BLOOD, liquid tissue circulating in the closed circulatory system of animals and humans; ensures the vital functions of all organs and tissues of the body and their performance of various functions. physiological functions; during ontogenesis it is formed from the embryonic connective tissue. tissue - mesenchyme. The science of blood formation and hematopoiesis is called hematology. The functions of oxygen are diverse: it transfers oxygen (O2) from the lungs to the tissues and carbon dioxide (CO2) from the tissues to the lungs (respiratory function), and transports nutrients. substances to the place of their consumption (trophic function), and metabolic products to the excretory organs (excretory function), delivers hormones, enzymes, mediators and other biologically active substances from the place of their production to the places of their active action (mediator function). Along with lymph and tissue fluid, K. is involved in maintaining the constancy of internal fluid. body environment (homeostasis). The heat exchange of K., located in the skin vessels of warm-blooded animals, with the environment helps maintain optimal body temperature (thermoregulatory function). It plays an important role in protecting the body from foreign substances, pathogenic microorganisms, aging and malignancies. cells (see Immunity, Phagocytosis). The protective function also includes blood clotting, due to which, with any injury, a blood clot is formed that prevents bleeding.
Only in a few low-active animals can oxygen transport a sufficient amount of O2 in a dissolved state without the participation of respiratory pigments. With the appearance of the latter during evolution (including hemoglobins, chlorocruorin and hemoerythrin, containing iron ions), the ability of K. to bind O2 and release it to tissues increases sharply. The most widespread red pigments in living nature (hemoglobins) are found in the erythrocytes of a number of invertebrates and almost all vertebrates. In invertebrates, the ratio of the mass of fluid that performs the functions of blood to body weight is much higher (up to 20–30% of body weight) than in vertebrates. The decrease in blood volume in the latter (2–8% of body weight) is explained by the closed circulatory system and the presence of respiratory pigments that effectively bind O2.
In mammals and humans, K. is a homogeneous red liquid; O2-saturated arterial blood is scarlet, venous blood is dark cherry in color. K.'s mass in adults is 6–8% of body weight, in newborns – up to 10%. The volume of human circulating blood increases from 200–350 ml at birth to 3.9 liters in women and up to 5.2 liters in men (on average). An increase in blood volume (hypervolemia) can be a consequence of both an increase in the number of blood cells and an increase in plasma volume (for example, after taking a large amount of liquid), a decrease (hypovolemia) - after blood loss, increased sweating, profuse vomiting, and frequent diarrhea. The stabilization of blood volume is facilitated by the secretion of the glands of the stomach (approx. 2 l/day), kidneys, etc. Approx. 80% of all K. circulates through the blood vessels, making a full revolution in the body of an adult in 50 s. A smaller part (approx. 20%) moves slowly, lingering in the vessels of the skin, liver, and spleen, called the K depot. In the capillaries, through the walls of which K plasma leaks, the speed of K movement does not exceed 3 mm/s.
Table of contents
- Erythrocytes (red blood cells)
- Leukocytes (white blood cells)
- Platelets (blood platelets)
Blood consists of 60% plasma. This is a yellowish-white liquid, which in turn consists mainly of water, as well as various proteins, salts, trace elements and vitamins. About 40% of blood consists of cells [cell], which are called blood corpuscles or blood cells. There are three types of blood cells, which are found in different numbers and perform different tasks:
- red blood cells (erythrocytes)
- white blood cells (leukocytes)
- blood platelets (platelets)
Hemostasis
The complex of body reactions aimed at stopping bleeding and maintaining circulating blood in a liquid state (hemostasis) involves the vascular endothelium, platelets (vascular-platelet hemostasis), and the blood clotting system (coagulation hemostasis). Impaired hemostasis leads to either bleeding or thrombosis. Normally, K.'s coagulation system is balanced by K.'s anticoagulant system, which includes natural. anticoagulants (heparin, antithrombins, proteins C, S, etc.), fibrinolytic. system (plasmin, urokinase and other plasminogen activators), as well as prostacyclin, salicylates and other disaggregants that reduce platelet adhesion. The anticoagulation system prevents thrombosis of intact vessels, limits the spread of the blood clot and promotes its dissolution after restoration of the integrity of the vessel. Age-related depression of fibrinolysis begins at 45–50 years of age, and is intensified by hypokinesia (limited movement) characteristic of older people.
Erythrocytes (red blood cells)
Most of the human blood contains red blood cells, which are also called red blood cells or red blood cells. They make up 99% of all blood cells. In one microliter of blood (that is, in one millionth of a liter) there are from 4 to 6 million red blood cells.
The most important task of red blood cells is to carry vital oxygen through the blood vessels (which enters the lungs) to the organs and tissues of the body. They perform this task with the help of the red blood pigment - hemoglobin.
If the number of red blood cells in the blood is not enough, or if there is little hemoglobin in the red blood cells and therefore they cannot fully perform their work, then we are talking about anemia, or anemia. “Anemic” people often have very pale skin. Since their body does not receive enough oxygen, they also experience symptoms such as fatigue, weakness, shortness of breath, decreased performance, headache or back pain.
The main thing in assessing the work of red blood cells is, first of all, not their number in the blood, but their volume, the so-called hematocrit (abbreviated in Ht tests), and the level of hemoglobin (abbreviated in Hb tests). For children older than infancy, the normal level of hemoglobin is considered to be between 10 and 16 g/dl, and the normal hematocrit range is between 30 and 49% (see table for details) [KUL2002].
