Therapeutic apheresis in the prevention of premature aging

There is no doubt that the biologically predetermined person's age is not less than 110 years, and according to some reports should reach 150 years, although in reality the average life expectancy does not exceed half of that period. Was it ever a golden age of mankind, when people lived to this age, as evidenced by the biblical sources, hard to say. On the other hand, there are those evidence that ancient man lived an average of about 40 years.
Course of illness, injury peacetime and wartime significantly shorten the period of life. If a person for life even avoid any diseases and injuries, anyway, he will inevitably die "of old age." But why in some cases the "old age" carries 60-year-olds, and other 90-year-old spared ? What is the basis of aging?

Many authors affecting these issues are limited to the directions on the "slagging" body for life, a kind of self-poisoning him. What are the mechanisms of subsequent disorders? How does the immune system – our main guardian of Health, which largely depends on the quality of our lives?
Indeed, with advancing age, the changes in the immune system grow up also, affecting all of its elements – stem cells, T- and B-lymphocytes, macrophages. Since early childhood, there is a gradual deceleration "thymic hours" that manifests itself in reduced proliferative activity of T-cells and a decrease in their effector and helper functions predisposes to infections and malignancies, the frequency of which is known, increases with age. In old age really increased susceptibility to infections, which are some of the main direct causes of death. There are especially frequent respiratory infections, pyelonephritis [1]. With age, the frequency increases also many other diseases – cardiovascular disease and cancer, diabetes and dementia. Such changes in the body are often referred to as "age", "normal age appropriate."

Immunodeficiency weakens control over the appearance of abnormal mitosis – cell division and the appearance of tumor cells. In the body, they are constantly appearing and often enough, however, having an alien antigenic structure, they immediately fall into the "field of view" immune custody and immediately destroyed. If these guards "overlooked" when they occur in a timely manner and did not destroy them, they soon recognized their antigenic structure like "own" and according to biological laws that blocks the production of corresponding antibodies and predetermines the outcome of this confrontation between the body and the tumor. Therefore, the most terrible consequence of age immunodeficiency in the elderly is to increase the probability of tumor growth [2], which is confirmed in specialized studies of oncologists [3].

Function of the immune system depends on the diversity of antigen receptors of lymphocytes. With age, the general decline in the ability of the thymus and bone marrow lymphocytes in the generation of antigenic stimulation combined with their clonal expansion. This leads to the emergence of monoclonal antibodies, and the direction of their reactions varies with the external (foreign) to autoantigens [4].
But the greatest danger is the weakening of suppressor T-cell function, which is accompanied by the appearance of "forbidden" under normal conditions of lymphoid cell clones reacting to self-antigens of the organism that causes different types of autoimmune pathologies, which is consistent with a higher prevalence in the elderly and senile various autoimmune diseases [2]. More than 50% of the elderly different autoantibodies can be detected , but not at high concentrations of [5]. Therefore, rheumatoid factor is the emergence of signs of arthritis, is not as pronounced as in true rheumatoid arthritis, but a rare person in old age does not suffer fr om joint pain, considering them only consequence "salt deposits." There are characterized by the appearance of antibodies to thyroglobulin, causing autoimmune thyroiditis with hypothyroidism. On the other hand, thyroid hormones are necessary to maintain proper immune system activity, and hypothyroidism only aggravates immunodeficiency in old age.

Interestingly, autoantibodies to three major thyroid antigens – thyroglobulin, peroxidase and thyroid-stimulating hormone found in healthy individuals aged 18-24 years 10.6-14.9% of cases, but in the age of 55-64 years, this frequency increased to 24.2-30.3% [6]. Even healthy donors showed anticardiolipin antibodies with frequency 27%, of anti-DNA antibodies – 17% [7].
Even senile dementia is a consequence of the appearance of autoantibodies to the elements of the central nervous system. In Alzheimer's disease mutations in genes may contribute to the appearance of autoantibodies presenilin-1 and presenilin-2 protein detectable by immunochemical methods in relation to the nerve fibers postmortem studies of the brain of these patients [8]. Mutations in DNA and RNA contribute to the appearance of protein molecules that differ from normal, and further leading to metabolic disorders. In particular, during Alzheimer's disorder there are arrived cascade successive disorders leading to the deposition of amyloid as plaques in the vascular walls, infiltration of microglia cell, apoptosis and ultimately increasing neuronal loss. And also show signs of cerebral amyloid angiopathy, an important pathogenetic factor in vascular disorders of the brain and even intracerebral hemorrhages. One reason for this is the mutation of presenilin-1, which depends on the increase of amyloid-b deposits [9].

