somatostatin-immunoreactive cells were located most frequently in the lower midzone of the gastric crypts. None of the parameters measured showed a correlation with age or sex. The group with duodenal ulcer tended to exhibit gastrin- and somatostatin-cell-hyperplasia whereas the size of both cell types remained unchanged. In comparison with the control group, the numerical density of gastrin-immunoreactive cells was significantly increased in gastric ulcer patients, whereas the numerical density of somatostatin-immunoreactive cells was decreased in this group. Immunoreactive areas of both cell types were significantly increased in patients with gastric ulcer.

Immunohistochemical staining was performed by the ABC method using antibody against S100 protein for the identification of dendritic cells (DC) in the gastric mucosa, including gastric ulcer (n = 19), chronic atrophic gastritis (n = 28), gastric carcinoma (n = 65), fetal gastric mucosa (n = 11) and normal controls (n = 15). Lower numbers of DC may indicate an antigen-deficient state in normal and fetal gastric mucosa, while the diverse densities of DC in pathological conditions may reflect the differences in antigenic quantities and qualities and in individual immune responses. The close association between DC and lymphocytes in situ suggest an antigen-presenting capacity of DC controlling the activation of lymphocytes.

Autotransfusion of sorbent blood was used in the complex treatment of 62 patients with gastric ulcer characterized by an unfavourable course. The course of autotransfusions favoured scarring of the gastric ulcer in 70.9% of patients, normalized the helper/suppressor relations of regulatory subpopulations of T-lymphocytes, normalized the indices of natural killer activity.

It has been postulated that herpes simplex virus type 1 may be a causative factor of duodenal ulcer. Serum antibody titres to herpes simplex virus type 1 in duodenal and gastric ulcer patients were compared with race-, sex- and age-matched controls. No differences in antibody titres could be demonstrated between duodenal ulcer and gastric ulcer patients and their respective controls, between gastric ulcer and duodenal ulcer patients or between acute and convalescent sera in either gastric or duodenal ulcer. Although Chinese are more susceptible to ulcer disease than Malays and Indians, antibody titres were comparable between subjects of different races. The results of this study do not support a causal role for herpes simplex virus in peptic ulcer disease.

The interaction of extravascular erythrocytes with lymphocytes, macrophages, polymorphonuclear leucocytes and fibroblast like cells in human gastric ulcer and in post-ulcer scar was studied by means of electron microscopy and cytochemical methods. It was shown that such interaction results in autologous rosette formation. There were also autorosette in the capillaries where autorosette forming cells were endothelial cells and lymphocytes. Many kinds of autorosette forming cells were connected with some peculiarities of ulcer process in the stomach.

Chronic ulcer edges and pylorus of 6 stomachs removed because of ulcer and 10 biopsies of the stomach pylorus from patients with duodenal ulcer were studied. T-helpers and T-suppressors (cytotoxic) were revealed by the indirect three-step immunoperoxidase method with the use of monoclonal antibodies OKT-4 and OKT-8, respectively. T-suppressors (cytotoxic) prevailed among interepithelial gastric lymphocytes in both normal conditions and ulcer. T-helpers dominated in the mucosa tunica propria. They ensure immunoglobulin synthesis after the antigen stimulation and favour the activation of other immunocompetent cells. Both cell types are found in the lymphoid nodules and their centres. Helicobacter pylori seems to take part in the activation of all components of local immune system of the stomach.

Factors of unspecific defense and immunological state were evaluated in 520 patients with ulcer disease. It was established that these patients revealed disorders of excessive release into the internal medium of the body of food antigens, in particular partially split proteins. The latter induce the immune response. An increase occurs of the production of secretion of IgA in the secretions, IgG in the blood, the T-system of immunity is inhibited, the complement consumption is increased. On the basis of obtained data the author proposes a hypothesis of ulcer formations, the essence of which is that food antigens entering the body causes sensibilization of the organism with a development of an immune-complex reaction of the Arthus phenomenon type in the gastroduodenal zone.