If these indicators are significantly lower than normal and at the same time the child develops symptoms of anemia [anemia], for example, due to leukemia, or after chemotherapy [chemotherapy], then a transfusion (transfusion) of red blood cell concentrate (packed red blood cells, abbreviated as “ermass”) may be required ) to stabilize the child's condition.
| Child's age | Hemoglobin (Hb) level in g/dl | Hematocrit (Hk) indicator in % |
| 1 year | 10.1 — 13.0 | 30 — 38 |
| 26 years | 11.0 — 13.8 | 32 — 40 |
| 6 – 12 years | 11.1 — 14.7 | 32 — 43 |
| 12 – 18 years old women | 12.1 — 15.1 | 35 — 44 |
| 12 – 18 years old men | 12.1 — 16.6 | 35 — 49 |
Blood diseases
are caused by both the pathology of K. cells and disturbances in the composition of the plasma. The first group of diseases includes hemoblastoses, among which are leukemia and hematosarcoma, or malignancies. lymphomas, the second group includes some anemias and hemorrhagic diathesis. Much more common are reactive changes in blood cells (its cells and plasma) in response to internal diseases. organs or to changes in external conditions. A decrease in the level of red blood cells and hemoglobin is a symptom of anemia, an increase in their level is observed in pulmonary and heart failure, erythrocytosis, as well as in overexertion (the so-called stress erythrocytosis), etc. A decrease in platelet content is observed in infectious mononucleosis and other viral infections, with disseminated (scattered) intravascular coagulation of K. (DIC syndrome) due to increased capture of platelets in microvessels, with radiation sickness, immunothrombocytopenia - a decrease in the level of platelets caused by antibodies against their own. platelets, that is. an increase in their level - with metastases to the bone marrow, with hypernephroma, in the advanced stage of chronic. myeloid leukemia. A moderate increase in platelets is observed during physical exercise. and mental overload (so-called stress thrombocytosis), bacterial infections, toxicosis during pregnancy and the postpartum period. Activation of the blood clotting system without thrombus formation (hypercoagulation syndrome) occurs with injuries, infections, and tumors. Moderate leukocytosis (10–15 109/l) usually indicates inflammation. process - pneumonia, acute appendicitis, cholecystitis, etc., more pronounced - myeloid leukemia, sepsis, as well as opisthorchiasis, whooping cough. A decrease in the number of leukocytes is characteristic of acute viral infections and tuberculosis.
Quantitative and qualitative analysis of K. is important in the diagnosis of various types. diseases, organ and tissue transplantation, forensic medicine. examination (establishing the species, group, sex and age of the animal, how long ago its traces were formed, resolving issues of disputed paternity, etc.).
Due to the increasing shortage of donor blood, hematologists are faced with the task of obtaining more effective blood substitutes. Synthetic solutions have been created. hemoglobin (prototypes are undergoing clinical trials), a perfluorocarbon emulsion (perfluorane, oxynetite, etc.) is used, which has a high ability to transfer O2. Samples of hemalbumin (a compound of albumin with heme), which carries out O2 transport, the so-called. universal K., in which red blood cells are devoid of group and Rh antigens. See also Blood circulation, Red blood cells, White blood cells, Platelets.
Leukocytes (white blood cells)
White blood cells or white blood cells, also called leukocytes, together with platelets in healthy people, make up only 1% of all blood cells. A level of 5,000 to 8,000 leukocytes per microliter of blood is considered normal.
Leukocytes are responsible for the body's immune defense. They recognize “foreigners”, such as bacteria, viruses or fungi, and neutralize them. If there is an infection, the white blood cell count can increase greatly in a short time. Thanks to this, the body quickly begins to fight pathogens.
White blood cells are divided into different groups depending on their appearance, where they grow, and exactly how they work. The largest group (60 to 70%) consists of so-called granulocytes; from 20 to 30% are lymphocytes and from 2 to 6% are monocytes (“eater cells”).
These three types of cells fight pathogens in different ways, while simultaneously complementing each other's work. Only due to the fact that they work in harmony, the body is provided with optimal protection against infections. If the number of white blood cells decreases or they cannot work normally, for example in leukemia, then the body's defense against “foreigners” (bacteria, viruses, fungi) can no longer be effective. Then the body begins to pick up various infections.
The total white blood cell count is measured in a blood test [blood test]. The characteristics of different types of white blood cells and their percentage can be examined in a so-called differential blood test (leukocyte formula).
Granulocytes
Granulocytes are primarily responsible for protecting the body from bacteria [bacteria]. They also protect against viruses, fungi and parasites (for example, worms). And they are called that because their cellular fluid contains grains (granules). In the place where the infection appears, they instantly accumulate in large quantities and become the “first echelon” that repels the attack of pathogens.
Granulocytes are so-called phagocytes. They capture an enemy that has entered the body and digest it (phagocytosis). In the same way, they cleanse the body of dead cells. In addition, granulocytes are responsible for working with allergic and inflammatory reactions, and with the formation of pus.
The level of granulocytes in the blood is very important in the treatment of cancer. If during treatment their number becomes less than 500 - 1,000 in 1 microliter of blood, then, as a rule, the danger of infectious infections increases greatly, even from pathogens that are usually not dangerous at all for a healthy person.
Lymphocytes
Lymphocytes are white blood cells, 70% of which are found in the tissues of the lymphatic system. Such tissues include, for example, the lymph nodes, spleen, pharyngeal tonsils (tonsils) and thymus gland.
Groups of lymph nodes are located under the jaws, in the armpits, on the back of the head, in the groin area and in the lower abdomen. The spleen is an organ that is located on the left side of the upper abdomen under the ribs; The thymus gland is a small organ behind the breastbone. In addition, lymphocytes are found in lymph. Lymph is a colorless, watery fluid found in lymphatic vessels. It, like blood, covers the entire body with its branches.
Lymphocytes play a major protective role in the immune system, as they are able to specifically recognize and destroy pathogens. For example, they play an important role in viral infection. Lymphocytes “organize” the work of granulocytes, producing so-called antibodies in the body. Antibodies are small protein molecules that attach to pathogens and thus mark them as “enemies” to phagocytes.
Lymphocytes recognize and destroy body cells affected by the virus, as well as cancer cells, and remember those pathogens with which they have already been in contact. Experts distinguish between T-lymphocytes and B-lymphocytes, which differ in their immunological characteristics, and also identify some other, rarer subgroups of lymphocytes.
