Mikuksts V. Syndrome of endogeno-exogenous intoxication at systemic scleroderma disease: course and pathogenesis (clinical & experimental research)

The thesis is devoted to improving the diagnostics quality through establishing new pathogenesis links and identification of the disease course prognostic criteria for systemic scleroderma diagnosis. For the first time, the relationship between individual clinicallaboratory SSD manifestations and environment ecological factors (atmosphere and groundwater xenobiotics’ content levels) in the patients’ residence regions, with syndrome of endogenic intoxication development dependence of those factors being assessed, the influence of components syndrome of endogenic intoxication on the disease course peculiarities with structural changes in the skin and SRSC, the role of silicon in SSD pathogenetic formations is proved with the disease diagnostic and prognostic criteria descriptiveness. The SSD course depends on the environmental factors in regions where the patients do live, thus determining the pathological process clinical form (ammonia levels in the inhaled air and nitrates contents in the groundwater) as well as the skin syndrome severity, the arthropathy development (nitrates and sulfates in grouldwater), the disorders severity as to the heart (industrial wastes accumulation in the atmosphere), lungs (phenol and nitrogen dioxide in the air), liver and kidneys (lithium concentration in water) and central nervous system (sulfur dioxide environmental levels) therefore the said influencing the lipids’ peroxidation products blood contents and integral parameters (benzipyrene and phenol in air), as well as the non-protein nitrogen compounds (nickel in water), mediumweight molecules (phenol and nickel), and the phosphates groundwater level directly correlates with the endogenous intoxication integral index, while the environment’s hygienically-critical components embody the risk factors for the disease individual signs. At that the pulmonary vessels sclerosis effect due to SSD model being directly related to the bronchosclerosis development, the heart muscle perivascular infiltration contributing into myocardium stroma’s lymphocytic macrophage infiltration and the renal arteriolar sclerosis to stromal nephrosclerosis degree, the xenobiotic air pollution level creates the dependence between alveolar septa cellular infiltration degree and the perivascular pulmonary infiltration, the cardiomyocytes hypertrophy development depending from the heart endothelial vessels proliferation, and the increase in mesangial renal matrix is due to the kidney glomerular capillary endothelium proliferation. The blood content with silica has an effect onto parameters of antitope isomerase antibodies, the Raynaud's syndrome development and liver damage; the same microelement level in the hair rendering the nature of changes in the esophagus, kidneys, disturbances of myocardial excitability and the pathological process progression rate.