Method for predicting the efficiency of treating patients with schizophrenia with atypical neuroleptic quetiapin (seroquel)

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: before prescribing quetiapin, it is necessary to conduct immunological studying in patients and at the content of natural killers (CD16+)0.15x109/l and more, IgA concentration in blood serum being 2.50 g/l and less one should predict positive dynamics of therapy with atypical neuroleptic quetiapin (seroquel). The innovation enables to elaborate prognostic criteria for therapeutic efficiency in schizophrenia-suffering patients with atypical neuroleptic quetiapin (seroquel) and carry out rehabilitation of pharmacological measures purposefully.

EFFECT: higher accuracy and efficiency of prediction.

3 ex, 3 tbl

 

The invention relates to medicine, namely to psychiatry, and can be used to predict the effectiveness of treatment of patients with schizophrenia.

Pharmacotherapy of schizophrenia associated difficulties. Antipsychotics, including atypical, have common disadvantages: limited spectrum, the frequency of occurrence of drug resistance, the severity of side effects, the actual absence of reasonable approaches to differentiated assignment of specific antipsychotic drugs. In this regard, the importance is currently gaining clarification and individualization testimony to the use of existing antipsychotics, development of criteria for prediction of efficiency of their application [1, 2].

There is a method of predicting the effectiveness of treatment of schizophrenia in which the positive effect of therapy with quetiapine (seroquel) is expected in patients with schizophrenia phenomena acute sensual delirium, dramatizations, affective symptoms as anxiety, depression, confusion and even mania; the presence of clinical anxiety-phobic and negative symptoms [3, 4].

The downside of it is the lack of specific criteria for the appointment of the drug.

The task of the invention is to develop criteria for predicting the effectiveness of treatment, the Oia patients with schizophrenia atypical neuroleptic quetiapine (seroquel).

This object is achieved by the determination of the immunological parameters of the patient before administering the drug, and when the content of natural killer cells (CD16+) to 0.15×109/L or more, the concentration of immunoglobulin A (IgA) in serum 2.50 g/l and less predict clinical efficacy of the treatment of atypical neuroleptic quetiapine (seroquel).

The proposed criteria (content of natural killer cells and the concentration of IgA in serum predict the effectiveness of treatment of patients with schizophrenia were obtained from clinical and immunological examination of 20 patients with schizophrenia (code ICD-10 F20.5), treated in the Department endogenous disorders clinics Institute of mental health in conjunction WITH Russian. Group survey was 14 women, 6 men, aged from 26 to 58 years (average age amounted to 43.5±9,75 years)with disease duration more than 5 years (the average duration of the disease 17,0±7,42 years). The dynamics of improvement during treatment was assessed using the Scale for the assessment of the effectiveness of therapy" (CGI podskalo the overall degree of improvement during therapy CGI-I). Dynamics of psychopathological symptoms were assessed using psychometric scales PANSS.

Quetiapine (quetiapine) was administered pre-emption is about in addition to used by patients neuroleptic drugs. The last dose was reduced to minimum before assigning seroquele. In addition, as a concomitant therapy was used correctors (trihexyphenidyl up to 6 mg/day), antidepressants. Quetiapine (quetiapine) was applied twice a day (morning, evening), regardless of the meal. The daily dose was increased during the first four days: day 1 - 50 mg; day 2, 100 mg; day 3 - 200 mg; 4-th day - 300 mg from the fifth day dose of quetiapine were selected individually and ranged from 200 to 400 mg/day. Duration of treatment was six weeks.

In the study patients according to the Scale of assessment of the effectiveness of therapy" CGI were divided into 2 groups: 1st group (13 patients), with a significant improvement in the mental state (the group included gradation with a substantial and significant improvement); 2nd group (7 patients) - with a slight improvement in mental state.

Before the study the mental state of the patients was presented manifestations of negative symptoms with symptoms apato-abolicao syndrome (8 people); paranoid symptoms with affective intensity and phenomena of acute sensual delirium: tempations symptoms (affective symptoms in the form of anxiety, depression, confusion) was diagnosed in 7 patients and paranoid - in 2 patients; "Defoe is the information structure of personality" in 1 patient, and hypochondriacal symptoms - 2 patients.

When comparing psychopathological symptoms (PANSS) between groups before treatment with quetiapine (seroquel) the total score of positive disorders were comparable, the sum of the scores of negative disorders was slightly higher in group 2, but these differences did not reach the level of confidence (Table 1).

Table 1

Characteristic psychopathological symptoms on the PANSS (podskalo positive and negative disorder)
IndicatorsGroup inspection
Group 1 (significant improvement) M±mGroup 2 (slight improvement) M±mThe significance of differences P
PANSS Positive12,67±0,9612,50±1,610,93
PANSS Negative23,67±1,6928,17±2,340,14

Dynamics of changes in the severity of psychopathological symptoms (PANSS) for therapy for the first group the following: decreased severity of delusions, suspiciousness and ideas of persecution, the total score of positive symptoms; become less obvious opastnosti affect emotio the social withdrawal), the difficulty in communication, passive apathetic social withdrawal, violations of abstract thinking; disturbances of spontaneity and fluency, stereotypical thinking, decreased total score of negative symptoms; decreased levels of anxiety and physical tension, decreased symptoms of depression, motor retardation, unusual contents of thoughts, of being noncritical to himself, willful violations, active social astranet total score obschepsihopatologicheskogo symptoms. In the second group clinical characteristics of mental changes less bright: decreased suspiciousness, ideas of persecution, became less obvious mannerisms, decreased total score obschepsihopatologicheskogo symptoms.