Monocytes
Monocytes are blood cells that go into tissues and there begin to work as “large phagocytes” (macrophages), absorbing pathogens, foreign bodies and dead cells, and clearing them from the body. In addition, they present part of the absorbed and digested organisms on their surface and thus activate lymphocytes for immune defense.
Human blood components
Human plasma consists of a liquid part - plasma and suspended cells, or formed elements, located in it. K.'s plasma is straw-yellow in color, making up 46–65% of the K.'s volume. The color is due to the presence in the plasma mainly. carotenoids and bilirubin. Plasma contains approx. 90% water (mostly comes from the gastrointestinal tract and kidneys) and approx. 7% diff. proteins - albumins (they account for more than 50% of all plasma proteins) and globulins (including factors and inhibitors of K. coagulation, proteins of the complement system, enzymes, lipo- and glycoproteins, ceruloplasmin, transferrin). Plasma also contains carbohydrates (mainly glucose), hormones, vitamins, cholesterol (usually associated with lipoproteins), and minerals. substances, dissolved gases, decomposition. metabolites, etc. The share of cations ($\ce{Na+}$, $\ce{K+}$, $\ce{Ca^2+}$, $\ce{Mg^2+}$) and anions ($ \ce{Cl-}$, $\ce{HPO^{2-}4}$, $\ce{HCO3^-}$) accounts for approx. 0.9% of the volume of acid. The acid-base balance of acid is maintained at a pH level of 7.4 for arterial acid and 7.34 for venous acid. In humans, even a slight acidosis (pHQ6.95) causes a coma or leads to death outcome. With alkalosis (pH up to 7.7), convulsions occur. There are effective systems that can ensure the removal or neutralization of H+ ions when they are in excess or the retention of H+ ions when they are deficient. Such systems include the K. buffer systems, respiratory (lungs) and excretory (kidneys) systems. The properties of buffer systems depend on the presence of salts of weak acids (mainly carbonic acid), as well as hemoglobin (it dissociates as a weak acid), low molecular weight organic. acids and phosphoric acid. To maintain a constant plasma pH, carbonic acid (bicarbonate buffer system) is of greatest importance, and the pH of whole plasma is proteins (primarily hemoglobins, which provide approximately 75% of the total buffering capacity).
Osmotic plasma pressure is determined by the sum of all its components—molecules, ions, colloidal particles. It is supported physiologically. mechanisms at a constant level, which is important for the normal functioning of all body tissues. In the main osmotic pressure depends on the content of sodium chloride and other low-molecular substances in K., as well as proteins, Ch. arr. albumins, which hardly penetrate the capillary endothelium. Protein-dependent osmotic pressure is called colloid-osmotic, or oncotic. It is only approx. 0.5% osmotic value. pressure and determines the degree of water retention in the vascular bed (hydremia), the rate of urine formation and absorption of water in the intestines. Proteins give blood a certain viscosity, which slows down the speed of its movement through the vessels. Plasma viscosity K. 1.7–2.2 Pa s, solid K. – 4.5–5.0 Pa s; the first increases with profuse sweating, increased content of red blood cells per unit of peripheral volume. K. (erythrocytosis), the second is directly proportional to the number of red blood cells. The density of plasma is 1.024–1.030 g/ml (depending mainly on the content of proteins), whole plasma – 1.050–1.060 g/ml (depending mainly on the content of red blood cells, proteins and lipids in it). The exchange of substances between plasma and tissue cells occurs through the intercellular fluid. Plasma after one of the coagulation factors, fibrinogen, has been removed from it is called blood serum.
Cells K. – erythrocytes, leukocytes and platelets. Most numerous K. cell fraction – erythrocytes (red blood cells); they are biconcave, disc-shaped and have no nucleus. The total surface of all red blood cells K. approx. 300 m2, which is 200 times the surface of the body. Basic their function is to participate in the transport of gases. The most important role in this process belongs to the hemoglobins present in these cells and the enzyme carbonic anhydrase, which mainly provides. CO2 transport. Red blood cells are also carriers of group and Rh antigens (see Blood groups, Rh factor). The shape of red blood cells can change due to the elasticity of their membrane, which allows them to pass through capillaries, most of which have a diameter of 5 microns. In humans, 1 mm3 of blood contains 4.5–5.5 million red blood cells (men have slightly more than women); their total number in K. is up to 25·1012. In addition, K. contains immature red blood cells - reticulocytes; normally they make up 0.2–1.2% of the total number of red blood cells. Red blood cells are destroyed primarily. in the spleen, which is called the “graveyard of red blood cells,” as well as in the bone marrow and liver.
Leukocytes, or white blood cells, are represented by granulocytes (basophils, neutrophils, eosinophils) and agranulocytes (lymphocytes, monocytes). They, unlike erythrocytes, are larger, colorless, contain a nucleus and are present in cells in the amount of 6–9 thousand per 1 mm3 K. Leukocytes perform a protective function, providing phagocytosis of microbes, cell breakdown products, and also participate in the formation of immunity . They have an amoeba-like movement, which allows them to pass between capillary endothelial cells into surrounding tissues; Neutrophils and monocytes are especially active, showing the greatest ability for phagocytosis. Lymphocytes (the main types are B- and T-lymphocytes) occupy a special place in the K system. They are considered as the center. link in specific immunological reactions (see Immunocytes) as plasmatic precursors. cells that produce antibodies, and as carriers of immunological memory (B- and T-memory lymphocytes).
Platelets (blood platelets) have a diameter of approx. 4 µm; in 1 μl of K. there are 180–320 thousand of these cells. They contain 11 coagulation factors, enzymes of glycolysis, ATP, and a number of other compounds. They exhibit the ability to adhere to endothelial cells in places where the vessel wall is damaged and are necessary to start the blood clotting process.
