scholarly journals Immunodiagnostics, immunotherapy and immunoprophylaxis in the clinic of otolaryngology. Message 2. Indicators of local immunity in assessment of clinical and laboratory status of patients in inflammatory ENT diseases (Analytical summary)

Author(s):  
Oleg F. Melnikov ◽  
Dmitry I. Zabolotny ◽  
Diana D. Zabolotna ◽  
Alexander Yu. Bredun ◽  
Oksana G. Rylska ◽  
...  

Topicality: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account modern trends in assessing the immunological status, a mandatory component is to determine the state of local immunity in the upper respiratory tract. Aim: to conduct an integral analysis of data to determine the state of local immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal necessary informative indicators. Materials and methods: A generalization of the data of immunological studies of 168 people with inflammatory pathology of the upper respiratory tract (VDS) was carried out, of whom 42 had chronic tonsillitis (CT), 36 – chronic rhinitis (HR – catarrhal form), 40 – chronic pharyngitis (CP), 28 – secretory mean otitis media (CO), 22 people made up the control group (C) of practically healthy donors. The age of the surveyed was from 14 to 60 years, the duration of the diseases was from 1 to 5 years, female patients predominated (~ 60%). The examination was carried out at the stage of clinical remission. The material for the research was mixed saliva, in which the content of immunolobulins and citrokines was investigated by the ELISA method: enzyme immunoassay, the following factors of immunity and inflammation in the CGS were determined: - secretory and monomeric form of immunoglobulin A (Hema Medica, RF); - immunoglobulins of classes G, M (Hema Medica, RF); - interleukins – 1β; 4; 8; 10 (Cytokine, RF); - interferons α and γ (Cytokine, RF); - pro- and defensins (Nucalt bioteknology, Netherlands); - macrophage inflammatory protein-Mip-1b (Assauro, USA); - salivary lysozyme (Diagnostik Nord, Germany). Statistical processing was carried out using the methods of Student’s t-criterion and angular transformation “φ” according to Fisher. Results: Integral of all methods for determining various types of immunity in diseases of the upper respiratory tract with a chronic course is the insufficiency of factors of both innate and acquired immunity, especially during the period of clinical remission of the disease. A special role in protective reactions belongs to the humoral component, in which the most stable indicator is the level of class A secretory immunoglobulin; it has been shown that almost all the studied components of the immune response had abnormalities in the presence of a chronic inflammatory process in the upper respiratory tract and they can be presented as a line the degree of decrease in the frequency of deviations: secretory IgA, IgG., pro-inflammatory cytokines (IL1β and IL-8), γ-interferon, lysozyme, defensin-β, Mip-1b. Conclusion: The developed criteria and approaches to assessing systemic immunity in patients with inflammatory diseases of the upper respiratory tract can be used in examining patients and assessing the effectiveness of therapy.

2016 ◽  
Vol 15 (2) ◽  
pp. 66-75
Author(s):  
A. E. Shulzhenko ◽  
I. N. Zuikova ◽  
A. V. Karaulov ◽  
R. V. Shchubelko

Introduction. In the formation of recurrent and/or prolonged chronic inflammatory diseases of the upper respiratory tract in addition to the known, previously studied, factors that play an important role in the violation of the human immune system at the level of local (mucosal) and systemic immunity and activation of herpes virus group (Epstein Virus Barr virus, cytomegalovirus, herpes simplex virus type 6). In the treatment of herpesvirus infections, activation of antiviral immunity in domestic medicine used drugs interferon inducer. Objective. To evaluate the efficacy of interferon inductor Amiksin® in patients with chronic recurrent inflammatory diseases of the upper respiratory tract. Materials and methods. Based on separation of “Allergy and Immunotherapy” SSC “Institute of Immunology” FMBA studied low-molecular interferon inductor Amixin® (JSC “Pharmstandard-Tomskhimpharm”, Russia) in the treatment of chronic recurrent inflammatory diseases of the upper respiratory tract. The study included 40 patients between men and women, aged 18 to 65years old with a history of recurrent chronic inflammatory diseases of the upper respiratory tract. Clinical research methods included a medical history, previous efficiency of the treatment, the presence of comorbidities. Laboratory methods include bacteriological crop on flora in the material from the oropharynx and the detection of DNA viruses of herpes group in saliva. Patients of the main group, after clinical and laboratory examination, prescribed therapy with Amixin®. Patients in both groups received symptomatic therapy. The total duration of observation of each patient was 3 months. Results. Amiksin® receiving the drug in patients with acute exacerbation of chronic recurrent upper respiratory tract inflammatory diseases contributed to a more rapid relief of general and local symptoms. Also it found that reduces performance Amiksin® average viral load against Epstein-Barr virus. Over the next 3 months follow-up, 25 % of patients the main group marked exacerbation study pathology of the upper respiratory tract, in the control group of patients with recurrent exacerbations were more - 60 %, indicating that preventive action Amiksin® therapy. Conclusions: The use of low-molecular interferon inductor Amiksin®(JSC “Pharmstandard-Tomskhimpharm”, Russia) in the combined therapy showed good efficacy in reducing the concentration of chronic viral infections in the oropharynx and prevention of chronic relapsing inflammatory diseases of the upper respiratory tract.