On the sixth week, the difference between groups on the level of achieved improvement scale (CGI-I) was explicit: positive therapeutic changes have largely been characteristic of the first group of patients. At the end of the study, differences between groups on a scale of PANSS were different than at the beginning: in the second group was dominated by flattened affect, emotional withdrawal, passive apathetic social withdrawal, disorders of spontaneity and flow of communication, the total score of negative symptoms remained almost unchanged (Table 2).

Table 2

Dynamics of psychopathological symptoms on the PANSS (podskalo positive and negative disorders) (M±m)
IndicatorsGroup 1 (significant improvement), M±mGroup 2 (slight improvement), M±m
1 point2 pointThe significance of differences P1 point2 pointThe significance of differences P
PANSS Positive12,67±0,969,67±0,62<0,0512,5±1,6110,17±1,01>0,05
PANSS Negative23,67±1,6916,92±0,84<0,0528,17±2,3422,17±2,61>0,05

To determine the immune status used the complex immunological tests: defining indicators of cellular immunity (the number of immunocompetent cells with different phenotypes surface receptors), indicators of humoral immunity (the concentration of serum immunoglobulins M, G, a, and the level of circulating immune complexes), phagocytic activity of leukocytes.

The comparative characteristic of the state of the immune system in two surveys the data groups before therapy with quetiapine (seroquel) has the following differences in immunological parameters (Table 3): reliable compared with the second group the decrease of band neutrophils, the level of circulating immune complexes and IgA concentration, increasing the number of natural killer cells; (CD16+).

The most pronounced features of the immune status in the first group of patients (with significant improvements in mental state) compared with the second group (slight improvement) are higher values for the number of natural killer cells; (CD16+) and lower concentrations of IgA. The obtained data allow to consider these immunological parameters as criteria for the effectiveness of treatment of patients with schizophrenia atypical neuroleptic quetiapine (seroquel).

New in the present invention is the use of immunological criteria for an effective assignment of the preparation of quetiapine (seroquel), namely the percentage of natural killer cells (CD16+) 0,15×109/L and more (0,17-0.02) and the concentration of IgA in the serum of 2.50 g/l or less (2,14+0,35).

Significant new features demonstrated in the inventive combination the new properties that are not obvious to the expert and are not explicitly derived from the prior art in this field.

Table 3

Immunological characteristics of patients with schizophrenia before the appointment of the drug quetiapine ("quetiapine")
IndicatorsGroup inspection
Group 1 (significant improvement) M±mGroup 2 (slight improvement) M±mThe significance of differences P
Leukocytes abs5,97±0,504,78±0,11>0,05
Lymphocytes abs2,05±0,251,52±0,16>0,05
Lymphocytes %34,17±2,8531,83±3,30>0,05
Neutrophils fell. the poison. abs0,25±0,181,67±0,42<0,01
Neutrophils, segm. the poison. abs55,50±3,42of 60.50±2,68>0,05
Monocytes abs6,33±1,004,33±0,67>0,05
Eosinophils abs3,50±0,941,00±0,82>0,05
CD2+abs1,22±0,150,85±0,20>0,05
CD3+abs0,98±0,140,80±0,15>0,05
CD4+abs0,56±0,060,47±0,06>0,05
CD8+abs0,45±0,050,34±0,04>0,5
CD16+abs0,17±0,020,08±0,01<0,001
HLADR+abs0,56±0,110,45±0,07>0,05
CD20+abs0,22±0,040,15±0,02>0,05
CD95+abs0,43±0,060,31±0,05>0,05
IgM g/L1,41±0,181,82±0,28>0,05
IgG g/L14,29±1,8117,22±1,86>0,05
IgA g/L2,14±0,352,96±0,38<0,01
CEC used102,90±11,80182,10±38,40<0,05
FI %64,67±4,9359,67±6,56>0,05

Identical set of features in the studied literature is not found.

Proposed as a method of the invention can be widely used in clinical practice, as it allows you to take an individual approach to the drug and to increase the efficiency of treatment of schizophrenia in General.

Based on the foregoing, it should be proposed as an invention is a technical solution to the relevant criteria of "Novelty", And oprettelse level" and "Industrial applicability".

The method is as follows: in schizophrenic patients take blood, define values CD16+and IgA, and when the content of natural killer cells (CD16+) 0,15×109/L or more, the concentration of IgA in the serum of 2.50 g/l and less predict treatment as effective and prescribed quetiapine (quetiapine).

To illustrate, here are clinical examples.

Example 1. A patient With s, born in 1950, case history No. 1376.