Time course of cellular and humoral immunity parameters in the course of ulcer defect healing was followed up in 47 patients with gastric ulcers. Immune status changes in these patient population were found dependent on the stage of ulcer defect healing, being the most manifest at the beginning of ulcer cicatrization and showing signs of immune system activation. A possible relationship between changes in the immunity status and reparative processes at the site of ulcer defect is discussed.

In ulcerative gastroduodenal bleeding, the high blood coagulability is preserved, and prescription of the hemostatic preparations of general action can lead in elderly and senile patients to the thromboembolic complications. The operative treatment should be performed, depending on immunoreactivity of an organism: at the peak of bleedings--at the first 24 h, in stopped bleeding--at the period of immunologic compensation.

Quantitative parameters of natural killer cells (morphologically defined as large granule-containing lymphocytes/LGL/) were monitored. Gastric cancer patients revealed a decrease in LGL level and absolute count. In patients with stage III tumor, LGL and A-LGL levels were half those in controls. The lowest LGL level was observed in stage IV cancer, particularly, following chemotherapy. LGL level is easy to measure. The test is instrumental in assessing non-specific reactivity of the body.

The mucous membrane of the fundal and pyloric parts of 26 stomachs resected for peptic ulcer was examined. The edges and bottoms of the ulcers were studied. The cells secreting immunoglobulin (Ig) of A, M, and G classes were detected by indirect immunoperoxidase method. The proportions (in per cent) of lymphocytes, plasma cells and Ig-containing cells were determined stereometrically. The intact mucous membrane of the fundal part contains 2.17% lymphocytes and 7.5% plasma cells. The portions of IgA-, IgM- and IgG-secreting cells were 0.99%, 0.39%, and 0.13%, respectively. In atrophic antral gastritis, plasma cell infiltration of the mucosa increases 2 1/2-fold, the number of lymphocytes remaining unchanged. The number of immunocytes secreting IgA and IgM increases almost 4-fold and that of secreting IgG over 13-fold. In the ulcer edges, plasma cell infiltration of the stroma reached 10.83% whereas the number of Ig-secreting cells was the same as in the pyloric part in the same patients. The activation of the secretory immune system in peptic ulcer is due to significant antigenic stimulation. The most predominant are the IgA-containing cells. A marked increase of IgG synthesis indicates the defect of autoregulation of the local immunity and may be of pathogenetic importance for the development of autoaggression which would facilitate progression and chronicity of the ulcer.

The reaction of changes in leukocyte adherence was compared in 79 cases of stomach cancer, 44 cases of other gastric diseases and healthy subjects. Tumor antigens were shown to inhibit the adherence of lymphocytes and granulocytes in 61 out of 79 cancer patients (77,2%); adherence inhibition was more frequently observed in patients with stage I-III tumors than in cases of stage IV tumors. The removal of the antigens of normal mucosa from tumor tissue extracts did not affect the frequency of positive reactions in cancer patients significantly. However, the frequency dropped from 22-34 to 2.3-13.6% in the group of non-tumor patients.

The content of T- and B-lymphocytes was studied in the blood of 72 patients with gastric ulcer and carcinoma. The amount of complete T- and B-lymphocytes and incomplete B-lymphocytes was found to dramatically decrease in patients with peptic ulcer and gastric carcinoma with distant metastases. The authors believe that the data obtained could be used in addition to others when choosing the specific treatment of patients with gastric carcinoma in the postoperative period.