Author(s):  
Oleg Melnikov ◽  
Diana Zabolotna ◽  
Dmitry Zabolotny

Introduction: It is considered proven that the state of the immune system determines the development and course of many pathological processes, which are based on inflammation. At the same time, taking into account current trends in assessing the immunological status, conditional variants of deviation from the norm, a decrease in the number of cells from the average statistical norm of the region and control parameters in the performing laboratory by 1.5 or 2 times were adopted, since deviations are within 30-60 % are borderline and quite easily compensated by the body. The aim of the work was to conduct an integrated analysis of data to determine the state of systemic immunity in inflammatory diseases of the upper respiratory tract (URT) to select the optimal informa-tional indicators. Materials and methods: Immunological methods were used to examine 260 people with inflammatory pa-thology of the upper respiratory tract, of which 82 had chronic tonsillitis, 76 with chronic rhinitis, 70 with chronic pharyngitis and 32 people made up a control group of healthy donors. The age of the subjects ranged from 16 to 60 years, the duration of the disease from 1 year to 5 years, female patients predominated (≈60%). Examinations were conducted in the clinical remission stage. When assessing systemic immunity, the number of T-lymphocytes (CD 3, 4, 8), B-lymphocytes (CD22), NK (CD56), monocytes (CD14), concentration of immunoglobulins of classes M, G, A, E, cytokines with regulatory properties, interferon-γ-IL4 were determined. Functional tests in assessing systemic immunity are presented by determining the cytolytic activity of blood mononuclear cells in relation to avian xenogenic red blood cells and the activity of phagocytic blood cells in relation to latex particles at the absorption stage. Statistical processing was performed using the angular transfor-mation method "φ" according to Fisher and the "one-sided" criterion "U" Wilcoxon. Results: Based on a wide range of immunological studies in patients with chronic diseases of the upper respiratory tract, it seems most appropriate to use the following laboratory tests to assess systemic immunity to determine the characteristic deviations in the immune status of patients: High diagnostic value: - decreased serum IgA concentration (<0.5 g/l); - low level of activity of ECC of blood (<20% for xenoerythrocytes); - increased level of interleukin-1β (> 25 pg/ml); Relative diagnostic value: - determination of the degree of dysimmunoglobulinemia in serum; - increased titers of antibodies to streptolysin-O, other microbial antigens; - increased serum IgM. Conclusion: The developed criteria and approaches in assessing systemic immunity in patients with in-flammatory diseases of the upper respiratory tract can be used to examine patients and assess the effectiveness of the treatment.


2021 ◽  
pp. 50-58
Author(s):  
Olga E. Chelpachenko ◽  
Elena I. Danilova ◽  
Irina N. Chainikova

The article summarizes the results of the work of domestic and foreign researchers on the study of homeostasis of the nasal cavity, including the state of the microbiota of the nasal mucosa in healthy children and in inflammatory diseases of the upper respiratory tract. The normal microbiota of the nasal cavity is represented by corynebacteria (diphtheroids), neisseria, coagulasenegative staphylococci, alpha-hemolytic streptococci. From among the transient species, such species as Staphylococcus aureus, Escherihia coli, beta-hemolytic streptococci would be found in the specified biotope. The main attention is paid to the features of the nasal microbiota in newborns and young children (dependence of the nasal microbiota on the type of feeding, age and season). The role of hypercolonization by opportunistic microflora and its persistent potential (ability to biofilm formation, degradation of lysozyme, interferon) in the pathogenesis of inflammatory diseases of the upper respiratory tract is noted. The pathogenetic mechanisms providing multilevel protection of the organism from pathogens are considered. The expediency of using elimination-irrigation therapy as a hygienic means of sanitizing the nasal cavity in young children has been determined. The questions about the advantages of the use of isotonic solutions, their effectiveness for ensuring normal colonization resistance of the nasal mucosa are discussed. In conclusion, we must say that for hygienic care and sanitation purposes it is recommended only to rinse the nasal mucosa in newborns and infants using drops of isotonic saline solution and an aspirator to avoid aspiration and inflow of liquid into the cavity of Eustachian tube and middle ear, and also for the preventive purposes, as it allows to maintain homeostasis of the nasal mucosa and prevent the development of acute respiratory diseases.