In childhood the patient had a type of care from the mother's side. At preschool age, he was behind in psychophysiological development from his peers. The patient in childhood had German measles with high fever and other infections flowed easily. Since childhood lagged in psychophysiological development from his peers, did not like noisy games. At school from the age of 7 and studied well before high school. With 15 years suddenly became interested in metaphysics, which coincided with the period of lower school performance. At the age of 18-22 years abused alcohol, being a student of the TSU. In 1972, after graduation he married and worked as a lawyer in the Siberian physico-technical Institute. In the premorbid period was marked paranoid traits. After eight years of marriage began to think that his wife is overly jealous, what was the reason for divorce, and the patient in 1981 left the family. In the end the 1981 (32 years old) patients occurred manifestation endogenous process by Kandinsky syndrome-clérambault. He began to address the problem of "exploring artificial intelligence", day and night working on its improvement. According to the patient, in July 1982 "won five formula that fits all mathematics, and actively promoted its opening was attended by many authorities, scientific institutions. In that year, the patient noted a pronounced fatigue after work came home and laid down to rest, the usual household chores performed by force. In the morning, barely woke up. The Institute refused to perform their jobs, could not cope with the assigned cases. Was delivered in the Tomsk regional clinical psychiatric hospital and stationroad forcibly

In the inpatient treatment was achieved remission "In" asthenic type, remained incomplete criticality to the transferred state. From 1982 to 1998 (32-48 academic years) the patient has suffered two vivid psychotic episode (1987, 1997), in interictal periods he registered varying degrees of severity of psychopathic symptoms, preventing to adapt and productive to work in teams. By 1998, it became clearly stand out negative symptoms, qualified remission "In" geoeffective type, the patient was decorated group II disability psychiatric ITU. For the mentioned period of treatment which took sloppy. After unstable remission in 1999 (49 years), the patient deteriorated condition. The subsequent treatment was observed calm orderly behavior on the background of persistent delusional ideas, no longer relevant. Up to the year 2000 (50 years) it is possible to speak about a clear progression schizophrenic process. From 2000 to 2003, the patient is determined by the emotional-volitional defect, with inclusions of irrelevant positive disorders, the level of pathological symptoms unchanged. The patient selectively sociable, has a hobby, regularly takes treatment in the clinic. Prescription disorders is 21 years. Treatment is mainly performed out of a psychiatric hospital. From 1981 to 2004, the patient was six hospitalizations in the Tomsk regional clinical psychiatric hospital and Institute of mental health in conjunction WITH RMAN.

Were in clinics Institute PZ with 25.11.2003 on 05.01.2004 on the invitation. Mental status at the time of the survey was described by blunting of emotional responses, emotional withdrawal and fragility, weakness, fatigue, reduction of social and professional productivity, social exclusion, manifestations of slovenliness, the presence of rare single, anecdotal and irrelevant delusional the made the of, not determine the behavior of the patient. The diagnosis of Residual schizophrenia (F 20.5).

Somatic condition: conclusion of therapist - CHD, angina, FC II-III dysfunction irritability, frequent ventricular premature beats; chronic bronchitis, remission; chronic gastritis, remission. The opinion of a neurologist - the consequences of neuroinfections (tick-borne encephalitis, 1994, 1998) as moderately expressed hypertensive syndrome, residual micro-organic symptoms. Conclusion eye - chronic blepharitis, aggravation, phlebopaty of the retina.

Immunological examination: Revealed clinical signs of secondary immune deficiency (infectious syndrome), presence of chronic somatic pathology. In immune status, the decrease of the relative amount of T-helpers (CD4+) 28%(0,54·109/L) and the concentration of IgG - 5.0 g/l; other values were within normal limits (leukocytes 5,4·109/L; lymphocytes 1,94·109/L (36%); T-lymphocytes: CD2+- 1,38·109/L (71%); CD3+- 1,22·109/L (63%); T-killers-suppressor (CD8+) 0,49·109/L (25%); b-lymphocytes: aHLA-DR+- 0,35·109/L (18%); CD20+- 0,1·109/L (5%); CD16+- 0,18·109/L (9%); IgM - 1.18 g/l; IgA 1.52 g/l; the level of circulating immune complexes 138 used; phagocytic Akti is the ability of leukocytes - 60%). Immunological parameters at the beginning of therapy seroquel correspond claimed; (CD16+- 0,18·109/L; IgA 1.52 g/l).

Ongoing therapy: quetiapine (quetiapine) 300 mg/day for 4 weeks, 5-week - 200 mg/day, 6-week 100 mg/day.

Mental status at the peak of the efficacy of quetiapine (seroquel) was characterized by a decrease dullness while maintaining the fatigue from stress, subjective improvement in overall health, increased social activity, limited to a narrow circle of close friends, some expansion in emotional resonance, greater openness in communication. The patient began to monitor their appearance. The mental state of the patient qualifies as cimpatichnoe. Dynamics of changes in the severity of psychopathological symptoms (PANSS) for therapy is characterized by a decrease in the total score of negative symptoms from 39 to 21; the overall score is reduced from 105 to 56. The patient on the background of the 6-week therapy atypical antipsychotic with seroquel (quetiapine) on the Scale assessing the effectiveness of therapy" CGI show significant improvement in mental state.

Example 2. Sick And Ko, born in 1977, case history No. 1214.

