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The results of the use of plasmapheresis in multimodality treatment of patients with endogenous psychoses are provided for the first time. The use of plasmapheresis was shown to be highly effective in overcoming resistance to psychotropic agents as well as in the treatment of lingering and chronic extrapyramidal neuroleptic disorders. The beneficial effect on the mental and neurologic status of the patients is coupled with pronounced immunocorrective action of the procedure.

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Immunologic changes in schizophrenic psychoses were examined by different methods of genetic analysis. The cytotoxic test and the method of fluorescent antibodies showed an increase in the antithymocytic activity (ATA) of the blood serum. A high index of the coefficient of a genetic correlation between elevated blood levels of ATA and the genetic component of liability to the disease indicates that genetic factors partially involved in the general structure of hereditary predisposition to schizophrenic psychoses participate in the determination of interindividual differences with regard to blood ATA levels. The data obtained suggest that the observed antithymocytic activity of the blood serum was due to at least 2 types of antibodies with different affinity to thymocytes.

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In 16 schizophrenic patients treated with aminazin changes of the serum antithymic activity (ATA) were studied in relation to the drug pharmacokinetics and peculiarities of the patients' psychic status. It was found that in a part of the patients the serum ATA level sharply fell immediately after the treatment onset; the psychopathological disturbances in these patients were reduced, and the patients developed remissions of a good quality. In another part of the patients the high serum ATA remained unchanged throughout the whole observation period. These patients were resistant to the drug therapy and had pronounced schizophrenic defects in their status.

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A genetic analysis of the immunological disturbances observed in patients with schizophrenic psychoses and registered from the level of the serum antilymphocytic activity was carried out. The analysis has shown that the contribution of genetic factors to the determination of interindividual differences in that feature exceeds more than twice the contribution of environmental factors. The close correlation between the serum antilymphocytic activity and the genetic component of the predisposition to the disease gives one grounds to regard a rise of the serum antilymphocytic activity as a pathogenetic marker of hereditary predisposition to schizophrenia. The results obtained, if taken together with literary data, may be of interest for studies concerned with the multicomponent structure of the hereditary predisposition to schizophrenic psychoses and their pathogenesis.

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The paper concerns results of the studies, accomplished according to the WHO project within the framework of international collaboration in biological psychiatry. It was demonstrated that the blood sera of mental patients and normals possess antithymic activity. However there are statistically significant differences between the groups of patients and normals with regard to the level of sera antithymic activity (0,22 +/- 0,05 in normals and 0,47 +/- 0,04 in patients, p < 0,05). The medium level of antithymic activity in the group of schizophrenic patients depends upon the duration of the disease. The level of sera antithymic activity was significantly higher (p < 0,05) in the group of patients with a duration of the disease less than 5 years and lower in patients with a duration of the process over 5 years.

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The hemolytic properties of adhesive and nonadhesive lymphocytes in the blood of schizophrenic patients and normal donors were studied. It was demonstrated that adhesive lymphocytes possess hemolytic properties. It was shown as well, that the content of hemolytic active lymphocytes in the adhesive fraction of peripheral blood cells in schizophrenic patients is ten times higher than in a similar cell fraction of normal donors.

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The authors studied the cytotoxic activity of the lymphocytes in the peripheral blood of 16 schizophrenic patients and 14 normal donors in respect to autological erythrocytes. It was demonstrated that the hemolytic activity of the lymphocytes of patients was significantly higher, than in the control group. Activated cells possess cytotoxic properties.

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Using the Erne method in N.N. Klemparskaya's modification the author studied peripheral blood of 59 schizophrenic patients with different types of the course and 23 normals. It is shown that in the peripheral blood preparations of schizophrenic patients there is a reliably greater number of zones of local hemolysis of erythrocytes. This phenomenon is associated with a general immunological status of the body.

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In order to eliminate antibodies to water soluble proteins of the human brain which were preliminary divided into 10 fractions of DEAE-cellulose, the authors studied the serum of 30 patients with disseminated sclerosis and 30 patients with lateral amyotrophical sclerosis and determined their antithymic serum activity. The antibides were detected only to protein fractions 1,2 and 10. There was a tendency towards a more frequent detection of antibodies with an increase of the severity of the disease. It was not possible to determine antibodies with an increase of the severity of the disease. It was not possible to determine any correlation between the amount of antibodies and such clinical indices as the degree of severity, duration, form of the disorder, age and sex of the patients. The cytotoxic index of the patients was significantly higher than that in normals. The authors also found a correlation between the antibodies in the serum cytoplasmatic brain proteins and antithymic activity of the same sera.

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With the aid of a direct immunofluorescent method the per cent of the B-lymphocytes in the peripheral blood of schizophrenic patients and normals was determined. It was demonstrated that in the preparation of blood cells the portion of cells, possessing superficial immunoglobulins (B-lymphocytes) significantly exceeds the portion of cells in normal donors. On the basis of achieved data it can be assumed that in the blood of schizophrenic patients there is a higher % of B-lymphocytes than in normals and most likely lesser of T-lymphocytes.

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Sera from healthy people and from patients with schizophrenia were heated at 56 degrees for 30 min and then kept at 4 degrees . These sera were then tested for cytotoxicity and by the indirect immunofluorescence method with thymocytes, bone-marrow cells, and lymph-node cells of adult C(3)H mice. The cytotoxicity index for mouse thymocytes of sera from 60 healthy donors ranged from 0.00 to 0.4, with an average of 0.08. That of sera from 35 patients with schizophrenia ranged from 0.29 to 0.91, with an average of 0.71. The cytotoxicity index for mouse bone-marrow cells of sera from healthy donors ranged from 0.03 to 0.23, whereas that of sera from patients with schizophrenia ranged from 0.00 to 0.14. Sera of patients at dilutions of 1:8-1:32 displayed immunofluorescence of almost 100% of thymocytes and 58-78% of lymphocytes, whereas sera of healthy donors displayed none. We thus conclude that the sera of patients with schizophrenia contain antibodies against thymic antigens localized on thymocytes and thymus-derived lymphocytes.

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