As a result of autoimmune processes appear and symptoms of Parkinson's disease, but also do not reach the intensity observed in Parkinson's disease itself. Autoimmune processes underlie the formation also demyelinating disease with the advent of widespread sclerosis type of multiple sclerosis and muscular dystrophy type myasthenia. Characteristic of old age is the appearance of signs of paraproteinemia with accumulation of monoclonal immunoglobulin M- components resembling now myeloma.

True amyloidosis resemble amyloid deposition in the intercellular spaces, including the formation of the so-called senile plaques that 60% of older age characteristic feature appears. Amyloid deposition in the myocardium is also common in the elderly [10].

In recent years, drawn attention to the condition of the liver parenchyma in old age. Size of the liver, hepatic blood flow and perfusion of the liver is reduced by 30-40% between the third and tenth decades of life. Until recently it was ignored the link between aging and autoimmune liver disease. In this case, age is much worse prognosis in chronic hepatitis and cirrhosis. Half of those over 70 years of developing hepatocellular carcinoma, usually on a background of cirrhosis [11].

One of the manifestations of involutive processes in women is menopause. This period of adjustment of the hormonal status is accompanied by a number of specific menopausal symptoms – feeling "tide", "heat", sweating, irritability, which is a sufficiently long period violates health and "quality of life" of women. Upset not only the functions of the ovaries, but also in other endocrine glands, in particular – with the development of thyroid symptoms of autoimmune thyroiditis. There are broken also metabolic processes, decreasing the level of enzyme activity, in particular the succinate dehydrogenase, being marker of mitochondrial and energy processes in the Krebs cycle [12]. In cases wh ere the usual therapeutic measures do not help, plasmapheresis courses allow in a relatively short time to achieve the disappearance of the above symptoms, especially at small "seniority" climacteric syndrome when these symptoms are still unstable and did not develop pronounced psycho-vegetative disorders [13]. The positive effect of plasmapheresis courses lasted for 3-18 months. In 67.5% of the women with climacteric syndrome marked hypercholesterolemia and courses of plasmapheresis also help to normalize lipid metabolism also [14].

Thus,as a result ofdisordersof detachedparts of the immunesystemin oldage there is awide range of symptoms, more worn outthan thecorrespondingactualnosologicforms of diseases, but it is they whodetermine the shapeof an old man–slow response time,stiffness andincoordinatemovements,muscle weaknessandforgetfulnessetc.

With aging occurs and discharging the electrostatic forces of the organism, decreasing membrane potential, decrease of the ionization cytoplasm with coarsening of biocolloids particles, a decrease of their ability to swell, degradation and induration of protoplasm, its transition from a sol to a gel state. During ontogeny it is generally reduced hydrophilic colloids. Limiting the content of negatively charged ions in the inhaled air is one of the main factors accelerating the processes of biotransformation colloidal state of cells and tissues and premature aging.

It needs no special explanation the role of atherosclerosis in the process of premature aging also. Many researchers even consider atherosclerosis as a natural process associated with aging [15]. However perfidy of atherosclerotic vascular lesions is almost complete asymptomatic until the moment of blockage of the lumen when late to think not only on the prevention of these lesions, but even a qualitative treatment. Therefore it is necessary to closely monitor how the content of lipoproteins in the blood, and known for soft signs of vascular disorders.

