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The attempts to use different indices, characterizing human adaptive abilities, in the interests of applied medicine, have found their reflection in the transactions of famous scientists (Agadjanyan, 1997; Anohin, 1962; Vasilivskiy, 1977, Kaznacheev, 1980; Kopanev, Vlasov,1982; Kochetkov, 1990; Medvedev, 1984; Meerson, 1981, 1991; Orbely, 1961; Slonim, 1964; and many others).
Using the term “adaptation”, many authors mean different aspects of the interaction of living organism with the environment:
" the result of the evolutional process of adaptation development;
" the process of the organism adaptation to the environmental conditions;
" the condition of the balance between the organism and the environment.
The last approach to the determination of the adaptation obviously doesn’t only reflect the main point of the phenomenon, but also has a very distinct applied orientation. At the same time the term “balance” can’t adequately reflect the dynamic changes in the organism, permanent violations of the balance, directed to keep the homeostasis. That is why it would be more correct to say about stable non-balance, the main point of which E.Bauer revealed in his work (1935). The conception of adaptation in such a way is the basis for the forming of the adaptive response and adaptation development.
Human life is closely associated with the influence of different stimuli: gravitation, atmosphere pressure, temperature, electromagnetic radiation and other factors. The influence of stimuli first of all leads to the increase of organism tonus and, along with it; permanent changes take place under the influence of the environment. However, the organism systems selectively respond to every stimulus from the whole aggregate of them. The investigations show that the main factors in the organism response to this or another stimulus are:
- relative power or intensity of the affecting stimulus;
- relative amplitude-temporal dynamic stimulus characteristics (exposure time, rate of rise, coming out on plateau, descent rate, cumulative dose);
- underlying localization of the stimulus application (central nervous system, respiratory tract, gastrointestinal tract, skin and others).
Ðåøåíèå òàêîé ñëîæíîé çàäà÷è, êàêîé ÿâëÿåòñÿ öåëîñòíàÿ îöåíêà ñîñòîÿíèÿ îðãàíèçìà, äîëæíî îñíîâûâàòüñÿ íà ñèñòåìíîì ïîäõîäå, èçó÷åíèè âçàèìîâëèÿíèÿ ïðîöåññîâ, ïðîòåêàþùèõ â îðãàíèçìå.
Forming of the system response depends on the influence of the mentioned factors and individual genotypic features. This process has non episodic, but permanent nature, i.e. indissolubly connected with the vital activity of the organism and is the basis f the process of “stable non-balance”, according E.Bauer (1935). The possibility to respond to both strong and weak stimuli should be emphasized too. From this point, stress response, described by G.Selie (1960), is only a particular manifestation of this system response to the very strong stimulus.Investigations, carring out in the Institute of the Air and Space Medicine, allow to establish common biologic regularities of the discrete changes of blood composition arisen from the influence of various agents modified by different doses and dynamic characteristics (Pic.1). On basis of received regularities the scale of the organism adaptive condition was formed. Adaptive level and coefficient of reaction are the indices of this scale (Pic.2). Zero level – the level, when the blood indices, taking into consideration by revealed regularties, have minimal values. Adaptive level represents reccurent phases of blood composition changes. Coefficient of reaction is the formalized index of blood composition changes within every phase.
Adaptive level obliquely characterizes the power budget of the organism for responding to the influence of the external and internal environmental factors. Coefficient of reaction reflects the degree of the energy resources sufficient to form adequate system response. Both adaptive level and coefficient of reaction regards as adaptive organism potential.
Discontinuity of the adaptive response changes can be explained by the portional inclusion of superfluous or structural backup components of the human organism. V.Fedorov’s scientific works are devoted to the discussion of these questions. They show that hightened stress mainly doesn’t lead to the growth of active structural elements or to the increase of the work regime, but to the involoving of the superfluous or structural backup structures.
Adaptive potential reflects system organism changes. During investigation of the adaptive condition connections with different organism systems more than 114 indices were taken into consideration. Received results show the dependence between the central nervous, endocrinic, immune system changes and the adaptive potential (Pic.3).
Use of absolute values of the regulatory systems indices for the characteristic of the adaptive potential of the concrete individual cann’t correctly reflect the organism condition. Such regularities don’t take into cinsideration particular individual indices changes. Decrease or increase of absolute values concerning accepted standards do not always say about pathology. This can just characterise the level of system functioning under the condition of different balancing of its indices. That is why medical intervention for the purpose of its correction is not always right. Therefore, for the more correct estimation of the system condition the degree of its balancing should be determined. Such approach demands characteristics of the system indices concerning some certain condition, for example, when the system works in otimal regimen. Determination of the optimal condition, that will become a peculiar reference point for the relative evaluation of the organism indices changes, will allow to estimate the violations in their work more really and to correct discovered changes more reasonably.
Regularities changes investigations of regulatory systems according to the adaptive organism potential allow to determine universal reference point. It was determined that optimal organism condition (according to the evoluation of the common condition, clinical finding and numerous laboratory researchs, including determination of the regulatory systems indices) is characterized by the middle, 3rd adaptative level with the average coefficient of reaction changes range within 0,50 – 0,80 with median 0,65. That is why organism indices in adaptive condition, characterized by the 3rd level, are considered to be 100%. Releative evaluation of the indices give an idea of the system balancing, that allows to accomplish an individual approach to the organism condition evaluation. Therefore, the recommendations about the necessity and degree of their correction can be given. The individual regularity for the describtion of the connection of separate characteristic with the organism condition can be established for the concrete individual.
