Manifestation of functional capabilities of an any cell in the body is largely determined by intracellular metabolism, changing his parameters in dependence on the specifity of the pathological process. Indices with high informativeness and relevance for the recording features of intracellular processes in most of exogenous and endogenous effects on the cells are activity of enzymes in them and their lipid profile.

Сведения об авторахЖила Иван Евгеньевич -пульмонолог клиники госпитальной терапии

Внутриклеточный метаболизм лимфоцитов регулируется широким набором ферментов, и это обеспечивает возможность выполнения клетками многообразных специфических функций. Проявление ими функциональных возможностей в полном объеме лимфоцитов возможно лишь при соответствующем состоянии внутриклеточного обмена. При формировании иммунного ответа изменяется активность внутриклеточных ферментов лимфоцитов, а также липидный спектр их структурных элементов – параметров, определяющих функциональные возможности клеток. Результаты изучения этих изменений позволяют использовать указанные показатели для оценки течения иммунопатологического процесса и в целом состояния иммунной системы человека. На сегодняшний день изучена активность различных ферментов и липидный спектр не только суммарной популяции лимфоцитов периферической крови, но и отдельно в Т- и В-лимфоцитах. Установлено, что эти клеточные популяции различаются по ряду ферментных и липидных параметров. Активность ферментов в лимфоцитах является весьма чувствительным показателем их состояния, они используются для дифференциальной диагностики и разработки прогноза течения заболеваний.

The article presents results of a survey of 63 patients with virus infections (flu and chicken pox). The assessment of character and intensity of metabolic processes in lymphocytes of patients with virus infections by the changes of intracellular enzymes activity showed that at the peak of disease the intensification of glycolysis reactions is noted, together with substantial increase of functional load on cells. There is a considerable decrease in intensity of reactions at the initial stage of a tricarbonic acid cycle that has to reduce power efficiency of the cycle, as well as intensive receipt of metabolites to supply the tricarbonic acid cycle with substrata from amino acid exchange, providing the raised transport of amino acids in lymphocytes. Application of preparations of amber acid or its salts gives additional substrate saturation of tricarbonic acid cycle, increasing energy efficiency of the cycle and functionality of lymphocytes.

Flu of the person – the acute highly contagious infectious disease of respiratory ways caused by viruses of flu. In the general structure of infectious diseases it is the share of a share of flu and other sharp respiratory virus infections to 92%. Patogenez of flu grows out of interaction of a set of factors of a macroorganism with virus proteins. Receptors of cages to which viruses of flu of the person have preference, экспрессируются on epitelialny cages throughout respiratory ways – in a mucous membrane of a nose, okolonosovy bosoms, a drink, a trachea, bronchial tubes, bronchioles and alveoluses, but their quantity variously on different sites. In the period of a pandemic a major factor of risk of development of influenzal virus pneumonia is lack of specific protection of lungs antibodies against related strains of a virus. An important role in патогенезе flu is played by immune system. It is established that flu viruses in the course of the evolution got mechanisms which are capable to limit and suppress immunity of the owner. Manifestation in full functionality of immunocompetent cages in the course of recognition of an anti-gene and formation of the immune answer happens only at the corresponding condition of their intracellular metabolism which is provided with a certain level of activity of intracellular enzymes.

Review of the literature is devoted to the study of the pathogenesis of SARS and influenza, the severity of clinical symptoms which are largely determined by the degree of activity of immune reactions host. Severe and complicated forms of influenza and SARS are developing against a background of reducing the functional activity of natural killer cells, phagocytic and metabolic activity of peripheral blood neutrophils, the presence of interferon deficiency.. Activation of lipid peroxidation, which leads to a loss of barrier function of cell membranes a major cause of the generalization of a viral infection and cytokine storm is the trigger for the development of systemic inflammatory response syndrome with the risk of formation of multiple organ dysfunction syndrome.

The estimation of temperament and intensity of metabolic processes in lymphocytes at patients with varying severity of upper respiratory tract infection was determined according to changes of desmoenzymes activity. It showed that the different reacting intensification of pentose phosphate cycle and glycolysis was registered at the height of disease. Also at substantial increase of functional load on cells there is an appreciable reacting intensity depression of initial stage of tricarboxylic acids cycle that should reduce power efficiency of cycle. And intensive admission of metabolites for supply of tricarboxylic acids cycle by substrates of amino-acid exchange will provide the raised transport of amino acids to lymphocytes.