The examination of elderly persons whose average age was observed hypertension, there are found greater frequency of intellectual disability and depression with symptoms of cerebral atrophy [16]. Increasing age occurs also the accumulation of toxic products of lipid peroxidation on the background of depressed antioxidant defense system [17]. Older people are also observed higher levels of acute phase proteins with signs of oxidative stress, which confirms the special clinical value of efferent therapy [18].

On the one hand one could regret that the Creator or Nature itself (depending on the world) were not wise enough, without providing more stringent ban on the formation of autoimmune processes. However, on the other hand, maybe this is and the highest was their wisdom, because otherwise life would go on indefinitely long, and if it is impossible to completely avoid the accumulation of such "micro-errors" of immune and metabolic processes, it would create a number of other intractable problems.

So more and more clearer picture of disorders of homeostasis, leading to premature aging. More Seneca said that "old age – an incurable disease", and therefore the attitude to it should be as a disease. And disease can and should be treated! Mainly you should stop these vicious circles interdependent violations that can only be done in a timely removal of all accumulated large molecular pathological products from the body, that the kidneys are not output, and do not destroy the organs of biotransformation. And to completely solve this problem could be only efferent therapy, mainly – plasmapheresis.

The main taskisnotjust an extension oflife.Ifsuch a lifewill be extendedwith symptomsof dementiaand helplessnessin a wheelchairoron a bed, then such workis not worthpursuing.It should be bornein mindthat the level ofhealth–physical functionandpsychological status–are more importantfor the elderlythan the duration oftheir lives. [19]
The challenge isto increase theimmunepotency, which means the extension ofthe productivemiddle agewhile maintainingthe level of healthandenergy, ie,quality of life, on which depends the creativeandphysical performance, the opportunityto experience lifein all itscolors.The challenge ismaintaining the"youth to old age" [20, 21].

The question is– whenitstartsagingand when tostartits treatment? Wait forthe development of appropriateagemanifestingsymptomsor preventtheir occurrence? Of course–the last one!
As mentioned above, many diseases, as well as old agecreep upunnoticed.For manymonths, even yearsgrowingmicro-disordersvarious partshomeostasisuntil reachinga critical levelwhen thesymptomsof a particulardisease[22].

Thus, according tothe summary data ofresearchpathologistswho reviewed theresults of3000autopsiesof youngpeople aged15-34yearswho had noclinical evidence ofcardiovascular diseaseanddied as a resultof accidents[23, 24] revealedthe following picture:allteenssurveyedwere foundfatty streaksin some segmentsof the arteries.  These changes grew with age, with lesions of the coronary arteries were found in their walls leukocytes and circulating immune complexes; obesity increased the risk of vascular lesions; changes in the growth of abdominal aorta increased sharply in smokers; smoking and hypertension clearly correlated with the development of primary atherosclerotic plaques in young humans. Given that none of these young people have not seen any manifestations of cardiovascular disease, it is clear that their primary prevention was necessary to begin without waiting for the manifesting symptoms.

The same can be said about micro-shears and soft signs of other diseases. Task is to find these micro-disorders not turn a blind eye and do not consider them a fluke.
In many cases, involutive processes in old age do not require medical treatment, and even more so, the drugs can harm because even when used correctly, they can cause a number of other functional disorders [7]. In recent years, many authoritative experts note that "pills strategy", which is based on Western medicine, practically exhausted itself. This not only practitioners, but even pharmacologists recognized that "tablets" really effective in less than 30% of cases [22].

Timely primary prevention of diseases will serve as the primary prevention and early aging. And the main point of such prophylaxis is efferent therapy aimed at removing what can be seen now, and that is still not even manifested [20, 25, 26, 27].

Various cosmetic surgery is certainly justified, but after the elimination of defects in shape, posture, wrinkles, remain inside "wrinkles internal environment" and all the reasons that caused them. Therefore, these operations must be accompanied by reorganization of the internal environment, and some complicated plastic surgery should be performed only after the efferent and immunotherapy for the prevention of inflammatory complications, bringing to naught all the cosmetic effects.
Notonly an honor, but old ageis necessary to protectfrom an yearly ages!This meansthatthere can not beany specificage at whichwe should startmeasures to preventseniledisorders.We must realizethat this was theorganic changesof organs and tissuesare resistantreverse development, so effort should be madebefore the onsetof these lesions.