2021 ◽  
Vol 26 (4) ◽  
pp. 104-112
Author(s):  
D.I. Zabolotny ◽  
O.F. Melnikov ◽  
S.V. Timchenko ◽  
M.B. Sambur ◽  
O.G. Rylska ◽  
...  

When studying the effect of vaccines against influenza, attention is mainly paid to obtaining high titers of protective antibodies in the blood and reducing the incidence of respiratory infections among vaccinated people. At the same time, the changes  occurring in patient,s body from the factors of local specific and innate immunity remain insufficiently studied. The aim of the study was to determine the effect of parenteral influenza vaccination on the state of local immunity, cytology and microbiota of oropharyngeal secretion (OS) in patients with chronic inflammatory diseases of the upper respiratory tract. The study of immunological and microbiological parameters was performed in 32 patients with chronic inflammatory diseases of the upper respiratory tract, including 11 diagnosed with chronic rhinosinusitis, 9 – with chronic tonsillitis, 12 – with chronic pharyngitis, 3 and 12 weeks after vaccination with trivalent inactivated influenza-vaccine (PASTEUR, SA, France), which was administered intramuscularly. Single vaccination against influenza A and B has been shown to normalize reduced local humoral immunity indices, in particular sIgA and immune complexes concentrations, increase lymphocyte output to oropharyngeal secretions and cause a significant decrease in the representation of OS transient microflora without affecting the overall level of bacterial contamination. In both periods after the vaccination the reduced content of interferon-α in the OS of patients with chronic inflammatory diseases of the upper respiratory tract did not change. The obtained data allow to recommend vaccination against influenza virus in the period up to 3 months before the the beginning of mass infections as an effective means of stimulating the protective reactions of local immunity of oropha­rynx and nasopharynx mucous membranes in patients with chronic inflammatory diseases of the upper respiratory tract.


2020 ◽  
pp. 14-20
Author(s):  
S. V. Ryazantsev ◽  
S. V. Pavlova

Introduction. At the present moment, the healthcare system has faced significant problems in terms of infectious safety: an unprecedented increase in the spectrum of pathogenic microorganisms, the annual appearance of 1-2 “new” infectious diseases, an increase in the proportion of emergent infections, especially of viral etiology, against which there are no effective drugs, and the spread drug-resistant microorganisms, as well as the establishment of a direct etiological or trigger role of microbial agents in the development of somatic human pathology.The aim of our work was to evaluate the topical preparation (amylmetacresol and dichlorobenzyl alcohol) used to stop the inflammatory process and eliminate pain in patients with pharyngeal diseases.Patients and methods. We studied the antimicrobial, antiviral and anti-inflammatory effect of a fixed combination of 2,4-dichlorobenzyl alcohol 1.2 mg, amylmethacresol 0.6 mg. 20 patients with manifestations of inflammatory changes in the pharyngeal cavity underwent treatment with Strepsils resorption tablets according to the scheme. The control group consisted of 10 patients who received therapy according to the usual scheme.Results and discussion. As a result of the therapy, sore throat in patients in the first group completely disappeared amongst 15 patients, and its intensity significantly decreased amongst 5 patients. Patients noted that the use of Strepsils resorption tablets reduces the sensation of a foreign body, irritation in the pharynx and oral cavity; eliminates pain, tickle, feeling of soreness in the throat. The analgesic effect of the drug manifested itself after about 5 minutes and lasted up to 2 hours. By the end of the treatment, all patients from this group had unpleasant sensations and discomfort completely stopped.Conclusion. Amylmethacresol/Dichlorobenzyl Absorption Tablets is a well-tolerated and effective over-the-counter treatment offering functional, sensory and emotional benefits for patients with acute sore throat, providing a quick onset of effect and may be more relevant and suitable than antibiotics when pharyngitis associated with viral infections of the upper respiratory tract.


