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[Role of lymphocytes and corticosteroids in the pathogenesis of caseous pneumonia].

A complex of clinical, X-ray, cytochemical, immunological, and biochemical studies of total 11-OCS, its free forms and separation of free hydrocortisone and corticosterone in the fractions was performed in 52 patients with caseous pneumonia. The patients with caseous pneumonia were found to have the phenomena of dyscorticism, which were characterized by the predominance of the concentration of corticosterone over that of hydrocortisone in the peripheral blood. These changes were proportional by the decreases in the activity of major energy enzymes and in the functional activity of lymphocytes. Under these conditions, the predominance of peripheral blood corticosterone levels determines the increased inflammatory potential and neutralizes the biological effects of hydrocortisone. The detected dyshormonal metabolic and functional changes form the essence of the pathogenesis of caseous pneumonia and the extent of caseous lung tissue necrosis. Under the influence of chemotherapy, complex disintoxication treatment in combination with prednisolone, there is a marked trend of the peripheral blood concentration of hydrocortisone to increase, for metabolism and lymphocytic functional activity to become normal.