The capacity to generate cytotoxic cells in mixed cell culture was studied on the regional lymph node cells (LNC) from patients with gastric carcinoma, in comparison with that of the similar lymph node cells from patients with benign lesions. Generation of cytotoxic cells in LNC from cancer patients was significantly depressed, as compared to either that in peripheral blood mononuclear cells (PBM) from the same patient or that in LNC from patients with benign lesions, whereas no significant difference between those in PBM and LNC was observed in patients with benign lesions. The addition of LNC from cancer patients to autologous PBM did not result in suppression of the cytotoxic response. There was no significant difference between the ability to produce interleukin 2 (IL 2) in LNC from patients with carcinoma and benign lesions. However, OKT11+ and OKT3+ cells in LNC from cancer patients were significantly decreased without any alteration of the OKT4/OKT8 ratio, as compared to that from patients with benign lesions. In contrast, B-1+ cells were significantly increased. These results indicated that the relative inactivity of the generation of cytotoxic effector T cells in LNC from patients with gastric carcinoma might be partially related to the reduction of T cell population in the regional lymph nodes.

The state of cell immunity was studied in 30 patients with precancerous processes (polyps and ulcers) and 30 patients with malignant tumors of the stomach. It was established that such indices of cell immunity as the amount of circulating T and B lymphocytes could be used for the assessment of the degree of "higher risk" of the appearance of malignization of the stomach, for the choice of the extensiveness of surgery in gastric cancer and for prognosis of the outcome.

Effects of surgery on generation of cell-mediated cytotoxicity in mixed cell cultures were studied in patients with various carcinomas, and the results were compared to those in patients with benign lesion. Peripheral mononuclear cells were cultured with the B-lymphoblastoid cell Raji in a mixed culture and the induced cytotoxicity was measured by 51Cr release assay. In 15 patients with various carcinomas, the capacity of peripheral mononuclear cells to generate cytotoxic cells was significantly depressed 1, 3 and 6 days after surgery, as compared to findings before surgery. Preoperative levels were reverted to by the 8th postoperative day. In 8 patients with benign lesion, significant decreases in cytotoxic cell activity were observed 3 and 6 days after operation and, on the 8th postoperative day, there was a significant increase in the generated cytotoxicity, as compared to the preoperative activity. Thus, postoperative depression of the generation of cell-mediated cytotoxicity may affect the host-tumor relationship in patients with carcinoma.

To clarify the significance of immunoreactive carcinoembryonic antigen in gastric juice (gastric CEA) from gastric cancer patients, we studied the gastric CEA in comparison with cancer progress, histologic types of tumors, staining for CEA and extent of intestinal metaplasia. The gastric CEA levels from patients with other gastric diseases, i.e., gastric ulcer, duodenal ulcer and chronic gastritis were also investigated. The mean gastric CEA level from gastric cancer patients was significantly higher than from gastric or duodenal ulcer patients, but there was no significant difference between levels in patients with gastric cancer and in those with chronic gastritis. The gastric CEA levels from cancer patients increased with progression of the cancer. The differentiated carcinomas showed significantly higher gastric CEA levels than the poorly differentiated carcinomas. Positive CEA tumors showed significantly higher gastric CEA levels than did the negative CEA tumors. The tumors with diffuse intestinal metaplasia revealed high gastric CEA levels. Determination of gastric CEA levels is considered to be useful for screening of gastric cancer.

The problem of the pathogenetic significance of IgE-mediated inflammatory processes in simple unspecific gastritis was studied in mucosal biopsies of 396 cases with unequivocal histological classification. The results demonstrate that only in acute and erosive gastritis high IgE cell counts are found, thus, indicating a pathogenetic significance. Furthermore the statistical evaluation showed a parallel age distribution of IgE containing cells in the four biopsy groups. Mucosal biopsies from patients 40-65 years of age exhibited higher IgE cell counts than younger and older persons. These results suggest that there is a higher IgE-reactivity in the middle age.

Praomys (Mastomys) natalensis were sensitised by peritoneal injection of ovalbumin mixed with aluminium hydroxide. The animals developed homocytotoropic IgE and IgG 1 antibodies. When presensitised animals were challenged with ovalbumin in the gastric wall, a gastric ulcer appeared. This ulceration, induced by an immunological release of histamine, could be inhibited by the administration of disodium cromoglycate. The present model is useful for producing a gastric ulcer in a determined site. It supports the theory of a possible allergic component in the pathogenesis of the human disease.