Heredity burdened by alcoholism of the father. Birth of the patient proceeded later period and was accompanied by entanglement of the umbilical cords is. In the growth and development of peers insisted differed psihologicheskie character traits. The family felt "useless" because of the frequent quarrels between the parents. According to the patient, with 11 years has periodically undergone auditory pseudohallucinations. To 15 years have increased sensitivity, vulnerability, isolation and maloobespechennost, was dissatisfied with their appearance. In 1993 (16 years) occurred debut paranoid schizophrenia: a sharply decreased mood, lost 15 kg, refused to eat, aroused themselves vomit after eating, experienced auditory pseudohallucinations was difficult to contact. From 1993 to 1998, the patient was noted four distinct schizophrenic attack, twice she tried to commit suicide (1993, 1998). In interictal periods, there were not only the improvement of the mental state with rehabilitation, but also the desire and ability of the patient to continue their education to get a profession. Since 1998 (21 years) became a prominent negative symptoms, the patient decorated group II disability mental illness. Between 1998 and 2001 is characterized by increasing activity and continuity of the course of the disorder with predominantly hallucinatory-paranoid symptoms. In 2001 (24 years) within six months took place remission "With" paranoid is the type. In 2002 the newly intensified procedural hallucinatory-paranoid symptoms. After treatment, her condition improved so much that he began to do all the sewing. Home occur regularly conflicts with her mother, which was one of the causes of treatment in the hospital in early 2003. Status at admission were consistent with remission "With" paranoid type. After the correction of pharmacotherapy within a week the patient continued treatment on an outpatient basis. Since mid-2003 the patient prevails lethargy, fatigue, lack of desire within the emotional-volitional defect, periodic sketchy and outdated pseudohallucinations, bouts of overeating. Prescription disorder is 10 years. Treatment is mainly performed out of a psychiatric hospital. From 1993 to 2004, the patient was 12 hospitalizations in the Tomsk regional clinical psychiatric hospital and Institute of mental health in conjunction WITH RMAN.

The patient was in the clinics of the Institute PZ RAMS Siberian branch with 22.10.2003 on 02.12.2003 on the invitation. Mental status at admission were documented total lethargy, emotional dullness and withdrawal, lack of desire to do anything, low mood. The patient occasionally have bouts of overeating and subsequent spontaneous normalization of appetite. who have periodic verbal pseudohallucinations in the form of individual phrases and words, which do not define the behavior of the patient, have no relevance and affective charge. To his critical condition. Significant social and professional unproductive. The diagnosis of Residual schizophrenia (F 20.5).

Somatic condition: conclusion of therapist - CHD, angina, FC II, NC 0-I; alimentary obesity class II). Conclusion neurologist - diffuse neurological symptoms within the primary disease, and vascular abnormalities. Conclusion eye - angiopathy of the retina.

Immunological examination: Clinical signs of secondary immune deficiency is not detected. Immune status: identified relative and absolute lymphocytosis (3,38·109/L, 47%), which increased the absolute number of T-lymphocytes: CD2+- 2,54·109/L (75%), CD3+- 2,23·109/L (66%) and b-lymphocytes: aHLA-DR+- 0,85·109/L (25%); CD20+- 0,41·109/L (12%). We found a decrease in the relative number of T-helper cells CD4-phenotype (54%), however, due to the limfozitoza absolute number of CD4+lymphocytes compensated (0,98·109/L). In the serum decreased IgA level of 0.5 g/L. Other indicators within the normal range (leukocytes 7,2·109/L; lymphocytes 3,38·109/L (47%); T-killers-suppressor (CD8+) 0.81·109/L (24%); natural is Hillary D16-phenotype - 0,30·109/L (9%); IgM - 0,48 g/l; IgG, and 13.2 g/l; the level of circulating immune complexes 65 used, phagocytic activity of leukocytes 64%. Immunological parameters at the beginning of therapy seroquel correspond to declare (CD16+- 0,30·109/L; IgA 0.50 g/l).

Ongoing therapy: quetiapine (quetiapine) 400 mg/day for 6 weeks, fluoxetine 20 mg, chlorprothixene 25 mg at night for insomnia.

Mental status at the peak of the efficacy of quetiapine (seroquel) was characterized by the appearance limited social activity, vigor, desire to love - sewing, which is for the patient additional income declined difficulties in communication, passive apathetic social withdrawal, anxiety, tension, motor retardation. The mental condition of the patient qualifies as appropriate paranoid type of remission. Dynamics of changes in the severity of psychopathological symptoms (PANSS) for therapy is characterized by a decrease in the total score of negative symptoms from 25 to 18; total points total symptoms was reduced from 42 to 35; total score decreased from 80 to 63. On the Scale of assessment of the effectiveness of therapy" CGI dynamics of the mental state of the patient after a 6-week course of therapy with quetiapine (seroquel) is characterized as substantially the E. improvement.

Example 3. The patient And society., born in 1954, the case history No. 1246.

