Efferent therapy

Human, like any biological entity, is in constant contact and interaction with the environment. Life is a constant process of metabolism both within the body, and with environment, absorption of oxygen and release of carbon dioxide, water and food intake and excretion of end products of metabolism. The very existence of the organism depends on the ability of constancy maintaining within certain limits of its internal environment.

During thousands of years of evolution there were perfected mechanisms of autoregulation of internal environment - homeostasis and protection against aggressive influences both fr om outside, and from poisonous and toxic substances, and microbial-viral contamination. But during the process of own metabolism as well, there are formed relatively toxic intermediate and final products of metabolism, which are subject to slow inactivation or removal. Therefore, formed a complex and multi-stage system of protection and correction of the internal environment. It consists of three main components:
1. Microsomal monooxygenase system of liver detoxification.
2. Immune system
3. Excretory system.

Hundreds of thousands of foreign compounds - xenobiotics - always get to the body from outside. The main liposoluble toxic substances undergo biotransformation during the process of digestion in intestine, from which by portal vein they can not bypass liver, wh ere due to oxidation and enzymatic processes they finally convert into non-toxic water-soluble compounds, which are further metabolized in all organs and tissues.
Liver is a barrier not only for exogenous, but also for endogenous toxic compounds, constantly arising during the process of metabolism - synthesis of some and decay of other substances: lactate and pyruvate, urea and creatinine, ammonia and fatty acids, aromatic amino acids, alcohols and aldehydes, phenols and ketones, products of proteolysis and hydrolysis, activity of automicroflora and viruses, etc.

Immune system, in its turn, consists of three components: the central organs (thymus and bone marrow), lymphoid structures scattered over the body (spleen, lymph nodes), and immunocompetent cells.

There are the following parts of the immune system: recognition of foreign substances - antigens, phagocytosis, a cooperative function of T-lymphocytes and antibody production, interaction of antibodies with antigen and of complement with immunoglobulins and target cells. There are physical and chemical processes occuring: reception, immune adhesion and adsorption.

Interaction of antibodies with antigen is an adsorption process of forming the immune complex "antigen + antibody + complement". It is retained in the lymphoid tissue, phagocytized and degraded by lysosomal enzymes. Natural serum factors - opsonins - promote adherence of microorganisms, dead cells and their fragments ("detritus") to the plasma membrane of phagocytes (monocytes, neutrophils), increase the velocity of phagocytosis. It should be borne in mind that in case of depletion or absence of opsonins of complement, even normal phagocyte is not capable of capturing the bacteria, so defects in humoral immunity entails failure and cell-phagocytic defense mechanism.
But humoral immunity depends on the cell immunity as well, since T-cells are required for both, start of antibody forming by B-lymphocytes, and regulation of this process. In particular, T-helper cells (CD4) stimulate production of antibodies, and T-suppressor (CD8) inhibit this process, and, depending on the relations between the two subclasses (CD4/CD8), there are possible hyperimmune reactions and immunosuppression.

The task of the immune system also includes a struggle not only with food of foreign origin, but also with those arising within the body, including ever-emerging abnormal cells, which include tumor ones. Here also works a mechanism of a "friend or foe" reaction, and own cell with anomalous properties is destroyed along with the foreign ones by natural killer cells (T-killers) and other macrophages.

All final products of own metabolism and degradation of foreign substances, require removal from the body. The structure of excretory system consists of four components: kidneys, gastrointestinal tract, lungs, sweat and sebaceous glands of skin.

Kidneys remove water (1.5-2 liters a day) and dissolved urea, creatinine, potassium, sodium, chloride, calcium, magnesium, sulfates, phosphates. In addition, kidneys eliminate water-soluble products of biotransformation xenobiotics, products of proteolysis of immune complexes, remains of bacteria, viruses, protozoa, fungi digested by phagocytes, and substances spontaneously transformed into foreign substances.

Gastrointestinal tract eliminates lipids, cholesterol, bile acids, steroids, bilirubin, water, food debris, nonviable microbial body unabsorbed xenobiotics.

Through lungs there are removed carbon dioxide, water, volatile xenobiotics (ethanol, ether, etc.).

Sweat and sebaceous glands of skin derive water (400-600 ml), sodium, potassium, calcium, magnesium, phosphorus, chloride. Also urea, creatinine in case of uremia; in diabetes - glucose; in hepatic failure - ammonia, bile acids; in poisonings - mercury, arsenic, iron, iodine, bromine, quinine, benzoic acid, succinic and hippuricacid, salicylates, salol, antipyrine, methylene blue, etc.