2020 ◽  
Vol 10 (2) ◽  
pp. 359-367
Author(s):  
I. I. Ababii ◽  
L. A. Danilov ◽  
M. K. Maniuc ◽  
P. I. Ababii ◽  
S. S. Ghinda ◽  
...  

Currently, a rise in incidence of polyethological inflammation of the upper respiratory tract mucosa paralleled by altered resident and transient microbiota displaying in many cases increased antibiotic resistance has been noted. Opportunistic microbes play a major role in developing inflammatory process in Pirogov–Waldeyer’s ring. An inflammatory process occurring in the tonsillar lymphatic tissue results in host systemic complications. Fighting against acute and chronic infections of the upper respiratory tract holds the main task in pediatric otorhinolaryngology, as they can consequently elicit the cardiovascular, genitourinary and musculoskeletal complications. The results of studies examining this issue remain very contradictory, which accounted for a need to conduct our study on the territory of Moldova featured with mixed climatic conditions. Here, we wanted to study a role of microbial factor in etiopathogenesis of chronic tonsillitis in children. Bacteriological microbiota data for superficial palatine tonsils were obtained form 608 children subdivided into 5 groups: group I — 333 children with compensated chronic tonsillitis; group II — 87 children with decompensated chronic tonsillitis; group III — 91 children with acute upper respiratory tract infections (comparison group); group IV — 48 children with acute upper respiratory tract infections treated with antibiotic therapy; group V — 49 apparently healthy children (control group). It was found that β-hemolytic streptococcus exerting high sensitivity to virtually all antibiotics groups was detected in 17.4% of children with acute tonsilar inflammatory processes and decompensated defense in the lymphatic pharyngeal ring compared to 3.5% in control group. Streptococcus pneumoniae was isolated in all study groups ranging within 4.8–21.7%, including 14% in apparently healthy children characterized by reduced antibiotics sensitivity. The data obtained suggest that sickly children with acute and chronic upper respiratory tract infections constitute a risk group for developing somatic diseases. The high incidence of Streptococcus pneumoniae indicates a need for performing immunoprophylaxis, use of therapeutic vaccination as a up-to-date, combined approach in treatment of such pediatric cohort.


2019 ◽  
pp. 105-108
Author(s):  
A. A. Krivopalov ◽  
V. A. Shatalov ◽  
S. V. Shervashidze

According to WHO, the respiratory system diseases are currently inside the ten most common pathologies. The modern strategy for treating influenza and ARVI gives priority to the antiviral and immunostimulating agents, but the symptomatic drugs, which include preparations based on silver and its compounds, also play an important role. The large positive experience in using silver preparations supported by numerous clinical studies shows their high efficacy and satisfactory safety profile in the treatment of infectious and inflammatory diseases of the nose and upper respiratory tract in children and adults.


2021 ◽  
pp. 127-133
Author(s):  
A. V. Gurov ◽  
A. V. Muzhichkova

The article provides data on the effectiveness of the use of the drug in the treatment of acute, chronic and recurrent diseases of the respiratory tract and ENT organs. The drug is an extract of Pelargonium sidoides. From the standpoint of modern pharmacology, it is known that the use of natural products based on plant materials ensures safety and the absence of pronounced side effects. The main active ingredients of pelargonium are phenolic compounds: coumarins, flavonoids and phenolic acids. The article details the biochemical and pharmacological properties of each of the above groups of compounds. It has been shown that the presence of several classes of phenolic compounds simultaneously contributes to the potentiation of the pharmacological effects of each group separately. Therefore, drug has a pronounced polytropic effect: antiviral, antibacterial, immunomodulatory, mucolytic, anti-inflammatory, antioxidant, cytoprotective. The article presents the results of numerous domestic and foreign randomized, placebo-controlled studies demonstrating its high efficacy and safety in the treatment of ENT diseases, upper respiratory tract infections and bronchitis, not only in adults, but also in children over 1 year old. On the basis of the analyzed and presented material, the authors concluded that the use of a natural-based drug in the treatment of acute respiratory infection is effective and safe, both as monotherapy and in combination with other medicinal substances. He is able to quickly eliminate not only the symptoms of inflammation, but also to support the body with any ailments of this type.


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