In the premorbid period patient was different psihologicheskie traits, led a secluded life, which, however, did not prevent her to start a family. In 1986 (32 years) after a short initial period, the patient had happened manifestation endogenous process paranoid syndrome. After an intense and short-term therapy, the patient's condition was characterized by remission "In" geoeffective type. Over the next 8 months the patient has been improvement with recovery. But in the spring of 1987 in depressive background reappeared specific mental disorder. As a result of repeated inpatient treatment, the patient's condition was classified as remission "With" geoeffective type was set II group disability psychiatric ITU. Over a three year period, the patient's condition can be characterized by affective instability with a single delusional inclusions on the background of the emotional-volitional reduction. In the beginning of 1990 (36 years) aggravated paranoid symptomatology. After discharge for almost 7 years, the patient exhibited different expression of the persistence of depressive-paranoid symptoms with specific disorders associating the process on the background of alcoholism and psychopathic behavior. Since 1993 (39 years) the patient is a disabled person of group II in psychiatric ITU indefinitely. In General from 1986 to 1997 was expressed progredient schizophrenic process. From 1997 to 2002 activity psychotic manifestations decreased, but remained affective instability, inadequate behavior in the framework of the emotional-volitional defect. Since 2002 (48 years) in the clinical picture of the patient there are no procedural symptoms. In subsequent state does not undergo significant changes. Characteristic are small oscillations of the mental state in the direction of improvement, for the worse. In other words, there is no progression characteristic of the schizophrenic process. Mental status at the time of examination the patient was characterized by apatoabulicheskie syndrome. Prescription disorder is 17 years. Treatment is mainly performed out of a psychiatric hospital. From 1986 to 2004, the patient was eight hospitalizations in the Tomsk regional clinical psychiatric hospital and Institute of mental health in conjunction WITH RMAN.

The patient was in the clinics of the Institute PZ RAMS Siberian branch with 29.10.2003 on 10.12.2003 (by invitation).

Mental status at admission were documented pronounced apathy, emotional withdrawal and inadequacy, reduction of social and professional the national productivity alienation from society, fatigue, General weakness, significant volitional reduction, untidiness, intermittent unmotivated anxiety. The diagnosis of Residual schizophrenia (F 20.5).

Somatic condition: conclusion of therapist - CHD, angina, FC II, NC 0-I; alimentary obesity class II). Conclusion neurologist - diffuse neurological symptoms within the primary disease, and vascular abnormalities. Conclusion eye - angiopathy of the retina.

Immunological examination: Clinical signs of secondary immune deficiency is not detected. Laboratory examination revealed a violation of the ratio of white blood cells: lymphocytosis and neutropenia. Immune status: we found a decrease in the relative number of T-lymphocyte CD2-phenotype (54%), however, due to the limfozitoza absolute number of T-lymphocyte CD2-phenotype compensated (1,02·109/L); decreased absolute and relative number of natural killer cells D16-phenotype - 0,06·109/L (3%); identified activation of the humoral immune response, accompanied by an increase in the serum levels of IgA 3,74 g/l; reduced phagocytic activity of leukocytes 46%; other values were within normal limits (leukocytes 4,6·109/L; lymphocytes 1,89·109/L (41%); T-lymphocytes (D3+/sup> - 1,32·109/L (70%); T-helpers (CD4+) 0,60·109/L (32%); T-killers-suppressor (CD8+) 0,45·109/L (24%); b-lymphocytes: aHLA-DR+- 0,49·109/L (26%); CD20+- 0,17·109/L (9%); IgM - 1,02 g/l; IgG - of 14.76 g/l; the level of circulating immune complexes 127 used On immunological parameters at the beginning of therapy seroquel (CD16+- 0,06·109/L; IgA 3,74 g/l) it is impossible to predict a significant improvement in the mental state that corresponds to declare.

Ongoing therapy: quetiapine (quetiapine) 300 mg/day for 4 weeks, 5-week - 200 mg/day, 6-week 100 mg/day; azaleptin 100 mg/day.

Mental status at the peak of the efficacy of quetiapine (seroquel) was characterized by increased activity of the patient, her interest in treatment, some decrease emotional OBLASTNOI, anxiety and psychomotor retardation. The mental condition of the patient qualifies as apato-abolishable. Dynamics of changes in the severity of psychopathological symptoms (PANSS) for therapy is characterized by a slight decrease in the total score of negative symptoms from 27 to 22, total points total symptoms was reduced from 34 to 23; total score decreased from 71 to 54. On the Scale of assessment of the effectiveness of therapy" CGI dynamics of the mental state of the patient is after a 6-week course of therapy with queationa (seroquel) is characterized as a slight improvement.

The method is simple in implementation, based on the determination of a number of immune parameters (natural killer cells (CD16+) and the concentration of immunoglobulin a) allows us to predict the effectiveness of treatment of patients with schizophrenia atypical antipsychotic quetiapine (seroquel), purposefully conduct rehabilitation pharmacological activities.

Sources of information

1. Gurovich IA, Lobov E.B., Risperidone (Rispolept in daily practice in the treatment of schizophrenia: a Pharmacoepidemiological and pharmacoeconomic research // Social and clinical psychiatry. 2004. No. 3. P.44-53.

2. Popov M. Pharmacotherapy of schizophrenia: analysis of objective difficulties // Rospechat. J. 2003. No. 4. P.41-45.

3. Kalinin V.V. Quetiapine is an atypical neuroleptic: features psychotropic effects and indications /Psychiatry and psychopharmacotherapy. - Volume 3, N5. - 2001.

4. Smulevich A.B. Range of clinical effects of quetiapine (seroquel) in large psychiatric hospital /Psychiatry and psychopharmacotherapy. - Volume 05. - N2. - 2003.