Estimation of the organism condition through the determination of its adaptive potential gives an opportunity to receive a plain picture of the regulatory systems changes. Further to this information for the formalized evaluation of the organism condition on the basis of the adaptive potential the use of the following integral indices was suggested:
a) common organism condition, determined by the degree of the regulatory systems indices deviations from the optimal characteristics of the adaptive potential;
b) protective and compensatory organism functions determined by the degree of the immune system indices deviations from the optimal characteristics of the adaptive potential;
c) the power of the affecting factors (evaluation of the affecting factors of the internal and external environment), which is determined according the intensity and directivity of the adaptive potential changes relatively to the optimal characteristics;
d) probability of the adaptive potential changes, determined according to the regularities of the adaptive potential changes in time period.
It was determined on the basis of clinical observations and laboratory data that adaptive potential of the organism, characterized by the adaptive level and coefficient of reaction, can reliably reflect clinical stages of the desease: incubation period, prodrome, appearance and development of the clinical finding, maximum of the process development, crisis, ending of the clinical presentations, reconvalescention, recovery or conversion of the desease into chronicity.
Detected regularities show, that the most favourable organism condition is characterized by the 2nd – 3rd level under the middle range of the coefficient of reaction changes. Human age has an effect on the adaptive organism condition (Pic.4). Analysis was carried out among people who don’t have any manifestations of acute desease or exacerbations of chronic desease. Adaptive levels distribution revealed that for the group aged 17-25 mainly the 3rd adaptive level is typical (71,7%). A small amount of people from this group had 2nd and 4th levels (17,9% and 10,4% pro tanto). In the group aged 46-55 only 32% belonged to the 3rd level. Coefficient of reaction decrease takes place as the age passes.
Created system allows to trace the organism condition changes during the desease, beginning with the early asymptomatic periods till recovery, estimate adequacy of therapeutic effect and make an opportune correction. Prophylactic direction of the adaptive potential use is emphasized too. Such investigations give an opportuniy to detect changes that can lead to the development of the acute desease or exacerbations of the chronic desease beforehand. Observation show that in most of the cases it can by avoided by the mean of opportune regulation of the stimuli, influencing the organism every day, such as food, physical and psychoemotional activity, temperature conditions e t.c. In a number of cases some medical and prophylactic measures can be demanded. Elaboration of the tactics and methods of organism changes correction for the purpose of prophylaxis must become an important line of adaptive potential use in the monitoring regime.
Regularities of the adaptive potential changes allow to form common principles of the purposeful effects. Invstigations reveal an opportunity to reach required adaptive potential by force of modifing of nonspecific characteristics of affecting agents. It was established that the transfer of the organism from the 1st adaptive level to the optimal 3rd leads only to the short-term improvement of its condition. Higher level demands more energy outlay, and after short period of the improvement drastic worsening comes accompanied by the decrease of the adaptive level. Taking this circumstance into consideration, the schemes of nonspecific stimuli use with the step junction to the optimal level were developed. For example, the transfer from the 1st to the 3rd level should be started with the scheme, directed to the optimization of the coefficient of reaction at the 1st level. On reaching of this condition medical stabilization scheme turns on. At the next stage transfer of the organism at the higher (2nd) adaptive level takes place. The scheme directed to the optimizaion of the organism condition according to the coefficient of reaction of this level with its following stabilization is used further. Then the transfer of the organism at the 3rd optimal level and its stabilization takes place. Stabilization of the organism condition at the 3rd level within the range of the coefficient of reaction 0,50-0,80 is accompanied by the regulatory systems functioning optimization that contributes to the organism rehabilitation. Effectiveness of therapeutic schemes was observed using the medical effects in doses considerably smaller than recommended average therapeutic doses. Important results were reached just by the change of the effective dose in the process of treatment (Pic.5).
In practice determination of the adaptive potential was carried out by hematologic indices on basis of periferal blood composition analysis. The necessity of frequent blood drawing limited considerably the effectivness of the developed method use. At the same time we loose an opportunity of the full permanent supervision of patients, realization of the supple medical tactics, opportune correction of the organism changes, that demand frequent patient’s checkup. The same problem is the obstacle for the determination of adaptive potential and its concurrent indices in prophylactic purposes. However, cumulative experience allows to prove enough simple noninvasive method of the organism adaptive potential evaluation by way of formalized estimation of vegetative changes over skin thermometry. This approach was realized in diagnostic system “Adaptolog-Expert”.
Method, used in diagnostic system “Adaptolog-Expert”, foresees the evaluation of the organism response to the well-known external effect (temperature of the environment). For all that we measure the environmental temperature and body temperature from its central to peripheral sections. Temperature differential is connected with the homeostatic regulation of the organism. In the conditions of equal environmental temperature the temperature differential from central to peripheral organism sections differs in sick and healthy people. This mechanism is nonspecific and little depends on individual features. The most ancient mechanisms of nonspecific responses are connected with thermoregulation. In spite of temperature variability of different skin zones, adaptive potential and its concurrent indices are rather stable. Skin temperature lability doesn’t have any considerable influense, as temperature changes of different skin zones correlates and their combined characteristics don’t possess such variability and enough exactly reflects adaptive ptential. For all that different combinations of temperatures of the investigated zones can charaterize equal organism condition. Adaptive potential is a peculiar attractor for such unstable system of indices as skin temperature.
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For the temperature measurement an infrared thermometer, connected with computer, is used. All the received information registers in programm and undergos necessary mathematical treatment. On basis of experimentaly established regularities the diagnostic system allows to estimate the organism condition: determines its adaptive potential; gives a quantitative evluation of the common organism condition, protective and compensatory functions; energy resources; stability; determines stage of desease; gives the releative quantitative evluation of some regulatory systems indices and recommends common medical tactics; forms individual corrective schemes.
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