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52 *+ ) -2Anlagen zum Gutachten zur UV-Blutbestrahlung

Anlagen 1-6

Anlage 1: Vier in Medline gefundene Publikationen, die exemplarisch Hinweise auf eine

mögliche Wirksamkeit der UV-Bestrahlung von Blut bei Infektionen zeigen

Anlage 2: Kurz kommentierte Arbeiten, die bezüglich Doping relevant sein könnten

Anlage 3: Detaillierte WADA-Verbotsliste von 2011

Anlage 4: Ergebnisse der Suche in der medizinischen Datenbank Medline

Anlage 5: Literaturverzeichnis der Stellungnahme des Bundesausschusses der Ärzte und Krankenkassen von 2001 Anlage 6: Literaturverzeichnis der Firma Eumatron GmbH 81547 München, Reichenhallerstr. 48 (Hersteller von UV-Blutbestrahlungsgeräten) !"# $ %& ' ( )* *+ $, -. / " 0+ 1 2 3- / " " 3 42 $ Anlage 1: Vier in Medline gefundene Publikationen, die exemplarisch Hinweise auf eine mögliche Wirksamkeit der UV-Bestrahlung von Blut bei Infektionen zeigen Publikation 1: Makarevich A, Pancratova J, Kyrkovsky V: The effect of extracorporeal efferent detoxication (EED) methods inclusion in the severe community-acquired pneumonia (CAP) treatment. Source. Adv Med Sci. 2006;51:73-87. Department of Internal Diseases N1, Belarusian State Medical University, Kirova str. 33-15A, Dzerzynsky av., 83, 220030 Minsk, Belarus.

„PURPOSE: To assess the clinical efficacy including of EED methods in the treatment of severe CAP with endogenic intoxication syndrome.

MATERIAL AND METHODS: Severe CAP in patients (n = 103, aged 18-60 years, male 89%) were randomly subdivided into the 4 comparable groups. The 1st group (n = 30) was standard treated with antibiotics. The 2nd group (n = 27) underwent additionally 3 courses of extracorporeal ultraviolet light-exposure (UVLE). The 3rd group (n = 25) was co-treated with 3 courses of biospecific hemosorption (BSS). The 4th group (n = 21) underwent 2 additional courses of BSS plus 3 courses of UVLE. The effectiveness of these schemes therapy was assessed by clinical and laboratory data.

RESULTS: The additional application of EED methods led to faster disappearance of clinical symptoms, focal chest signs and the infiltrate resolution in chest X-ray (CXR) as compared with standard treatment. Mean time of the disappearance of fever and sweating was 2.2; 2.5; 2.0 days and 4.8; 5.0; 4.6 days in the 2nd, 3rd and 4th group respectively after EED courses vs 6.1 and

8.0 days in 1st group (P 0.05). The baseline elastase activity was elevated by 5 times in the 1stth groups vs the control (healthy) group and was decreased by 1.5; 2.1; 4.1; 6.6 times respectively (P 0.05) after treatment in these groups. The initial trypsin-like activity was increased about 5.5 times in all groups vs control and decreased after therapy by 2.1; 3.8; 6.4;

6.0 times (P 0.05) in the 1st-4th groups respectively. Small CXR residual changes persisted in 7, 4 and 5 patients from the 2nd, 3rd and 4th groups vs 12 patients in the 1st group. The spirometry data were normalized faster in the patients who underwent EED methods (by the 14th day) vs the 1st group.

CONCLUSIONS: Additional using of EED methods in severe CAP therapy is more effective (as compared with traditional management with antibiotics only) in term of faster improvement of patients general condition, reduced time of inflammatory infiltrate resolution and hospitalization by 3-4 days. It has been shown that EED methods correct the main pathogenic mechanisms of severe CAP. Our results indicated on the EED methods as an attractive supportive therapy for the empiric antibiotics treatment of this disease.“ Publikation 2: Kuvshinchikova VN, Selina LG, Shmelev EI.: Effectiveness of extracorporeal ultraviolet blood irradiation in patients with chronic obstructive bronchitis. Probl Tuberk.

1998;(1):42-4.