The ratio of the mass of cells to the total mass of cells in an adult is 35–54%, in children – 55%. The cellular composition of blood cells and hematopoietic organs, in which the process of gradual formation of mature cells of blood takes place from the “parental” elements - hematopoietic stem cells (about 30 thousand, mainly in the bone marrow), in a healthy body is a system located in dynamic equilibrium: the continuously occurring destruction of “aged” blood cells is balanced by the formation of new ones in the hematopoietic organs. Intrauterine hematopoiesis in humans begins in the yolk sac of the embryo at the end of the 2nd week after conception, simultaneously with the development of blood vessels. From the 4th–5th week of pregnancy until childbirth, it occurs in the liver. From the 4th to the 6th month of fetal development, it also occurs in the spleen. Bone marrow hematopoiesis is formed at 14–16 weeks of pregnancy. In an adult, the hematopoietic organs, along with the bone marrow (the main hematopoietic organ), include the spleen, thymus, and lymphatic. nodes, Peyer's patches of the small intestine. The composition of calcium changes during intense digestion, heavy sweating, excitement, pregnancy, etc.
Platelets (blood platelets)
Blood platelets, also called platelets, are primarily responsible for stopping bleeding. If damage occurs to the walls of blood vessels, they clog the damaged area in the shortest possible time and thus stop the bleeding.
Too low a platelet level (occurs, for example, in patients with leukemia) manifests itself in nosebleeds or bleeding gums, as well as small hemorrhages on the skin. Even after the most minor injury, bruises may appear, as well as hemorrhages in the internal organs.
The platelet count in the blood may also drop due to chemotherapy. Thanks to transfusion (transfusion) of blood platelets (platelet concentrate), as a rule, it is possible to maintain an acceptable level of platelets.
The mystery of “blue blood”: The tragic fate of the creator of perftoran
"Unsolved Mysteries": The Mystery of the "Blue Bloods"
Early 1980s. Soviet science is making a breakthrough. Professor Felix Beloyartsev announces the creation of an emulsion capable of performing the functions of blood - carrying oxygen throughout the body.
Have scientists really managed to recreate human blood? Nevertheless, the facts speak for themselves. Beloyartsev’s drug, perftoran, saves lives. However, unexpectedly, “blue blood” – as journalists dubbed the drug – is banned.
So what secrets does “blue blood” hide and why was the world’s first artificial substitute for human blood banned in the USSR? Read about this in the documentary investigation of the Moscow Trust TV channel.
In the midst of destruction
December 17, 1985. The frozen dacha of pharmacologist Felix Beloyartsev. Investigators are hastily turning things over and tapping on the walls. Sitting in the middle of the destruction, Beloyartsev calmly waits for this farce to end. Having found nothing, the prosecutor's office workers leave.
The professor is left alone. In the morning they will find him in the noose. The reason for the suicide of the 44-year-old scientist remains a mystery to this day. Almost all 20 volumes of the investigation are either securely hidden in the archives or destroyed.
“These matters, personal (we say in quotes - “business”) - they are still classified. Both the suicide case and Beloyartsev’s investigative case are closed, so everything I say is, as scientists say, interpolation,” explains historian Alexei Penzensky.
The search at Beloyartsev’s dacha is a consequence of a denunciation. One of his colleagues shared valuable information with the authorities: supposedly the professor was doing repairs at his dacha, and was paying the workers with alcohol from the laboratory. This accusation is insulting and ridiculous. For those who remember the 80s, it is clear that alcohol is just a reason to start checking. It gets stolen everywhere.
Photo: TASS/Pavel Smertin
Alexey Penzensky, historian: “This is the alcohol that was stolen and stored in a safe. If there was no safe in the laboratory, there was a case when the director of a chemical laboratory told me that after or during repairs the bottle became empty. They are coming. What's happened? The builders are drinking."
However, Beloyartsev is facing another charge. Rumors are spreading around the city that the laboratory management is extortionately taking salaries from employees. Of course, revelries and banquets are organized with the stolen money.
“One of the unfortunate violations of the rules that the unfortunate Beloyartsev committed was the fight for funds. This is known in Soviet science. This was the main prize. It was a carrot that laboratories, research teams, entire institutes, academies of sciences ran after these carrots.
Funds. Funds. What did our hero do? He agreed and ordered the employees to donate part of the bonus (some percentage) to the fund for their development. Project Development Fund, as they would say now,” says Alexey Penzensky.
Beloyartsev is fanatically devoted to his work. He constantly orders unique devices, paying for them with money from bonuses. All this is done with the sole purpose of creating a drug that will change history.
Blood substitute
Late 70s. The threat of AIDS looms over the world. Cases of diseases resulting from blood transfusions have become more frequent. Scientists from different countries are struggling with its artificial substitute. But only Beloyartsev succeeds. In just three years, his laboratory in Pushchino, near Moscow, begins to produce an emulsion capable of saturating the body with oxygen. The drug is called "Perftoran".
“An emulsion that could transport gases - oxygen and carbon dioxide. Why? Because this is generally the only liquid that has such a high capacity for these two gases. These properties were discovered a long time ago, back in the 40s of the last century,” explains biologist Elena Tereshina.
The press widely covers this discovery and calls perftoran “blue blood.” In 1985, Beloyartsev’s drug was nominated for a State Prize, so the persecution and suicide of its creator comes as a shock to many.
“The man was simply driven to suicide. And the man fell into these gears of this machine. He took on Goliath. And in this fight Beloyartsev had no chance. Moreover, Ivanitsky, his right hand, his, as I understand it, his closest confidant, was almost pulled into these gears. Yes, and a neighbor. In Pushchina we lived together, in the same city. He was, however, only brought to a heart attack,” says historian Alexey Penzensky.
This is especially incomprehensible to Anya Grishina’s parents. A five-year-old baby, having once escaped from her nanny, jumps out onto the roadway. It would not have been difficult to save the child if the doctors had not mixed up the donor blood. A strong reaction begins in the girl’s body. Fighting for Anya’s life is becoming more and more difficult. The last hope remains - Beloyartsev’s artificial blood. But the drug has not yet been tested.