        Ecology and homeostasis
 That is not to say that earlier it was "well". Even in Garden of Eden environment was not probably really clean. However, civilization in all its benefits and achievements has brought in a lot of anthropogenic pollutions growing from year to year. Every year millions of tons of nickel, arsenic, cadmium, silicon, cobalt and zinc are emitted to the atmosphere. It is polluted with oxides of carbon and nitrogen, sulfuric anhydride and sulfuric acid, sulfates, etc.

Tens of thousands of toxic or at least unnecessary substances are constantly penetrating to the human body through food, water, air. These are products of "household" chemicals, chemicalization of agriculture (pesticides, insecticides, defoliants, chemical fertilizers), products of tobacco smoke, transport and industries fumes, alcohol, drugs, even medicines, including antibiotics and hormones fed to domestic animals and contained in their meat.

To an even greater extent this is applied to large industrial centers. Usually the maximum permissible concentrations (MPC) of toxic compounds are established for a workplace, considering that within the rest of a plant, not to mention sites outside it, there should not be any of these products at all, but in our practice multiple excess of MPC is usual not only inside plants themselves, but also outside.

It should be noted that about 30% in the structure of atmospheric pollution of residential areas make toxic exhaust fumes of motor vehicles, which is not uncommon even for the suburbs and recreation areas.

Water purification system, though with difficulty, but is capable of maintaining satisfactory titers of microorganisms, but purification from harmful chemical substances, including oxides and salts of heavy metals, is far from being perfect. Food does not always comply with environmental regulations.

There is another aspect of human relationship with the environment, and this problem arose back in ancient times, when people began to build houses, depriving themselves of the opportunity to breathe the outer air. The latter, in addition to the oxygen necessary for life, contains so-called atmospheric electricity in the form of negatively charged ions resulting from thunderstorm electrical discharges in the atmosphere and other natural phenomena. The whole evolution of living beings proceeded in such ionized air, and all internal metabolic processes also formed on the basis of electrical phenomena - transfer of nerve impulses, muscle contraction, and metabolism - transfer of molecules across biological membranes. Everywhere the leading role played the potential difference, which causes some substances to move into the cell, others - out.

When breathing, negative air ions charge the walls of airways with negative potential and, proceeding from them, quickly reach the alveoli. All body fluids are electrostatic colloids and carry a negative charge. Blood, enriched with air ions, washes all tissues and cells, providing them with a negative charge and sol condition of their cytoplasm, which is essential for optimal metabolism. Reduction of electric negative potential of cell membranes leads to their "electrical discharge" with sol-gel transition of colloidal state of the cytoplasm, which contributes to their coagulation with sharp violation of metabolism.

Membranes themselves also have a certain electrical charge. Moreover, the blood is a rather dense mass of cells that should not stick together, create cell aggregates or conglomerates that would immediately plug the small vessels, and life within the body would stand still. This does not happen only because each such a cell also carries a negative electrostatic charge, which contributes to their mutual repulsion. Therefore, not only oxygen, but also electricity are needed for life provision in inhaled air. In the same way as breathing in oxygen, people exhale carbon dioxide, and breathing in negative ions, people exhale positive ions.

Negative ions are formed as a result of capturing free electrons by the molecule of oxygen, the peripheral shell of which contains 6 electrons, and seeks to acquire stability by capturing two more electrons, which transforms a neutral molecule to the negatively charged ion. Positive ion is formed mainly from carbon dioxide, when its molecule loses one of the valence electrons [V.P. Skipetrov et al, 1995].

Inside houses the number of these negative ions is much smaller, especially in crowded places. But outer air is not always rich enough with negative air ions. In village, mountain and sea air there are about 1,000 negative ions per 1 cc of air. In many sanitaria their number reaches 10,000, and near waterfalls – 100,000. In city air the number of ions does not exceed 500, indoors - 50-100, and in smoky and overcrouded places negative ions may disappear entirely, which will have the most negative impact on the metabolic processes and the health of people there.

Sometimes with adequate site ventilation, but with air passing through a fine filter and even air conditioners, as well as internal "air purifiers" and heating devices, negative ions are almost entirely lingering. They are also destroyed by air passing through a layer of glowing tobacco when smoking. The presence of the same concentration of oxygen, as outside (21%), in these conditions does not ensure proper quality of indoor air.

