Abstract

 
 Introduction: To compare the features of the immune status in patients with chronic and complicated pyoderma in the course of complex pharmacotherapy using immunomodulators based on transfer factors and glucosaminylmuramyldipeptide.
 Materials and methods: A clinical examination of 107 patients with pyoderma, divided into three groups, was carried out. All individuals underwent immunological examination before and after etiopathogenetic treatment. The patients of the first group were additionally treated with a drug containing signaling immunoactive molecules (transfer factor) as an immunomodulator; the patients of the second group received glucosaminylmuramyldipeptide; and the patients of the third group received standard antibacterial therapy.
 Results and discussion: Prior to the beginning of pathogenetic therapy, the patients were found to lack non-specific mechanisms of antimicrobial protection; there was a decrease in the activity and intensity of phagocytosis: phagocytic index and phagocytic number of neutrophils by 1.2 and 1.3 times; the production of proinflammatory cytokines IL-6 increased by 2.3 times, IL-8 –by 2.1 times, and TNFa – by 2.4 times. The study of immunological parameters after the inclusion of immunomodulators into the therapy revealed an increase in the phagocytic activity of neutrophils, and the indicators of the NST test were close to the control ones. The production of proinflammatory cytokines in the blood serum was restored to the level of the healthy individuals. Normalization of the number of CD4+-, CD8+-, CD19+-cells was observed in 86.0 ± 3% of the patients. At the same time, against the background of the use of glucosaminylmuramyldipeptide, a more intensive recovery of all links of anti-infectious immunity was recorded in comparison with the group where transfer factor molecules were used.
 Conclusion: A drug based on glucosaminylmuramyldipeptide can be recommended as the drug of choice in non-specific immunocorrection for complex pharmacotherapy of pyoderma accompanied by secondary immune insufficiency, in comparison with a drug containing transfer factors.
 
 
Highlights
To compare the features of the immune status in patients with chronic and complicated pyoderma in the course of complex pharmacotherapy using immunomodulators based on transfer factors and glucosaminylmuramyldipeptide
Prior to the beginning of pathogenetic therapy, the patients were found to lack non-specific mechanisms of antimicrobial protection; there was a decrease in the activity and intensity of phagocytosis: phagocytic index and phagocytic number of neutrophils by 1.2 and 1.3 times; the production of proinflammatory cytokines IL-6 increased by 2.3 times, IL-8 –by 2.1 times, and TNFa – by 2.4 times
Against the background of the use of glucosaminylmuramyldipeptide, a more intensive recovery of all links of anti-infectious immunity was recorded in comparison with the group where transfer factor molecules were used
Summary
To compare the features of the immune status in patients with chronic and complicated pyoderma in the course of complex pharmacotherapy using immunomodulators based on transfer factors and glucosaminylmuramyldipeptide. One of the reasons for a chronic course of pyoderma is a change in immunogenicity of the organism as a result of endogenic toxicosis and consecutive opportunistic pathogenic microflora (Chen and Tsao 2013; Goltser et al 2015; Samtsov et al 2018). It is followed by a disrupted activity of polymorphonuclear leukocytes, a decreased activity of T-cells, a changed T-cell subset distribution, and a changed cellular immunologic response (first of all, phagocytic activity of macrophages and complete phagocytosis) (Stalberg et al 2002; Khaitov 2018). Leukocyte influx induces potent and acute antimicrobial inflammatory response (Mikheev et al 2017; Khaitov 2018; Khaitov 2020)
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