Photo: TASS/Artem Geodakyan
“Perftoran - it has already been fully tested on animals, documents were sent to the pharmaceutical committee for permission to clinical trials, but permission has not yet been received. And Mikhelson, who was in charge of this department at the clinic, called Beloyartsev, and Beloyartsev, at his own risk, brought two bottles of perftoran,” says biophysicist, Felix Beloyartsev’s colleague Genrikh Ivanitsky.
The girl remains alive. And perftoran demonstrates its undeniable advantage - it suits everyone without exception, while ordinary blood has an amazing property: when transfused, it accepts only its own group, and fights with someone else’s. Nevertheless, it is precisely this ability of the blood to stand guard over the body that helps it fight infection.
“Our blood is a unique liquid in its protective properties. It is simply impossible to think of anything else, how quickly do leukocytes adapt to the pathogenic microflora that appears, how quickly they begin to work. And there are only individual cases when a leukocyte approaches and does not recognize this microflora. I see: a rod-shaped bacterium is swaying, for example, a leukocyte approaches, stands, thinks and moves away,” explains hematologist Olga Shishova.
Running through the veins
For centuries, the red substance flowing in the veins has been a mystery to mankind. To compensate for its deficiency, blood was even transfused from animals. Needless to say, many such experiments ended in death.
Today, thanks to a microscope, this mysterious substance is revealing some of its secrets. One of them is the amazing ability of blood cells (erythrocytes) to stick together under stress, forming columns of coins.
“A unique phenomenon about the gluing of red blood cells. Any tension we create creates a spasm in the body. As they say: everything inside became cold. What is a spasm? This means that the peripheral capillaries have narrowed and all the blood is in a small space. And this means that your hands are already cold, your feet are cold, your head hurts, your vision has deteriorated, your internal organs are not supplied with blood at a sufficient speed, and your red blood cells stick together, becoming “coin columns.” And their ability to deliver oxygen is impaired,” says Olga Shishova.
When red blood cells are stuck together, the blood becomes thick and has difficulty passing through the smallest capillaries. And in such a situation, the artificial substitute again proves its superiority over nature. Perftoran breaks up the “coin columns” of red blood cells, improving blood circulation.
“This is a very big problem, how to destroy this stasis, how to destroy these “coin columns.” And it turned out that perftoran has the ability to destroy this. They say that... The exact mechanism is not known, but they say that there are two components at work: the fluorocarbons themselves and the surfactant on which this perfluoran is made. The surfactant destroys the columns, and fluorocarbons transport gases,” says Elena Tereshina.
And yet, the main advantage of perftoran is that it does not come into conflict with the patient’s blood. Why? Everything is very simple. Particles of “blue blood” are so small that immune cells simply do not notice them.
“If foreign proteins enter the body, the blood begins to pull them out, and the person’s temperature rises. Well, the flu, for example, or any infection that enters the body. And perfluorocarbons - if they are broken down very finely, they will not be recognized by the formed elements that provide blood protection,” says Henryk Ivanitsky.
Check by Afghanistan
The first successful use of perftoran should bring glory to its creators. But instead, rumors are spreading throughout Pushchin that Beloyartsev is testing the drug on children and mentally retarded patients in boarding schools. And that the testing grounds for the experiments were hospitals overflowing with wounded from Afghanistan. What's really going on?
“There was a war in Afghanistan, and in difficult clinical conditions there was not enough donor blood, and therefore one of the heads of the department (Viktor Vasilyevich Moroz) - he did it at his own peril and risk, however, with the permission of his superiors, there is still discipline in the army. He took bottles of this perftoran with him to Afghanistan,” explains Genrikh Ivanitsky.
"Blue blood" is being transfused to several hundred wounded in Afghanistan. Once again, the use of perftoran gives great hope. Finally, on February 26, 1984, the USSR Pharmaceutical Committee gave permission for clinical trials of the drug. But soon after this, a criminal case was opened against Beloyartsev. The tests stop. At the same time, the events taking place around the “blue blood” are shrouded in secrecy. Why was perftoran banned?
“Brezhnev’s Soviet Union is a confederation of clans. No one there was interested in how talented you were. One thing was important: how strong your cover was. And do you have someone in the Central Committee, or even better, do you have a personal patron in the Politburo? And those who managed to reach the top and establish good relations prospered,” says Alexey Penzensky.
Photo: TASS/Artem Korotaev
Beloyartsev does not have such cover, so several denunciations to the KGB trigger a chain of tragic events. But who decided to settle scores with the scientist? Surprisingly, there would be a lot of people willing. The professor is perceived as a tough leader. But who else would force their subordinates to give up part of their bonus to purchase laboratory equipment? Maybe that’s what they remembered him for.
“Now they shrug their shoulders: “Well, just think, 20 percent of the bonus.” Do not understand. In the 80s, the prize was sacred. It’s there, I don’t know what exactly he had, they, in his team, what kind of bonuses there were, how often they were paid, and, again, they don’t name the amount, but it was sacred. And to encroach on the prize like this was a gross violation of the rules,” Penzensky asserts.
The machinations of competitors
But there is another version: in parallel with Beloyartsev, they are trying to create artificial blood at the Institute of Hematology and Blood Transfusion. True, to no avail. And then the employees of this establishment write a denunciation against the competitor.
However, the case is unlikely to be motivated by ordinary envy. In the late 70s, Soviet intelligence managed to obtain samples of artificial blood that the Japanese were developing. The drug is called "Fluasol". The Institute of Hematology receives from the Ministry of Defense the task of bringing it to fruition, and in the shortest possible time.
Elena Tereshina worked at the Institute of Hematology at that time. Today for the first time she speaks about the background of the conflict.