The flu and sharp respiratory virus infections are the most widespread virus infections of the person and represent a serious mediko-social problem. By estimations the CART flues diseases annually in the world are ill to 100 million persons. Relative density of a flu and sharp respiratory virus infections among all infectious diseases in Russia makes 90 %. Not an exception it and for Krasnoyarsk region where share sharp respiratory virus infections and a flu in the general structure of infectious disease makes 92%. It is known that development, weight of any infectious disease and its outcome depends on a condition of immune system, its answer to the taken root microorganism, as a result of development of this answer there is cognizance the activator, its inactivation and eliminaris from an organism. In patogenesis and clinical current sharp respiratory virus infections also the essential role is played by infringements of the immunological mechanism of protection of a human body. According to a number of authors, the changes occurring in immune system at sharp respiratory virus infections, are regarded as adaptable reaction of an organism to influence of viruses.

Aim. To assess the nature and intensity of metabolic processes in lymphocytes of patients with influenza according to the activity of intracellular enzymes in comparison to the severity of the disease. Methods. Determined were the enzymatic parameters of lymphocytes of 45 patients aged 18 to 42 years with a diagnosis of «influenza». Two groups of patients were formed: with moderate (24 patients) and severe (21 patients) course of the disease. Used as controls were the values the activity of intracellular enzymes of lymphocytes of 37 practically healthy individuals of comparable age. Results. In patients with a moderately severe course of the influenza compared with the controls noted was a significant increase in activity of glucose-6-phosphate dehydrogenase (3.17±0.53 and 2.74±0.31 mkE/10 000 cells, p 0.05) and glycerol-3-phosphate dehydrogenase (57.33±±5.65 and 0.84±0.16 mkE/10 000 cells respectively, p 0.001). The activity of lactate dehydrogenase was lower in patients than in controls (0.40±0.08 and 0.84±0.08 mkE/10 000 cells respectively, p 0.001). Indicators of nicotinamide adenine dinucleotide and nicotinamide adenine dinucleotide phosphate dependant isocitrate dehydrogenases in lymphocytes of patients were lower than in the controls: the first indicator in the patients was 0.17±0.02 mkE/10 000 cells, in controls - 1.95±0.25 mkE/10 000 cells (p 0.001), and for the second indicator these values were respectively 0.09±0.01 and 31.02±±2.20 mkE/10 000 cells (p 0.001). In patients with a moderately severe course of influenza the activity of nicotinamide adenine dinucleotide and nicotinamide adenine dinucleotide phosphate dependant glutamate dehydrogenases was significantly higher compared with healthy individuals: 63.67±5.32 and 0.34±0.06 mkE/10 000 cells, 1.45±0.18 and 0.11±0.02 mkE/10 000 cells respectively (p 0.001). The activity of nicotinamide adenine dinucleotide dependant malate dehydrogenase in patients was equal to 86.46±12.30 mkE/10 000 cells (in the control group 84.16±13.70 mkE/10 000 cells), and the activity of nicotinamide adenine dinucleotide phosphate dependant malate dehydrogenase was equal to 1.34±±0.25 mkE/10 000 cells (in the control group 0.33±0.07 mkE/10 000 cells, p 0.001). The activity of glutathione reductase was also higher in patients with the moderately severe course of the influenza: 5.86±0.25 mkE/10 000 cells, while the value in healthy individuals was 1.28±0.30 mkE/10 000 cells (p 0.001). In the group of patients with a severe course of influenza the activity of almost all (except for glucose-6-phosphate dehydrogenase) enzymes was higher than during the moderately severe course of disease. Conclusion. At the peak of the diseases noted were opposite changes in the activity of reactions of the pentose phosphate cycle and glycolysis. With a high functional load on the cells there is a significant reduction in the intensity of the reactions of the initial phase of the tricarboxylic acid cycle, which reduces the energy efficiency of the cycle, while the intense influx of metabolites to supply the tricarboxylic acid cycle with substrates of the amino acid metabolism provides enhanced transport of amino acids into the lymphocytes.

The review of the literature is devoted to the study of the immunopathogenesis of ARVI and influenza, clinical symptoms are largely determined by the degree of activity of macroorganism immune responses. Severe and complicated forms of influenza and ARVI are developed on the base of reducing the functional activity of natural killer cells, phagocytic and metabolic activity of peripheral blood neutrophils, the presence of interferon deficit. The activation of lipid peroxidation, which leads to the loss of barrier functions of cell membranes a major cause of generalization of viral infection and cytokine storm is the releaser for the development of systemic inflammatory response syndrome with the risk of the formation of multiorgan failure

In article results of the analysis of stories of illnesses with the diagnosis a flu of type And, caused by virus H1N1swin are resulted. The greatest susceptibility to disease is registered among persons of young age of 16-29 years. At flu H1N1svin along with an intoxication, a leading symptom is dry, приступообразный cough. The heavy current of disease with development of complications is registered in age group of 24-44 years. Risk group явиляются pregnant women and patients with a metabolic syndrome.