A method for predicting the effectiveness of treatment of patients with schizophrenia atypical neuroleptic quetiapine (seroquel) by identifying clinical indicators, characterized in that the appointment of a drug is conducted additionally immunological examination hurt is on and when the content of natural killer cells; (CD16 +) 0,15×109/l or more, the concentration of immunoglobulin A (IgA) in serum 2.50 g/l and less predict positive treatment.



 

Same patents:

FIELD: medicine, ophthalmology.

SUBSTANCE: due to the method of immunoenzymatic assay one should detect the content of antiphlogistic IL-1 and TNF- and antiphlogistic IL-4 cytokins in lacrimal liquid and based upon the values obtained one should calculate the index of inflammatory activity (IIA) by the following formula: where CHR - a coefficient of homeostatic reserves of cornea which should be calculated by the following formula: where T0 - the data of corneal thermometry before loading vacuum sample; T1 - the data of corneal thermometry immediately after the sample; T2 - the data of corneal thermometry 30 min after loading vacuum sample and at IIA value ranged 0.9-1.0 one should predict uncomplicated adaptive flow of inflammatory-regenerator processes, at IIA>1.0 one should predict exudative character of inflammatory-regenerator processes at the development of early subepithelial corneal disorders, and at IIA<0.9 one should predict chronic proliferative flow of inflammatory-regenerator processes at developing late subepithelial corneal fibroplasias.

EFFECT: higher quality and accuracy of prediction.

3 ex, 1 tbl

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: before immunotherapy one should detect initial leukocytic level in venous blood, the content of CD3-lymphocytes, the content of serumal IgG and phagocytic index according to the results of immunogram in patients with purulent-septic diseases. In case when patient's phagocytic index is under 54.97%, the content of CD3-lymphocytes is under 1.00*109/l, the content of serumal IgG is above 10.93 g/l, the content of leukocytes in venous blood is above 6.13*109/l application of immunophan should be considered to be useful for the purpose of immunotherapy. If in initial values of immunogram phagocytic index is under 51.19%, the content of CD3-lymphocytes is under 1.17*109/l, the content of serumal IgG is under 14.76 g/l, the content of leukocytes in venous blood is under 5.19*109/l application of licopid should be considered to be useful for the purpose of immunotherapy. The innovation provides the chance for carrying out adequate immunotherapy and optimize application of immunomodulators.

EFFECT: higher efficiency.

3 ex, 3 tbl

FIELD: immunology.

SUBSTANCE: through a flow microcell of 15-20 mcl volume one should pass the flow of phosphate buffer solution-carrier at the rate of about 30-90 mcl/min which should be supplemented with analyzed serumal sample at the volume of 200 mcl. The flow cell is supplied with a horizontally fixed piezogravimetric immunosensor at fluctuation frequency fm and receptor covering based upon one of the LPC Yersinia enterocolitica of serovars O:3, O:5 or O:6.30. Then it is necessary to register the binding LPC Yersinia enterocolitica of serovars O:3, O:5 or O:6.30 with antibodies according to the decrease of sensor's fluctuation frequency from fm up to f to detect the concentration of antibodies according to calibration graph being directly proportional against ▵f being equal to fm-f. Application of the present innovation enables to decrease the procedure of analysis up to 10 min and, also, carry out a re-usable analysis after regeneration of sorbed LPC at sensitivity being 1.3 mcg/ml and detect concentration of antibodies ranged 10-100 mcg/ml.

EFFECT: higher accuracy and efficiency of detection.

8 ex, 1 tbl

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: the present innovation deals with detecting the concentration of antibodies to neurospecific enolase (NSE) and gliofibrillo-acid protein (GFAP) in blood serum of pregnant women. The development of gestosis should be predicted at the level of anti-NSE-antibodies being above 0.6 mcg/ml or anti-GFAP-antibodies being above 0.9 mcg/ml. The innovation provides high information value and specificity of the method suggested to predict the development of gestosis.

EFFECT: higher efficiency.

3 ex, 1 tbl

FIELD: medicine, ophthalmology.

SUBSTANCE: while inspecting a patients with chorioretinitis it is necessary to fulfill immunogenetic typing of peripheral blood lymphocytes by HLA I class (loci A and B). At detecting antigens HLA-A9 and/or A24 and/or B53 one should predict light flow of chorioretinitis, at detecting antigens HLA-B5(B51) and/or B27 - sever flow and at detecting antigens HLA-B22 and/or B56 - highly severe flow of chorioretinitis. The innovation provides improved quality of diagnostics of chorioretinitis due to predicting the severity degree of the disease flow that enables to prevent irreversible retinal alterations and vascular membrane as it is by prescribing adequate therapy in due time.

EFFECT: higher accuracy of prediction.

3 ex, 2 tbl

FIELD: medicine, laboratory diagnostics.

SUBSTANCE: additionally to clinico-anamnestic survey it is necessary to carry out immunoenzymatic assay of a liquor for the content of IL-8, at its level being equal 95 pg/ml and higher one should diagnose hemorrhagic insult, and at IL-8 content being under 95 pg/ml - ischemic insult. The innovation enables to diagnose both ischemic and hemorrhagic insult under inpatient conditions in hospitals during the first days of insult occurred.