These measuresare indicatedat almost any age, whenthere's somesoft signsshowingdeviationsfrom the normal state–excessivefatigue, unusual sensationsandbody aches,joint pain, and changes in the formof the scleraof eyes, hair, nails, skinwrinkledface, hands; memory disordersand tinnitus, changes in gait, elasticityandmovement coordination, potency, and many others. Of courseit is importantto pay attention tothe appearance ofmore than oneof these symptoms, and theirwholecomplex, especially ifthey are heldfor many daysand weeks. Should not be ignoredrises in bloodpressure(assumingtheir naturalor age), pain in the heart,even ifusing drugsthey can bequicklycut short– “no smoke withoutfire”!Socreepsatherosclerosisone of the mainprecursors ofage.

Founder application efferent therapy in gerontology can be considered Greek hero Jason, who tried to restore youth to his father, replacing his blood with new wine. Although this attempt and failed, however, that removal of pathological products together with part of the normal components of the internal environment of the body that are in the blood plasma, is achieved not only its reorganization, but also given a powerful impetus to the renewal of her fresh, young ingredients. That is, the effect of rejuvenation is achieved simultaneously with the removal of accumulated gradually autoantibodies and other pathological metabolites such as exo- and endogenous origin.
Thus, based on the efferentpreventivetherapy should bean annualrate ofup to foursessionsof plasmapheresisandimmunosuppressionin the case ofsigns ofallergyorappropriate it is expedient to addalso photohemo-therapy(UVRorlaser irradiation of blood).

Should not be neglectedandaeroionotherapy, ie, walks on"fresh air" thatshould helprestoremechanisms to maintainelectrostatic stateof all componentsof the internal environmentto the prevention ofpathologicalbiotransformationcytoplasm.

Naturally, the efferent therapy should not preclude the need to lead a healthy lifestyle – exercise, proper diet (the main thing – do not overeat), and, of course, not to poison himself smoking, alcohol, drugs [2]. It was noted that food restriction increases life span of mammals, reducing the frequency age-depending pathologies including cardiomyopathy, and slows physiological disorders associated with aging. Limitation of food leads to an increase in myocardial contractility [28]. At the same time we must recognize that obesity is the most common disorder and its frequency increases with age.

However, even inold ageplasmapheresisalsoshown, although show a significantregression ofalreadyoccurringorganandsystemic lesionsis not expect.E.A.Chumaevaet al.(2004) [29] reported that after a courseof plasmapheresisandphotohemotherapyat91.9% of elderly patientsimproved overall health, in 68.9% of patients with elevated blood pressure levels it decreasedwith disappearance of headaches andtinnitus, vision improved.
But if the treatment of a variety of acute and chronic diseases now there is no doubt the advisability of efferent therapy, then with respect to the more practically healthy person may have doubts about the justification for such action. After all, there is no assurance that the expected health problems do arise. Virtually impossible to prove that we really have prevented the development of the disease, which still has not been diagnosed. On the other hand, we must be absolutely sure that such an invasive procedure as plasmapheresis will not cause any complications.

Such confidence isstill there, as experience shows thatmethodicallycorrectoperationwell-trained personnel, using onlydisposable needlesand systems, virtuallyno threatto healthof the patient.In addition,avoiding the use ofdonor plasmaand otherprotein-based drugsto replacedeletedplasmagives an additional guaranteeto prevent infectionviral diseasesandimmunization of foreign antigens(donor lymphocytes, for example).

Stopcanonly sufficientlyhigh cost ofefferent therapy, although in our country, it is much lowerthanin EuropeorAmerica.Awell-establisheddomesticindustrial productionplasmafilters"Rosa"andthe development of simpleand safe methodsand apparatus formembrane plasmapheresis “Hemofenix” (NPK AlphaCompany"Trackpore Technology) makesquite realisticthese important tasksin almost allhospitalsup to theirmunicipalmanagers.

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