EVALUATION OF THE CYTOKINE STATUS IN PATIENTS WITH DIFFERENT VARIANTS OF THE COURSE OF HPV INFECTION

Abstract

Aim.To evaluate the performance of some pro-inflammatory and anti-inflammatory cytokines in patients with various forms of papillomavirus infection (PVI), to conduct a clinical evaluation of the effective application of the drug containing a complex of sodium deoxyribonucleate with iron.Materials and methods. The examination of women with a latent course of PVI and a mild case of intraepithelial lesions of the cervix L-SIL (Lowgrade Squamous Intraepitelial Lesions) was conducted using a liquid-based Cytology ThinPrepR, colposcopy, biopsy of cervix, detection of HPV 16 and 18 in the cervical smear by DNA techniques (PCR in real time). Also, cytokines (IFN-gamma, IL-2, IL- 10, TNF-alpha) were quantified at the systemic level by the immunoenzyme method. The repeated examination was carried out after a course of treatment with a drug containing a complex of sodium deoxyribonucleate with iron in 3 and 6 months.Results.After 6 months of HPV therapy PCR was not detected in 94% of patients with a latent course of PVI and 75% of patients with L-SIL. Patients with a latent course of PVI showed a significant increase in the levels of IFNγ, TNF-α and IL-10 before the treatment. Patients with L-SIL showed less significant increase in IFNγ and TNF-α before the treatment, the levels of IL-10 and IL-2 had no significant deviations. After 3 months of the treatment patients with a latent course of PVI showed a decrease in the concentration of IFNγ, TNF-α and IL-10 to the indicators of conditionally healthy women. Patients with L-SIL showed a slight decrease in the concentration of TNF-α and a decrease in the concentration of IL-10 to the indicators of conditionally healthy women. The level of IFNγ and IL-2 remained almost at the same level as before the treatment.Conclusion.The use of a drug containing a complex of sodium deoxyribonucleate with iron during a latent course of PVI can help to prevent its transition to subclinical and clinical forms. The clinical efficacy of the drug Ferrovir was confirmed, manifested in the fact that 6 months after the treatment the virus DNA ceased to be determined in 94% of cases in patients from the group with a latent course of papillomavirus infection. There was a lack of immune response to HPV in L-SIL, as well as less pronounced clinical efficacy of Ferrovir in this group. It can be assumed that a more pronounced clinical effect in the treatment of patients with L-SIL can be obtained by using the complex therapy, including the appointment of the drug Ferrovir and destructive methods of treatment of the cervix or an additional prescription of the targeted therapy, aimed at the treatment of already affected and altered cells of the cervical epithelium.