“Well, if it’s my personal opinion, I don’t think the KGB played a role here. Why? Because, in principle, who brought this bottle of Fluasol? These were scouts who found out that there was such a direction, they quickly brought this bottle. The Ministry of Defense was working. It was a government order. What did Beloyartsev do that the KGB would pay attention to - I think there was nothing like that,” says Elena Tereshina.
What happens? The Institute of Hematology is conducting secret development for the military department. Suddenly Beloyartsev appears, who creates artificial blood, spending about three years and mere pennies on it. The managers of the secret development must have gone through some very unpleasant moments, making excuses to the customer for their own failure.
“Because they began to put pressure on them: “Why did you spend so much money and do nothing?” Yuri Anatolyevich Ovchinnikov (then he was vice president) - in fact, at first he had a very positive attitude towards this work. And we even had friendly relations, and everything was fine. But when these conflicts began, he said: “You know what, give up this job altogether. Why the hell is it needed, because there will be so many troubles later,” says Heinrich Ivanitsky.
But Beloyartsev’s competitors risk not only their reputation. We are probably talking about millions of investments, which stop with the advent of perftoran. It is not surprising that a denunciation of the scientist soon falls on the desk of a KGB investigator.
And while the professors are being harassed by humiliating inspections, all research on perftoran has been suspended. Beloyartsev is acutely worried about the fact that he cannot defend his name. After another search, he takes his own life, leaving a suicide note: “I can no longer live in the atmosphere of this slander and betrayal of some employees.”
“He defended his doctoral dissertation at the age of 33, which is an extremely rare case in medicine. Therefore, he was spoiled by fate, and this, apparently, was the first stressful situation in his life. This is the first point. The second point was that there was a terrible resentment, because it seemed that everything was the other way around: people did an excellent job in a short time, but instead they not only stopped the work, but also labeled him a swindler and so on.
And the third point - this was to some extent connected with specific circumstances, that he was alone at the dacha. Because if someone were nearby, he would have discharged himself simply by talking, perhaps,” says Henryk Ivanitsky.
Main enemy
But that's not all. Influential hematologist Andrei Vorobyov is an opponent of artificial blood. What is the reason for his hatred of perftoran? There is no answer to this question. One thing is clear: this man did everything to ensure that the “blue blood” never entered production.
“Hematology Research Center, VGNC,” he became its director. He was an opponent of this trend in general, a very tough opponent. In general, when he had his inaugural speech, when he became the director of this institute, he said: why all these infusion drugs? You can also pour in sea water - they won’t die,” says Elena Tereshina.
The official was not mistaken in this. Sea water really wouldn't hurt anyone. After all, human blood is surprisingly similar in composition to this brackish liquid.
“The composition of blood is almost completely identical to the composition of sea water, except for the salt content. This question remains a big mystery today. None of the experts can intelligibly answer this question - why our blood coincides with sea water. Moreover, we all know from our own experience that we can stay in sea water for a long time, while the skin does not deform or suffer in any way. But, if we are in fresh water for a long time, the salts are washed out, and the skin begins to wrinkle, and we feel uncomfortable,” says orientalist Pyotr Oleksenko.
Photo: TASS/Boris Kavashkin
This paradox must be explained by the fact that life originated in the ocean. But is that the only thing? Thanks to the study of the mysterious properties of blood, scientists make amazing discoveries. One of them belongs to professor of genetics Oleg Manoilov.
In the 20s of the last century, he collected in his laboratory the blood of representatives of almost all races and nationalities living on Earth. Manoilov forces all blood samples to react with a special solution, the composition of which is known only to him. And he gets amazing results: the blood of people of some nations changes its color to blue when reacting. The remaining samples remain unchanged. But what conclusions follow from this?
“That is, depending, perhaps, on race or ethnic type, the blood changed its color. But later a conclusion was made, or, most likely, a hypothesis was put forward by genetic scientists, that the races of people did not originate from one ancestor, but there was a different source, and that different races, accordingly, have different blood,” says Pyotr Oleksenko.
Gift of ancestors
It is possible that once upon a time there lived on Earth creatures in whose veins there was a substance that was not red, but a completely different color - blue blood. This expression originated in medieval Spain to refer to aristocrats. Their pale skin showed bluish veins, which distinguished them from the dark-skinned commoners. However, soon, according to some scientists, this expression will have to be taken literally.
Petr Oleksenko is an expert on ancient Eastern civilizations. He believes that the ancestors of modern civilization were indeed blue blood, and in the most literal sense.
“Today we know that the phenomenon of blue blood is not just words, so-called blue blood, but, apparently, in fact, in the history of mankind, blue blood once existed in the process of human evolution. Today we know that our red blood is primarily red because respiratory pigments are based on hemoglobin, and hemoglobin is based on iron ions,” says Oleksenko.
Blood, which contains copper ions, has a blue or blue color. Based on the metal vanadium, it will be yellow or brown. But why is perftoran called “blue blood”? Indeed, contrary to the erroneous belief, it is white in color and looks like milk. It turns out that the whole point is that the veins of the person to whom this emulsion was transfused acquire a bluish tint.
“When you pour the white emulsion into the veins, it shows through the veins in your arm with a blue color. Our veins are so blue. Blue - because there is red blood. And if you pour in a white emulsion, they will be a pale blue color. That’s why it got its name – “blue blood,” explains Elena Tereshina.
So, work on perftoran was stopped due to persecution of Professor Beloyartsev. But is this the reason for the ban? Several documents from the criminal case, which miraculously leaked to the press, provide unexpected details: when trials of the drug on patients at the Vishnevsky Hospital began in 1984, for some reason no one recorded their results. But what do the testers want to hide?
Vladimir Komarov is an immunologist who participated in the medical programs of the KGB and the FSB. In his opinion, perftoran was banned due to its significant shortcomings.
“It had a large molecular weight, it did not penetrate into the tissues themselves, and it seemed to be in a vessel. But intimately, with the tissue of the affected organ, it did not reach there. He couldn't transmit oxygen deeply. And a possible situation arose when there was a lot of oxygen in the blood itself, but there was none in the tissue. Moreover, I again emphasize that molecular oxygen is a chemically inert molecule. It is not capable of being absorbed by this tissue,” says Vladimir Komarov.