EFFECT: higher accuracy of diagnostics.

4 ex, 2 tbl

FIELD: analytical chemistry, immunology.

SUBSTANCE: invention relates to a method for selective determination of nonylphenol that is carried out by using a piezoelectric crystal immunosensor. Sample containing nonylphenol and fixed amount of antibodies raised to its in phosphate buffer (pH = 7.1-7.5) is passed through a flow-type cell comprising mass-sensitive piezoelectric crystal immunosensor with receptor cover based on aminophenol-protein conjugate. Nonylphenol is determined by recording change of the sensor frequency oscillation in interaction of aminophenol-protein conjugate with antibodies to nonylphenol wherein the sensor frequency oscillation change is inversely with the nonylphenol concentration in a sample to be analyzed. Then method involves regeneration of receptor cover for carrying out the following assays by passing 0.02-0.10 mM solution of potassium thiocyanate through a cell. Using the invention provides carrying out multiple selective analysis with the detection limit of nonylphenol 0.8 ng/ml and to determine the concentration of nonylphenol in the range 1-20 ng/ml.

EFFECT: improved assay method.

1 tbl, 13 ex

FIELD: medicine, immunology.

SUBSTANCE: the suggested composition contains cedar oil at the quantity of 5.6-24.4 (weight%) and lipopolysaccharide out of Yersinia enterocolitica at the quantity of 75.6-94.4 (weight%). The application of the present innovation enables to simplify and accelerate the development of covering at the surface of piezoelectric crystal resonator and, also, detect Yersinia enterocolitica antibodies at the range of detection being 1.3 mcg/ml.

EFFECT: higher efficiency.

7 ex, 1 tbl

FIELD: biotechnology, medicine, immunology.

SUBSTANCE: invention relates to a modified antibody comprising two or more V-regions in H-chain and two or more V-regions in L-chain of antibody bound directly or over a linker by covalent or noncovalent bond. Antibody has a lesser size as compared with the parent antibody possessing or not possessing the agonistic effect to TPO receptors. Antibody represents TPO agonist and able for specific recognizing and cross-linking the TPO receptor. For induction of the agonistic effect in cells expressing TPO receptors cells are contacted with the modified antibody. Measurement of the antibody TRO-agonistic effect is carried out by cross-linking TRO receptors. The modified antibody can be used as a medicinal agent in treatment of thrombocytopenia. Modified antibodies possess higher activity as compared whole antibodies (JgG) and improved penetration capacity into tissues owing to decreased molecular sizes and absence of constant regions.

EFFECT: improved and valuable properties of antibody.

38 cl, 92 dwg, 3 tbl, 8 ex

FIELD: medicine, pediatrics.

SUBSTANCE: in neonatal's blood serum one should detect neurospecific enolase and homocarnosine to calculate the following prognostic coefficient: P = 0.328 × HC + 0.0004 × NSE2 - 0.041 × NSE + 0.604, where NSE - neurospecific enolase (ng/m), HC - homocarnosine (nM/m). If the value of calculated prognostic coefficient is under 0.54 one should predict favorable flow of the disease at the background of standard basic therapy at unobserved symptomatics to the end of the 1st yr of life. In case if the coefficient is above 0.54 it is possible to predict unfavorable flow of the disease mentioned. For implementation of the present method one should require sufficiently small quantity of serum. The method provides high sensitivity and diagnostic accuracy.

EFFECT: higher accuracy and efficiency of prediction.

2 ex, 1 tbl

FIELD: medicine, ophthalmology.

SUBSTANCE: in lacrimal liquid one should detect the content of interleukin 8 (IL-8) and that of interleukin 1 beta (IL-1β) to calculate prognostic coefficient (PC) due to dividing the first value by the second one by the following formula: At PC value being below 10.0 one should predict favorable disease flow, and at PC value being above 10.0 - unfavorable flow.

EFFECT: higher accuracy of prediction.

2 ex

FIELD: medicine, medicinal microbiology.

SUBSTANCE: method involves growing microorganism culture to be studied in solid nutrient medium followed by preparing microbial suspension and its incubation in the presence of lactoferrin. Control sample is prepared in parallel series. Control and experimental samples are incubated, supernatant is removed from bacterial cells and lactoferrin concentration is determined in supernatant of experimental and control sample by immunoenzyme analysis. Then anti-lactoferrin activity is calculated by difference of concentrations of residual lactoferrin in experimental and control samples. This method provides enhancing the sensitivity and precision in carrying out the quantitative evaluation of anti-lactoferrin activity in broad spectrum of microorganisms that is urgent in diagnosis and prognosis of diseases with bacterial etiology. Invention can be used in determination of persistent indices of microorganisms for assay of their etiological significance in pathological processes.

EFFECT: improved assay method.

3 tbl, 3 ex

FIELD: medicine, biology.

SUBSTANCE: invention relates to nutrient medium used for accumulation of cells for the following cytological and/or immunocytochemical analysis carrying out. Invention relates to medium containing salts NaCl, KCl, anhydrous CaCl2, MgSO4 x 6 H2O, MgCl2 x 6 H2O, Na2HPO4 x 2 H2O, KHPO4, NaHCO3, and also glucose and Henx's solution, 10% albumin solution and polyglucin taken in the ratio 1:1:1. Invention provides enhancing the preservation of cells.