„The use of extracorporeal ultraviolet blood radiation (EUVBR) in the treatment of 67 patients with chronic obstructive bronchitis (COB) showed some specific features of the clinical course of bacterial complications of the basic process. With EUVBR, most patients exhibited normal temperatures, less signs of intoxication and coughing, and rare rale in the lung than in the controls. A most objective criterion for the efficiency of EUVBR was a marked increase in the forced expiratory volume per sec after the first 3 procedures, which improved the patients' condition, diminished exercise-induced dyspnea. The hemogram of the patients undergone EUVBR in combination with antibiotic therapy indicated a substantial drop in erythrocyte sedimentation rates following the first 3 procedures. The growth of pathogenic and opportunistic microbes from the sputum showed a great (10-fold) reduction when EUVBR and antibiotic therapy were concurrently used. The findings suggest that EUVBR has high therapeutical benefits in the treatment of COB.“ Publikation 3: Shurygin AA. [The efficiency of ultraviolet autologous blood irradiation used in the complex therapy of infiltrative pulmonary tuberculosis in children and adolescents]. Probl Tuberk Bolezn Legk. 2009;(9):20-3. [Article in Russian] „The purpose of the investigation was to study the clinical efficiency of ultraviolet autoblood irradiation (UVABI) used in the complex therapy of children and adolescents with infiltrative pulmonary tuberculosis. A controlled randomized study of the results of treatment in two groups of patients who had or had not received UVABI during the standard complex therapy was carried out by the experiment-control principle. The groups were randomized (first - second). In 91.9% of the children and adolescents with infiltrative tuberculosis, the process was accompanied by impaired immune defense with bacterial isolation in 68.0 to 54.1% of cases; every two patients had drug-resistant Mycobacterium tuberculosis. The use of UVABI in the complex therapy of patients with tuberculosis was ascertained to promote a rapid, two-fold more frequent bacterial isolation cessation resulting in a epidemic danger reduction in the patients, to have a positive impact on the formation of immune defense, mainly of a phagocytic link, in children and adolescents, to exert a detoxifying effect, to favor a better tolerability of antituberculous drugs, to cause positive X-ray changes, and to improve the quality of life. The clinical and laboratory effectiveness and safety of UVABI allow recommendation that the latter be introduced into a treatment protocol for children and adolescents with infiltrative pulmonary tuberculosis.“ Publikation 4: Chepik EB, Shamanova MG, Medvedeva EV, Vode ko LP, Isakov VA.





[Photochemotherapy in the treatment of acute pneumonias]. Vestn Ross Akad Med Nauk.

1994;(9):48-51. [Article in Russian] „The application of photochemotherapy in acute pneumonia is based on pneumonia pathogenesis and the mechanism of ALIB- (autotransfusion of laser irradiated blood) and AUVBIautotransfusion of ultraviolet blood irradiation) techniques. The ALIB is preferable since the technique requires no device sterilization. The complex treatment of acute pneumonia with ALIB and AUVBI was found to enhance therapeutic efficacy, to decrease the severity of the disease course, to reduce its duration and hospital stay in inpatients. No considerable impact of ALIB on the duration of pneumonia was observed, but X-ray examination revealed a definite reduction in pulmonary microcirculatory disorders. Laser therapy promotes the normalization of functional Tlymphocytic activity. ALIB should be applied individually and in relation to the severity of the disease, to the distribution of an inflammatory pulmonary process and to the duration of the disease course.“

–  –  –

Thema 1: Stimuliert die UV-Blutbestrahlung Erxthrozyten oder deren Produktion Mix E, Jenssen HL, Lehmitz R, Buddenhagen F, Hitzschke B, Richter M.: Einfluß von Ultraviolettbestrahlung des Blutes (UVB) auf Zellvolumen, Zelladharenz und Phagozytose bei Normalprobanden und Patienten mit Multipler Sklerose (MS). Folia Haematol 1988;

I115(5):669-687.

„UVB induced changes of blood cell properties were investigated in 12 MS patients and in 10 healthy volunteers serving as normal controls. The mean cell volume (MCV) was determined by electronic sizing, the granulocyte and lymphocyte adherence was estimated in a capillary assay, and the phagocytic activity of granulocytes was measured in a test system based on the incorporation of opsonized baker's yeast (Saccharomyces cerevisiae). In MS patients the MCV of red cells and lymphocytes decreased rapidly within 6 UVB treatments. In contrast, the reduction of the granulocyte volume was delayed (between the 6th and 12th UVB). In the control group the mean value of the red cell and lymphocyte MCV remained rather unaffected. There was a slight rise of the granulocyte volume after the 6th UVB. The only significant change of adherence was an increase of granulocyte adherence in MS patients. Untreated patients had a significantly enhanced phagocytic activity in comparison to the control group. 6 UVB treatments included a significant reduction of the phagocytic activity in MS patients. However, subsequently the percentage of phagocytizing cells increased again, whereas the particle uptake per cell continued to decrease. In the control group only minor UVB induced changes of phagocytosis were observed. The in vitro UV irradiation caused an enhanced phagocytosis in the majority of cases in both controls and MS patients. In general, under the UVB treatment all parameters examined changed in the sense of a normalisation, in that the measured values reached a new level lying between the extreme pretreatment values accompanied by a reduced standard deviation. The effect of UVB was more pronounced in MS patients when compared with normal controls. This could result from an enhanced sensitivity to the influence of UVB of pathologically altered cells in MS patients. The monitoring of the MCV of red cells and lymphocytes as well as the repeated testing of granulocyte phagocytosis are recommended for supportion of therapy planning and follow-up of MS patients“ Mein Kommentar: Bei MS-Patienten kam es nach mehrfach UV-Blutbestrahlungen zur Verringerung der Größe der Erythrozyten. Bei gesunden Vergleichspersonen war der Effekt bei gleicher Therapie nicht zu beobachten.