Photo: m24.ru/Vladimir Yarotsky
The materials of the criminal case also noted that perftoran was administered to 700 sick and wounded people in Afghanistan. And this was before the drug was officially approved. Investigators learned that more than a third of them died. Have scientists rushed to declare that perftoran is harmless?
“Perftoran is about the same as a Teflon frying pan or saucepan. These fluorates themselves affect blood viscosity and can affect metabolic changes in a pathological way, because this is again a foreign element. And I heard that this drug can also have a negative effect on reproductive functions in women,” says Vladimir Komarov.
Doctors' mistake or total failure?
During the investigation, KGB officers learn about the death of the experimental dog Lada. The scientists were extremely proud that during the experiment, 70 percent of her blood was replaced with perftoran. The autopsy results are horrifying: the four-legged animal has the last stage of liver cirrhosis. Was the professor really in a hurry to receive the notorious State Prize? And yet, it was never possible to prove that “blue blood” destroys the liver.
“Fluorine compounds are completely harmless, they are metabolically inactive and physiologically inactive in the sense that they do not cause any harm to the body. Their only negative quality was that they accumulated in the liver. Liver macrophages captured these particles, and compounds were selected that would be quickly removed from the liver,” says Elena Tereshina.
The unfortunate dog was probably infused with an experimental sample of perftoran. And the wounded in Afghanistan die because their wounds are incompatible with life. And yet, “blue blood” is able to compete, and quite successfully, with ordinary humans.
So why was perftoran banned in the Soviet Union? Many are still convinced that the case against their boss was fabricated. And not just anywhere, but in the KGB itself. The professor, due to his duty, is forced to receive foreign delegations, so he is approached with an urgent request - to transmit reports on meetings with foreign colleagues to the authorities.
Historian Alexey Penzensky conducted his own investigation and discovered an interesting fact in Beloyartsev’s biography, which is almost never talked about.
Photo: TASS/Valery Matytsin
“He had to receive foreigners, travel abroad, carefully monitor who communicates with foreigners among the delegates, so that foreigners are not shown people, so that they do not know about their existence at all, those who are conducting secret developments. Attend all meetings. Many things. Well, of course, write. Not exactly denunciations. What does denunciation mean? Denunciations are written by amateurs. And these people called the report, he is a full-time employee of the authorities. Institute department for work with foreigners. At any institute,” says Alexey Penzensky.
Beloyartsev's independent character rebels against such a need. The professor resolutely rejects the KGB's proposal. And what followed the refusal in such a case is not at all difficult to guess.
“If he opposed the appointment from above, as, for example, Beloyartsev opposed the appointment of deputy director for work with foreigners. Naturally, what a position it was! She was a KGB person through and through. He objected. The appointment took place anyway, as far as I understand. But he received a “tick” in his personal file,” explains Alexey Penzensky.
KGB pressure
That's when the problems with the KGB begin: interrogations of Beloyartsev's subordinates, searches of his house, absurd accusations. The tragic ending at the scientist’s dacha puts an end to this story. But driving to suicide is not too cruel revenge on an intractable scientist?
Not to mention sabotage on a national scale. Did the security officers really decide to take such a step? The reality turned out to be sadder and more terrible: the scientist came under attack because of his closest associate.
Genrikh Ivanitsky is one of the creators of perftoran and the right hand of Felix Beloyartsev. Today, for the first time, he explains the reason for the scandal with the KGB. Who would have thought that the notorious housing issue intervened in the matter.
“I was the director of the center, and when we delivered each new house, we had to allocate a certain percentage to military personnel who were demobilized. Then they gave a certain percentage to the builders, the rest went to the research workers, and sometimes (very rarely) they gave a certain number of apartments to employees who are in law enforcement agencies,” says Ivanitsky.
The era of socialism. Apartments are not sold, but distributed. Ivanitsky combines work on perftoran with the position of director of the Pushchino Scientific Center. And in this capacity, he has the right to distribute apartments in new buildings to his employees. Following unwritten laws, from time to time he donates housing to KGB officers. But one day a scandal breaks out around such an apartment.
“Then an employee who worked here, in the State Security, in the center itself (one of the employees), told me that they come there, organize drinking parties, bring some women. We went and opened this room and found that the entire table was filled with bottles and so on. I said that we are taking this apartment, because with the shortage of apartments that exist, in general, we need such an apartment more than you do. Later they told me: “You're crazy! How did you immediately…” But nevertheless, I took such a step,” recalls Heinrich Ivanitsky.
Photo: TASS/Yuri Mashkov
Then the organs fall on both creators of the “blue blood”. Moreover, Beloyartsev, as the project manager, suffers much more. After his death, attacks against Ivanitsky continue.
Meanwhile, work on perftoran is temporarily prohibited until the investigation is completed. According to this version, it turns out that a drug with an impeccable reputation simply became a hostage to the conflict. But then, where do the rumors come from that perftoran can cause cancer?
“I think that as a foreign element, everything foreign can cause and enhance cancer formation, let’s say. That is, here it is clear that if we worsen metabolism, then we first of all worsen oxygen nutrition. And cancer loves to live where there is no oxygen,” says Vladimir Komarov.
In some animals that received blue blood injections, suspicious nodules were found on the images. The drug is sent for research to Kyiv. Scientists are studying the effects of perftoran on rats. However, it cannot be proven that it causes cancer. On the contrary, animals that have received artificial blood transfusions live longer than their relatives.
“Parts of mice were infused with perftoran. And they wanted to see if this part would develop all kinds of tumors. But the end result was completely the opposite, that control died after a certain period of time, and these people all live and live. And they cannot send a conclusion, because... Then, in the end, I called there and said: “Guys, why are you holding up there?” And they say: “We can’t do anything. They live with us,” says Heinrich Ivanitsky.