EFFECT: improved an valuable properties of nutrient medium.

3 ex

FIELD: medicine, cardiology.

SUBSTANCE: in peripheral blood one should detect the level of CD95(+) and CD16(+) neutrophilic granulocytes and at combination of increased level of CD95(+) neutrophilic granulocytes by 4 times and more and CD16(+) neutrophilic granulocytes by 0.6 times against the norm with ECG signs of myocardial infarction one should predict lethal result of large-focal myocardial infarction.

EFFECT: higher accuracy of prediction.

FIELD: medicine, parasitology.

SUBSTANCE: one should carry out immunoenzymatic assay to detect diagnostic optic density and that of labeled immune complex in a plot's hole with tested serum measured in conventional units at wave length being 492 nm. One should calculate coefficient of antibodies concentration measured in conventional units by the following formula: CAC = (Odtsh - Odd) x 100, where CAC - coefficient of antibodies concentration, Odtsh - optic density of the hole with tested serum, Odd - diagnostic value of optic density, 100 - coefficient of serumal dilution. By CAC value one should detect the titer of antibodies to Lamblia intestinalis antigens to interpret results of the trial. The method enables to study the dynamics of disease flow.

EFFECT: higher efficiency and accuracy of diagnostics.

1 ex, 1 tbl

FIELD: medicine.

SUBSTANCE: the present innovation deals with studying and treating diseases of inflammatory, autoimmune and degenerative genesis. One should perform sampling of heparinized blood followed by its sedimentation to obtain blood plasma with leukocytes and centrifuging to isolate the latter which are washed against erythrocytic and serumal admixtures, and, also, it deals with calculating the number of cells in samples out of leukocytic suspension after incubation (B) for 1.5 h at 37 C in holes of plastic microplotting board, out of leukocytic suspension one should additionally prepare two samples, one should be applied to calculate total number of leukocytes before incubation (A), the second sample undergoes incubation at the same mode at addition of autoserum to calculate the number of cells remained after incubation (C). One should state upon adhesive properties of leukocytes by the index of spontaneous adhesion (D), where D=(A-B)/B.100%, and effect for enhanced cellular adhesion under the impact of autoserum should be detected by the value of K=(B-C)/C.100% at K ≥ 30%, where B - C - the number of cells undergone additional adhesion after addition of autoserum. The present innovation widens functional possibilities of the suggested method due to obtaining additional values depicting adhesive properties of blood leukocytes.

EFFECT: higher accuracy of detection.

FIELD: medicine, immunology.

SUBSTANCE: one should carry out reaction of blast-transformation, detect proliferation of T-lymphocytes activated with antibodies to CD3 in the presence of interleukin-7 (ACT IL-7) and in the presence of interleukin-7 and dexametazone (ACT IL-7 D), calculate the index for dexametazone action as the ratio of ACT IL-7 to ACT IL-7 D, moreover, the value of dexametazone action index being above 1.2 indicates increased production of cytokins that suppress T-lymphocytes in neonatals. The method enables to detect functional defect of immune system that characterizes neonatal period.

EFFECT: higher efficiency of detection.

2 ex

FIELD: medicine.

SUBSTANCE: method involves measuring forced exhalation volume per 1 s (FEV1) in l, full right ventricle evacuation time (RVE) in ms and angiotensin II value (AII) in ng/l. Discriminant relationship is built as D=0.504·RVE+3.038·FEV1 - 2.0·AII. D being less than 83.88, pulmonary hypertension occurrence is predicted within 1 year. D being equal to or greater than 83.88, no pulmonary hypertension is predicted to occur.

EFFECT: enhanced accuracy of prediction.

FIELD: medicine, medicinal immunology.

SUBSTANCE: method involves determination of heterophilic antibodies in human serum blood by the Paul-Bunnel's method relatively the level of circulating immune complexes, complement-activating properties of heterophilic antibodies by incubation of standardized ram erythrocytes with 0.8% serum for 30 ± 5 min and the following measurement of the erythrocytes lysis degree. The measurement of the effector function coefficient of heterophilic antibodies is carried out by the complement system Keff.f.h.a.-c.s. by the formula: Keff.f.h.a.-c.s. = Y/Tg.a. wherein Y means a lysis degree, %; Tg.a. means a reverse titer of heterophilic antibodies to ram erythrocytes. The damage assay is carried out by comparison of the immune status with the relative level of circulating immune complexes in serum. Method provides detection of preclinic from of immunodeficiency and autoimmune diseases that opens the possibility for their prophylaxis at most early stages of development. Invention can be used for assay of damage in the immune status in human serum blood.

EFFECT: improved method for assay.

5 tbl, 1 ex

FIELD: medicine.

SUBSTANCE: method involves concurrently examining anti-inflammatory IL-4 level in blood serum and lacrimal fluid. The value being within the limits of 60-70 pg/l in blood serum and 5-15 pg/l in lacrimal fluid, disease prognosis is considered to be unfavorable. The IL-4 concentration being within the limits of 90-100 pg/l in blood serum and 20-30 pg/l in lacrimal fluid, disease prognosis is considered to be favorable.

EFFECT: high accuracy of diagnosis.

Up!