Интерферонопатии при атипичных хронических активных герпесвирусных инфекциях: тактика проведения коррекции дефицита интерферонов

Abstract

A cytokine imbalance and interferonopathies associated with deficits of type I and type II interferons (IFN) are often observed in atypical chronic active herpesvirus infections (ACA-HVI). Objective. To study the features of IFN system functioning and cytokine profile in patients with ACA-HVI before and after the immune system correction integrative program (ISCIP) including local and systemic interferon therapy. Patients and methods. A total of 39 male and female patients aged 23–70 years with ACA-HVI characterized by isolated disorders in the IFN system were examined. The study included the following methods for herpesvirus detection: serodiagnostics and a real-time polymerase chain reaction (RT-PCR). The cytokine profile (interleukins IL-1β, IL1Ra, IL-6, IL-17) and the IFN system were analyzed by an enzyme-linked immunosorbent assay (ELISA). The study was approved by the Ethics Committee, and an informed consent was obtained from all patients. Results. Patients with ACA-HVI had antiviral immune response disorders. Against the background of serum IFN deficiency, induced and spontaneous production of IFNα and IFNγ, a functional impairment of cytokine profile with predominant hyperproduction of proinflammatory cytokines IL-1β, IL-6, tumor necrosis factor-α were revealed. Positive clinical and immunological effects of ISCIP were demonstrated. It was shown that IL1Ra can be used as a diagnostic biomarker to monitor the course and outcome of ACA-HVI. Conclusions. The developed ISCIP with the inclusion of targeted local and systemic interferon therapy for patients with ACAHVI demonstrated high clinical and immunological efficacy against the background of the confirmed absence of anti-IFNα autoantibodies. Key words: herpesvirus infections, interferonopathies, neutrophil granulocytes, interferon system