But, apparently, investigators are still eager to prove that perftoran is unusually dangerous. Then they resort to forgery. It's 1986. The Chernobyl disaster is on everyone's lips. The KGB officers decide to transfuse artificial blood to the liquidators of the accident, and attribute all the consequences of radiation to the effect of the drug. However, everything turns out exactly the opposite: those who were infused with the drug recover faster than others.
“They wanted to prove that he was bad, let’s put it this way, they sent him to Kyiv, and there were people there... Chernobyl just happened. And in 1998 I met a man who was a liquidator, and a friend from the KGB told him: “Let us use it for you.” And so, as he says, by chance or not, out of the entire brigade in 1998, he was the only one alive,” says businessman Sergei Pushkin.
However, despite all the positive qualities, perftoran cannot be called blood. This is an artificial emulsion capable of performing a single function - gas exchange. It is impossible to create an analogue of real blood.
“What controls this system? This cannot be said to be controlled by the brain. What are the control parameters? Therefore, I believe that blood is the most mysterious organ. Textile. Or an organ. You don't know what to call him anymore. Both tissue and organ, because it has its own functions, it’s not just some set of cells,” explains Elena Tereshina.
Spiritual substance
People have long believed that blood is a spiritual substance. Surprisingly, today scientists confirm this guess. Even when separated from a person, blood recognizes its owner. The red blood cells seem to be attracted to him, wanting to reunite with him. Under a microscope, scientists observe how the properties of blood change during prayer.
Olga Shishova, hematologist: “Amazing. I sometimes do this: I take a drop of blood, look at it and, if I see a lot of problems, I tell the patient: “Now pray. Now meditate. Now calm your brain. And after a while I will take blood from you.” And it turns out that, firstly, we see what dramatic changes when a person comes into concentration, when he begins to understand himself a little in this world.
Maybe that’s why the “blue bloods” went through such a difficult path. Its creators challenged nature and were as if punished by higher powers for this. In the early 90s, the modern history of Russia begins and the ban on perftoran is lifted.
Nevertheless, the fate of the “blue blood” will continue to be difficult. State funding will cease, scientific laboratories will survive as best they can. “Blue Bloods” will be bought by a private company.
Photo: m24.ru/Vladimir Yarotsky
Sergei Pushkin opened his own production of perftoran in the early 90s. However, the income from the “blue blood” turned out to be less than could be expected. This is all due to the distrust of doctors who cannot forget Beloyartsev’s disagreement with the authorities.
“It was 1997. That is, the drug was already registered, a registration certificate was received, but there was no license for release. This was precisely the difficulty, because all the doctors remembered her. And the drug had to prove that it really works, that there are no dangers of using perftoran, at least about which were written then, in the 80s,” says Sergei Pushkin.
Today, perftoran is produced in limited quantities. Donated blood is still transfused in hospitals. And “blue blood” is used in small doses in cosmetics. Why did perftoran suffer such a sad fate? The reason is simple: complex emulsion production, packaging under sterile conditions - all this is expensive.
“His life as a blood substitute is gradually beginning to fade away. But the difference here is that for blood replacement you need a lot of perftoran, but as a therapeutic drug you need very little, because when blood replacement occurs, you need to pour 20 milliliters per kilogram of weight in case of blood loss, but here two or three milliliters per kilogram of weight is enough in order to restore various functions. But a lot of things were also revealed there related to the treatment of burn injuries and so on. So his fate is twofold,” – Henryk Ivanitsky.
Today we have learned how to treat donor blood so that it does not come into conflict with the victim’s blood. Still, perftoran lost the fight. What nature created once again turned out to be more perfect than all human attempts to recreate something similar in the laboratory.
Plot: City stories
Signs of the composition of urinary stones
- changes in the biochemical blood test ( increased levels of calcium , phosphorus, uric acid);
- changes in general urine analysis (presence of salts in sediment);
- changes in daily biochemical urine analysis (increased excretion of calcium, phosphorus, uric acid, oxalates)
In addition, X-ray examination can provide the composition of kidney stones . Stones that contain calcium (such as oxalates and phosphates ) are clearly visible on X-rays, while urate stones (which do not contain calcium) do not block X-rays and therefore are not visible on X-rays (called X-ray negative stones).
Thus, in most cases, the doctor is able to determine the chemical composition of the stones, which is crucial both in selecting the optimal treatment and in preventing the re-formation of stones (see nutrition for urolithiasis).
Author: candidate of medical sciences, doctor of the highest category, Rotov Anton Evgenievich
Questions about the article
Alexei
October 15, 2021 at 02:32
They did an analysis of the stone that was removed from the ureter of the Mother (68 years old): OXALATES Vewellite (calcium oxalate monohydrate) 97.0% Anhydrous uric acid 3.0% One stone still remained in the kidney, the hospital said that after a while they would try to crush it. What can you recommend as a preventative measure for the future and regarding the removal of the remaining stone in the kidney? The mother also has hypertension, osteoporosis and joint problems.
Alexei
October 12, 2021 at 13:00
Please tell me, we want to submit the stone for analysis, which one is better? For example, in in vitro there are 2 options: the X-ray phase analysis method and the infrared spectrometry method, or would you recommend another one?
Anton Evgenievich Rotov
October 13, 2021 at 10:19 am
It does not matter. Any of the methods is quite accurate.
Meruert
October 11, 2021 at 11:54 am
Dd...I’m 29 years old; they couldn’t remove a stone in my left kidney (narrow ureter) and put a stent into my lower pelvis. Size 04×03×04 cm, density 450 put...what should be taken to dissolve? Sooooo I don’t want recurrence of attacks (((Thank you
Anton Evgenievich Rotov
October 13, 2021 at 10:22 am
Unfortunately, not all stones can be dissolved, only those consisting of uric acid. I would not rely on the density determined by CT scan, since the size of the stone is very small and the error is very large.