The famous Russian physiologist A.L. Chizhevsky (1959) back in the 20s proved the effect of negatively charged ions on the health and life of humans and animals. In particular, he showed that animals in a room devoid of any negative ions by filtering the outer air, after 8-10 days become lethargic, lose appetite, become weak and within 13-18 days inevitably die. In case of timely free access to the outside air, the animals again recover their strength and health. Exactly the same processes can occur in people under similar circumstances.

Developed during millennia, system of protection and correction of the internal environment is not able to deal with ever-increasing flow of a wide variety of substances, both of organic and inorganic origin. A number of compounds can not be metabolized at all. As a result of spontaneous reactions of xenobiotics or their intermediate reaction compounds with proteins, cell membranes or nucleic acids there are formed autoallergens, membranotoxins or carcinogens.

Contact with the body of any foreign substance, even in a minimal amount, does not disappear unnoticed. In some cases, there comes the selective damage of central nervous system (acrylamides, azides, barbiturates, cyanide, glutamate), liver (carbon tetrachloride, chloroform, trichlorethylene, Bromobenzyl, ethanol), lungs (carbon monoxide, dust and fumes containing quartz, graphite, kaolin, talc, asbestos), kidneys (chlorpromazine, trifluoperazine), gonads (isoprene, tetraethyl lead), embryo during fetal development (extraction solene, ethanol, aniline, ethylene glycol).

Numerous studies have shown the impact of such adverse conditions on health indicators. What became the confirmation of this concept were results of comparative studies of health status of two cities in Volgograd region with roughly similar climatic conditions - Volzhsky and Kamyshin. Their only one difference is a greater concentration of industrial enterprises in the first one (due to closeness of Volga hydroelectric station). At the same time in the air of the city Volzhsky almost always were about 10 toxic chemicals at the MPC (N2O, SO2, CO, asbestos, graphite, mercaptan). The most significant results are shown during not examination of employees of these enterprises, but the mass screening of children. Particular attention was drawn to disease incidence in children of the first years of life in pre-schools of these cities. There was revealed almost complete absence of healthy children under the age of two with a significant prevalence of frequent and long diseases in Volzhsky.

The same trend is observed when examining children of older age groups in kindergartens in these cities. Thus, the number of children ailing often and long, is reducing in Volzhsky (from 62.1% in the first year and 41.5% in the second year to 23.0% in older age), but always remains significantly (2-3 times) higher than in Kamyshin. Thus, among the causes of disease of the children in these age groups the leading role play respiratory diseases, allergies and chronic rhinitis. In particular, there is shown a twofold prevalence of respiratory diseases, and almost threefold - of allergic diseases.

Especially noteworthy is absence of children that never fell ill during the first year of life in Volzhsky, and it may indirectly evidence of more adverse conditions of intrauterine development of children in this city. This is confirmed by higher level of adverse pregnancy in Volzhsky. There is indicated a significant (threefold) increase of frequency of late toxicosis of pregnant (preeclampsia) in Volzhsky, which undoubtedly caused higher perinatal mortality and morbidity among newborns. It is to be supposed, that in this city a fetus is under double oppression - of endotoxins, typical for an ordinary pregnancy toxemia, and exotoxins, which penetrate to the mother's body with air, water and food.

Thus, presence of active oxidants (nitrogen oxides, sulfur dioxide, etc.) in the atmosphere of residential areas of Volzhsky leads to the depletion of antioxidant protective system of the body with accumulation of toxic final products of lipid peroxidation, which, in turn, activate the processes of proteolysis and other types of metabolic disorders with the subsequent suppression of immune defense mechanisms. All this, obviously, leads to a significant weakening of children's health, which will undoubtedly leave its mark on the rest of their life. Additional immunoassay of random cohorts of children and adults in the city confirmed the status of moderate immunodeficiency expressed in reduction of immunoglobulins A, M, G, and phagocytic activity.

Similar data have been published by M. Mikulska (1998) on the basis of observations in environmentally unfriendly district of Upper Silesia. Thus, in 1985-1995 there was observed an increase in perinatal mortality from 11.9 to 24.0%. The number of infants with extremely low birth weight (from 3.1 to 10.4%) increased as well. The most common cause of neonatal mortality was the increasing frequency of abnormal development (38.3%).

Thus, the presented results of medical and environmental studies strongly support the connection between adverse external conditions of human habitation with disorders of its internal environment and, consequently, the general weakening of health.

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