Kommentar des Bundesausschusses der Ärzte und Krankenkassen: Studie zu den Effekten der UVB auf Bluteigenschaften (Erythrozyten, Leukozyten) von Patienten mit Multipler Sklerose. Veröffentlichung eignet sich nicht zum Wirksamkeitsnachweis. Kein über die für die ausführliche Einzelauswertung ausgewählte Literatur hinausgehender Erkenntnisgewinn.

Firulina II, Samo lova KA, Belisheva NK.: [Growth-stimulating effect of UF-irradiated blood. I.

The radiation dose dependence of the initial growth potencies of blood and of the functional state of the target cells]. [Article in Russian] Tsitologiia. 1987 Jul;29(7):818-24.

„UV irradiation (UVI) of donor blood in the apparatus used in hospitals of the USSR with the therapeutic aim of autotransfusion of UV-irradiated blood (AUVIB), results in an increase of connective tissue cell growth potency: being added into culture media the supernatants of irradiated blood stimulate DNA-synthetic and proliferative activity of cultured human embryonic cells. The high activity of cells persists for about 2 days. The effect is great with low initial levels of cell proliferative activity. In this case the effect is maximum (about 125% of the control). It is suggested that the above effect may be involved in the mechanism of stimulation of regeneration processes in the organism after AUVIB.“ Mein Kommentar: Der Überstand UV-bestrahlten Blutes stimuliert das Wachstum embryonaler Stammzellen. Wenn dieser Überstand das Wachstum solcher Stammzellen stimuliert, könnte es auch sein, dass er die postive Effekte auf die Blutbildung hat.

Kommentar des Bundesausschusses der Ärzte und Krankenkassen: Nicht erwähnt.

Ulashchik VS, Zalesskaia GA, Kalosha II, Mit'kovskaia NP. [Involvement of hemoglobin in the therapeutic action of blood ultraviolet irradiation]. [Article in Russian]. Vopr Kurortol Fizioter Lech Fiz Kult. 2010 Jan-Feb;(1):7-11.

The objective of this work was to study the mechanism of therapeutic action of extracorporeal ultraviolet irradiation of circulating blood and to evaluate the possibility of its application to combined treatment of patients with acute coronary syndrome. It was shown that ultraviolet irradiation causes photodissociation of oxyhemoglobin thereby altering the oxygen-carrying function of the blood and improving oxygen supply to cells and tissues. The UV-induced modification of blood properties not only prevents tissue hypoxia but also triggers a cascade of metabolic processes. Taken together, these effects have beneficial influence on the clinical course of cardiovascular and other diseases.

Mein Kommentar: In UV-bestrahlten Erys kommt es zur Photodissoziation des OxyHämoglobins. Die Autoren interpretieren dies als Verbesserung der Sauerstoff-Versorgung des Gewebes.

Kommentar des Bundesausschusses der Ärzte und Krankenkassen: Nicht erwähnt.

Frick G (1974) Zur Wirkung der Ultraviolettbestrahlung des Blutes auf das Blutbild. Folia Haematol 101: 871-877.

Kein Abstrakt in Medline verfügbar Befund: In dieser Studie wurde die Entwicklung der Leukozyten und insbesondere der basophilen Granulozyten unter einer UV-Bestrahlungstherapie-Serie beschrieben. Beide zeigen einen Anstieg unter der Behandlung. Es finden sich keine Angaben zum Verlauf von Erythrozyten bzw. Retikulozyten.

Mein Kommentar: Nur der Titel lässt an doping-relevante Wirkungen denken. Die Arbeit befasst sich jedoch nur mit den Leukozyten.

Kommentar des Bundesausschusses der Ärzte und Krankenkassen: Nicht erwähnt.

Frick G (1975) Der Einfluß der Ultraviolettbestrahlung des Blutes auf das hämopoetische System. Z Physiotherapie 27: 425-429.

Kein Abstrakt in Medline verfügbar. Die Arbeit liegt mir vor.

Befund: Bei 108 untersuchten Patienten zeigte sich ein tendenzieller Anstieg der Gesamtleukozytenzahl. Bei 12 Patienten wurde der Verlauf weiterer Blut-Parameter untersucht: Erythrozytenzahl, Thrombozytenzahl, Bluteiweiße. Besonders interessant sind in Kontext dieses Gutachtens die Effekte der UV-Blutbestrahlung auf die Erythrozytenzahl.

Wörtlich heißt es in der Publikation:



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